Health care costs set to increase sharply next year... thanks, Obamacare!

[jaeger19]

All I can tell you guys is that in the large multinational company I'm in, we have had this conversation, and all of the Europeans would rather go back home and get treated for serious illnesses than stay in the US.

These are Germans, English and French nationals.

And they all are physicians who are quite knowledgable about their own healthcare systems as well as the US system. They generally make fun of how infuriatingly confusing it is to the end user.

Of course.. so? Most Americans that I treated abroad would rather have been back in the US rather than deal with the country they were in.

 

[jaeger19]

and you'll notice that Canadian and European conservatives rarely if ever show up in these threads and talk about how much they'd like to trade systems with us. but maybe one will eventually. that will be a fun discussion.

That's because 1. Most people aren't sick.

2. They don't know the American system.. just like you don't know all the other systems either. I have worked other systems outside this country..

 

[jaeger19]

If you are saying that someone that already has a disease seeing a doctor for more testing related to that disease is preventative, then no. I did not know that.

Of course it is preventative. Catching a disease before its progressed where its difficult to treat and expensive is the definition of preventative. If you get an cold.. and you get medication that prevents you from getting pneumonia.. then money is saved.

The problem here is that the definition seems to be "doing tests on healthy people is not effective".. well DUH... of course.. If a person is HEALTHY.. then what are you PREVENTING. DUH.

Its why this whole "preventative medicine doesn't work". is bunk... of course preventative medicine works (with the caveat unless you are just going to let people die.. then its more cost effective to let them die)..

The authors have a point that some things don;t work.. like legislating that every healthy person has a CBC.. or any smoker have a CT.. yeah that doesn;t work but crap man.. that's like concluding that seat belts don't save lives because if you put seatbelts on everyone whether they are in a car or not.. you find its not cost effective.

Its understanding what the data is telling you. Not just reading headlines. which seems to be happening a lot on both sides of this discussion lately.

 

[jaeger19]

Most preventative care costs more. It's just a fact. There are only a small amount of exceptions where that is not the case.

Wrong.

 

[Helix]

Great... read your own charts..

Lets just start with the forbes chart: Lets see where the US scores:

Quality of care: 5
Effective care: 3
Patient centered care 4

But but but.. the headlines say the US RANKS DEADLAST. Ohhhh... oh wait.. effective care 3, quality of care total 5.. patient centered care 4 timeliness of care... 5.

Now that's not deadlast is it?

Oh wait.. lets throw in the OTHER variables: equity 11, efficiency 11.. healthy lives 11.

Gee.. now what was it that Jaeger stated..



Okay.. you tell me exactly where what I said is "Consistently wrong"...

just because you looked at the headlines and don't understand the whole data is not MY fault. Just because you have a preconceived conclusion and don't understand the whole issue is not my fault. I have tried to educate you.

we pay far more for the same or worse outcomes than any other first world country. the US does better treating some kinds of cancer, but once again for a greater cost. we lose our health insurance when we lose our jobs unless we want to pay thousands of bucks a month to keep it. employers are saddled with the responsibility of being healthcare providers, which is bad for both them and their employees. some of us are a broken arm or a heart attack away from bankruptcy, and those with no insurance receive primary care at emergency rooms. the system also puts a paywall in front of preventative care, so people generally seek care when the disease is a lot more expensive to treat.

your main strategy is to post in each new health care thread like this all hasn't been explained to you before with charts and data. i think this is at least the fiftieth time. i don't blame you, though, because it's damned difficult to argue the other side of this debate.

 

[Helix]

That's because 1. Most people aren't sick.

2. They don't know the American system.. just like you don't know all the other systems either. I have worked other systems outside this country..

no, they wouldn't trade systems with us because ours is much more expansive and inefficient, and i doubt that most people would want to lose their health insurance if they lose their jobs.

 

[buck]

Wrong.

I can only discuss what the studies show.. and what Obamacare does in terms of mandating preventative care that is not cost efficient.

 

[buck]

your main strategy is to post in each new health care thread like this all hasn't been explained to you before with charts and data. i think this is at least the fiftieth time. i don't blame you, though, because it's damned difficult to argue the other side of this debate.

What he posted was correct, though, and supported by the charts. The WHO determined the same when they last did the global healthcare rankings.

 

[Helix]

What he posted was correct, though, and supported by the charts. The WHO determined the same when they last did the global healthcare rankings.

and the rest of us see which argument is correct whenever we have to use the US healthcare system. or change jobs. i get it, i just changed jobs, and my healthcare is much better at this one. i suppose if that was my experience all along, i might be more sympathetic to your interpretation. however, the fact that the healthcare experience is so completely tied to where one works is just one more indicator that something is seriously ****ed up and needs to be fixed.

 

[Threegoofs]

Of course.. so? Most Americans that I treated abroad would rather have been back in the US rather than deal with the country they were in.

These are people who have been living in the US for years and who are intimately familiar with the US delivery system.

 

[jaeger19]

we pay far more for the same or worse outcomes than any other first world country. the US does better treating some kinds of cancer, but once again for a greater cost. we lose our health insurance when we lose our jobs unless we want to pay thousands of bucks a month to keep it. employers are saddled with the responsibility of being healthcare providers, which is bad for both them and their employees. some of us are a broken arm or a heart attack away from bankruptcy, and those with no insurance receive primary care at emergency rooms. the system also puts a paywall in front of preventative care, so people generally seek care when the disease is a lot more expensive to treat.

your main strategy is to post in each new health care thread like this all hasn't been explained to you before with charts and data. i think this is at least the fiftieth time. i don't blame you, though, because it's damned difficult to argue the other side of this debate.

I see.. so now we have gotten off the "you are wrong".. maybe you have realized that what I

We pay more for better outcomes in some things.. for the same outcomes in some things.. and very rarely worse outcomes.. (but that's usually a function of the 10% that don;t have healthcare insurance).
If you have insurance in this country.. you are going to get better outcomes.. or identical outcomes. And in cases where you get identical outcomes... you spend less time in pain waiting for medical intervention.

So I see now you have moved away from our medical system to our insurance system... okay.. lets discuss that..

Yep.. employer healthcare is a bad thing. Absolutely.. it decreases choice, it decreases portability.. it increases costs.. all of that is absolutely true. (you see.. that's what happens in a debate when someone is looking at facts rather than a preconceived feeling).

Easy fix. No need to make a single payer government program that will be WORSE insurance than what 90% of americans have.

Set up a program that employers can help their employees pay for their own individual policies.. Employers still get a huge tax break.. Employees still get a huge tax break.. and younger employees that don't need as much healthcare insurance.. get more salary.. and older employees that want more health insurance can put in more salary on top of the employers contribution and do so pre tax.

AND any extra money beyond what an employee needs for his/her policy.. can be used to pay deductibles out of pockets, so on and so forth... again tax free. AND if they have money when they retire and go on to medicare.. its this money.. that can be used for paying deductibles etc on medicare.

My main strategy has been and will be.. to explain to you what your data and charts MEAN.. since you don;t seem to understand what they actually MEAN. that's natural though... you seem to have a desire for single payer government healthcare.. and will only look for things to justify that position.

 

[jaeger19]

no, they wouldn't trade systems with us because ours is much more expansive and inefficient, and i doubt that most people would want to lose their health insurance if they lose their jobs.

When they have cancer they would. When they need total knees and total hips they would.. when they need an MRI they would.. when they have a spinal cord injury they would. Etc etc.

Its why the wealthy step outside the public system in these countries... when they want treatments that are not provided by the public system or not provided timely by the public system.

Hey.. but why let facts get in the way of emotion.

 

[jaeger19]

I can only discuss what the studies show.. and what Obamacare does in terms of mandating preventative care that is not cost efficient.

And as I explained.. the studies do not show what you think they do. Not if the conclusion you draw from the study is that "preventative medicine does not work".

 

[jaeger19]

These are people who have been living in the US for years and who are intimately familiar with the US delivery system.

And most of the ex pat's from the US I treated had been living in Europe for years and were intimately familiar with the European delivery system.

Your point?

 

[buck]

And as I explained.. the studies do not show what you think they do. Not if the conclusion you draw from the study is that "preventative medicine does not work".

The conclusion was that in most cases, preventative care is not cheaper. At least that is what the studies show. I still have a hard time believing that getting care for a disease after it already occurred is preventative, but OK...

preventive care
Medical care that seeks to prevent illnesses. for example, yearly mammograms or regular checkups.

Once the illness is there...

 

[Helix]

I see.. so now we have gotten off the "you are wrong".. maybe you have realized that what I

We pay more for better outcomes in some things.. for the same outcomes in some things.. and very rarely worse outcomes.. (but that's usually a function of the 10% that don;t have healthcare insurance).

we pay a ****load more for everything. on top of that, the cost keeps a lot of people away from the doctor, which makes everything more expensive when they finally do seek treatment.

If you have insurance in this country.. you are going to get better outcomes.. or identical outcomes. And in cases where you get identical outcomes... you spend less time in pain waiting for medical intervention.

which insurance? it mostly depends on where you work. that's a dumb system. my employer should not be my health care provider.

So I see now you have moved away from our medical system to our insurance system... okay.. lets discuss that..

Yep.. employer healthcare is a bad thing. Absolutely.. it decreases choice, it decreases portability.. it increases costs.. all of that is absolutely true. (you see.. that's what happens in a debate when someone is looking at facts rather than a preconceived feeling).

Easy fix. No need to make a single payer government program that will be WORSE insurance than what 90% of americans have.

i don't agree. Canada's system is vastly preferable to ours, and beats our own system in every legitimate study. refer to earlier discussions.

Set up a program that employers can help their employees pay for their own individual policies.. Employers still get a huge tax break.. Employees still get a huge tax break.. and younger employees that don't need as much healthcare insurance.. get more salary.. and older employees that want more health insurance can put in more salary on top of the employers contribution and do so pre tax.

yeah, because older employees need to be funneling more of their money into for profit health insurance. meanwhile, we'll also be paying for it in the form of our premiums. and once again, it will depend on where you work. **** that.

AND any extra money beyond what an employee needs for his/her policy.. can be used to pay deductibles out of pockets, so on and so forth... again tax free. AND if they have money when they retire and go on to medicare.. its this money.. that can be used for paying deductibles etc on medicare.

My main strategy has been and will be.. to explain to you what your data and charts MEAN.. since you don;t seem to understand what they actually MEAN. that's natural though... you seem to have a desire for single payer government healthcare.. and will only look for things to justify that position.

your strategy is to take all of the data that doesn't support your position, claim that it does support your position, and then try to massage the interpretation of that data into supporting your position. meanwhile, health care in the US is still ridiculously expensive and inefficient, and other countries are doing it better. the next time most of us go to the hospital, it's going to be a big financial burden, and if we lose our jobs, we'll lose our access to anything resembling useful health insurance unless we can afford to pay thousands a month to COBRA. we can and should do better. i don't see it happening anytime soon, though.

 

[Helix]

When they have cancer they would. When they need total knees and total hips they would.. when they need an MRI they would.. when they have a spinal cord injury they would. Etc etc.

Its why the wealthy step outside the public system in these countries... when they want treatments that are not provided by the public system or not provided timely by the public system.

well, i'm sure that the wealthy are able to purchase preferential treatment in the states. the rest of us pay ridiculous amounts of money into the health care system when we get sick unless we work a specific job that provides great health insurance.

Hey.. but why let facts get in the way of emotion.

i suppose that you're fairly qualified to answer that question for yourself.

 

[jaeger19]

The conclusion was that in most cases, preventative care is not cheaper. At least that is what the studies show. I still have a hard time believing that getting care for a disease after it already occurred is preventative, but OK...



Once the illness is there...

And as I point out.. that conclusion was based on a false assumption that "preventative medicine" is giving physicals and blood tests to HEALTH PEOPLE.

Can you not see that disconnect there?

Preventative medicine is a fellow who has been having more thirst.. not feeling well, is obese, etc.. coming in and we discover he is borderline diabetic and we get him on exercises or maybe a low dose medication. And this prevents him from going into a diabetic coma.. and having all the problems associated with uncontrolled diabetes... THATS preventative medicine.

Now.. there is preventative MEASURES that can take place before someone gets sick or has illness. But that's more of a community wellness than traditional medicine "going to see your doctor"..

For example: a community obesity reduction plan.. for better foods served in school.. public areas for kids and adults to exercise, more phys ed in school.. more health education in school. Now that's preventative medicine and those measures pay big dividends... certainly more than giving every healthy adult a blood test.

 

[jaeger19]

well, i'm sure that the wealthy are able to purchase preferential treatment in the states. the rest of us pay ridiculous amounts of money into the health care system when we get sick unless we work a specific job that provides great health insurance.



i suppose that you're fairly qualified to answer that question for yourself.

Actually the wealthy are really prevented from purchasing preferential treatment in the states to a large degree. In the hospital.. the person in room one is a multimillionaire and the person in the bed next to him is on Medicaid and as poor as a church mouse. and they get the same care.

Only way to get preferential care is to step outside the insurance system and go completely private (say for lasik surgery, or cosmetic surgery).

And yes.. I am very qualified to answer without emotion.. since I know the facts. I don't have an emotional response like.. "we all are just a broken arm from bankruptcy". Come now. I have laid out the facts..l using YOUR research. I UNDERSTAND IT.. and I would like you and others to understand it too. Otherwise.. no real good change can come about.. and you are at the mercy of the pundits... whether that's those that think nothing needs to be done about healthcare in this country... or those that think unicorns are going to fly out of the sky and everything is going to be magical with a government system.. the same government that threatens to shut down every few months over issues like funding planned parenthood. Government systems like the VA and Medicaid.

 

[jaeger19]

we pay a ****load more for everything. on top of that, the cost keeps a lot of people away from the doctor, which makes everything more expensive when they finally do seek treatment.

Sure.. when it comes to the bill. We also pay better wages.. we end up paying for the doctors education in that bill rather than in taxes for public education.. we pay because we work harder and work longer before retiring.. and that comes out in healthcare bills. In other countries that money is paid in pension plans so that the manual laborer retires at 5o something.. rather than 65-67 like they do in the states. We end up paying for that extra 10 years of work in healthcare bills... they pay for that retirement program in taxes.

which insurance? it mostly depends on where you work. that's a dumb system. my employer should not be my health care provider.

Totally agree.. its one of the things really wrong with Obamacare since it moves us more toward employer purchased healthcare rather than away from it.

i don't agree. Canada's system is vastly preferable to ours, and beats our own system in every legitimate study. refer to earlier discussions.

Canada system is like Medicaid.. and would be a step down for people with insurance. and it doesn't beat our system in any measure other than equality and efficiency.. since it provides insurance to everyone.

Those are the facts. In fact.. I have treated a number of wealthy Canadians who come to the states to be treated rather than wait for their public system. Like YOUR research points out.. on quality measures.. the US scores in the top 5 on most.

Now interestingly.. americans often are substantially less healthy to begin with. And this of course increases our costs. Here is a comparison of US versus Canada. Say.. do you think that this might influence costs and outcomes? Naw right.. because a guy with 100 extra pounds on his heart is going to have the same outcome as the guy who is within his normal weight range right?

A new study from the Centers for Disease Control and Prevention (CDC) -- the first to compare American obesity data with another country -- finds (perhaps unsurprisingly) that American adults have a higher rate of obesity than their Canadian counterparts.

And the gap is quite disparate. According to obesity data from 2007 to 2009, an estimated 34 percent of Americans are obese compared to 24 percent of Canadians -- a 10 percent difference that further exposes the severity of America's struggle with obesity.

The study considered racial demographics and gender, and in each instance Americans were bigger. The percentage of obese American men was 8 percent higher than that of Canada (32.6 percent to 24.3 percent), and the obesity gap in women was even higher (36.2 percent to 23.9 percent).

 

[Helix]

Actually the wealthy are really prevented from purchasing preferential treatment in the states to a large degree. In the hospital.. the person in room one is a multimillionaire and the person in the bed next to him is on Medicaid and as poor as a church mouse. and they get the same care.

what absolute horse****. the wealthy can purchase whatever care they want even in nations with first world health care distribution systems. and in ours, they absolutely can do so.

Only way to get preferential care is to step outside the insurance system and go completely private (say for lasik surgery, or cosmetic surgery).

the rest of us can't do that. our employer's health insurance plan makes the call, and it's vastly different depending on where you work. that's a ridiculous system.

And yes.. I am very qualified to answer without emotion.. since I know the facts. I don't have an emotional response like.. "we all are just a broken arm from bankruptcy". Come now. I have laid out the facts..l using YOUR research. I UNDERSTAND IT.. and I would like you and others to understand it too. Otherwise.. no real good change can come about.. and you are at the mercy of the pundits... whether that's those that think nothing needs to be done about healthcare in this country... or those that think unicorns are going to fly out of the sky and everything is going to be magical with a government system.. the same government that threatens to shut down every few months over issues like funding planned parenthood. Government systems like the VA and Medicaid.

no, not malfunctioning pieces of our inefficient healthcare system. first world health care systems like those that consistently rank better than ours.

 

[jaeger19]

yeah, because older employees need to be funneling more of their money into for profit health insurance. meanwhile, we'll also be paying for it in the form of our premiums. and once again, it will depend on where you work. **** that.

Yeah no.. because they won't be paying high premiums when they are younger.. so they can save more money in their accounts.. and when they get older.. if they have saved money in that account.. they don't have to pay for a low deductible policy because they have the money to meet the higher deductible if they need to. The way insurance companies make profit is by having people pay for more insurance than they need. Its the nature of insurance. Pay for what you don't use.

And it won't depend on where you work. Work anywhere you want and that money follows you.. change job one hundred times and keep the same insurance policy that you want.

your strategy is to take all of the data that doesn't support your position, claim that it does support your position, and then try to massage the interpretation of that data into supporting your position. meanwhile, health care in the US is still ridiculously expensive and inefficient, and other countries are doing it better. the next time most of us go to the hospital, it's going to be a big financial burden, and if we lose our jobs, we'll lose our access to anything resembling useful health insurance unless we can afford to pay thousands a month to COBRA. we can and should do better. i don't see it happening anytime soon, though.

Nope.. my strategy is to use ALL the data and understand it. And make valid conclusions from it. I am sorry if that disturbs your pre conceived premise.. but its still the facts. If you would be intellectual honest.. you would admit that I have been right all along. I bring up great points.. like our costs have in part to do with our comorbidities.. our costs have to do with things like passing on the cost of education.. the cost of malpractice, and the cost of later retirement.. that other countries capture that cost in their education systems, in their retirement systems etc.

However, some of our cost IS due to our system of not having everyone insured. THATS for dang sure. but of course the fact that I will state that fact.. doesn't mean much to you when you have already dismissed whatever I say as partisan.

A good part of our cost is in our comorbidities like obesity.

And of course another issues is the employer purchased healthcare.. that's a very bad system.

But again.. you have a preconceived idea just like the folks on the other side of the equation that think nothing should be done other than "repeal obamacare"...

Its the folks unable or unwilling to listen to reasoned arguments and logic that are the reason that you won't see any appreciable improvement.

 

[jaeger19]

what absolute horse****. the wealthy can purchase whatever care they want even in nations with first world health care distribution systems. and in ours, they absolutely can do so.

Nope.. no horsecrap.. he wealthy cannot purchase increased care in say our hospital system. Can't legally do it since its a violation of our contracts with insurance. Only in things outside the insurance system

Listen.. you don't want to listen to the truth but that's your issue.

the rest of us can't do that. our employer's health insurance plan makes the call, and it's vastly different depending on where you work. that's a ridiculous system.

Yep.. completely agree. So change that system but you don't have to make everyone in the country have worse insurance than they do now to do it.

no, not malfunctioning pieces of our inefficient healthcare system. first world health care systems like those that consistently rank better than ours.

in some things yes.. like efficiency and equality.. in other things like quality..not they don't. Apparently you don't even believe your own research. Sorry for that.

 

[buck]

Preventative medicine is a fellow who has been having more thirst.. not feeling well, is obese, etc.. coming in and we discover he is borderline diabetic and we get him on exercises or maybe a low dose medication. And this prevents him from going into a diabetic coma.. and having all the problems associated with uncontrolled diabetes... THATS preventative medicine.

Even providing diabetes screening just for adults at risk is not cost effective. And again, I have no idea how seeing someone that is already having symptoms of the disease is preventative. I certainly could be wrong about this, and I realize you have more experience in this than I, but it seems to not make much sense. Can you provide any links confirming? Regardless, that is certainly not what Obamacare did, which would indicate Obamacare is making healthcare even more expensive due to that "free preventative care".

 

[jaeger19]

Even providing diabetes screening just for adults at risk is not cost effective. And again, I have no idea how seeing someone that is already having symptoms of the disease is preventative. I certainly could be wrong about this, and I realize you have more experience in this than I, but it seems to not make much sense. Can you provide any links confirming? Regardless, that is certainly not what Obamacare did, which would indicate Obamacare is making healthcare even more expensive due to that "free preventative care".

Listen.. just think for a minute. You are giving tests to HEALTH PEOPLE. THINK. How effective is that?

What is preventative is getting people into treatment that are having an issue.. and preventing further complications. That's preventative medicine.

And it IS what Obamacare did. By increasing the number of people that have insurance.. this means that people who have illness or other beginning health issues can get treatment early rather then end up in the ER with say kidney failure from uncontrolled diabetes..

Let me explain. Guy comes in. he doesn't feel good, family history of diabetes, thirst a lot, has fatigue. Blood tests show borderline diabetic. He gets counseling and loses weight and with some blood test monitoring.. his diabetes is controlled. OR he goes on a low dose medication.

NOW lets say he doesn't go to the doctor for the not feeling good... the fatigue, and thirst. He probably will get over it. Because he is a borderline diabetic. So his symptoms come and go.. and are quite subtle. He goes for 5 years, 10 years, maybe 20 years. With slowly failing kidneys, high blood pressure, etc.. then he collapses at work. Goes the the ER in kidney failure.. spends a week in intensive care and needs dialysis and maybe a kidney transplant. Those complications would have been PREVENTED by preventative medicine. Being seen earlier rather than later. And its way more cost effective.\

honestly.. that's why saying "preventative medicine is not cost effective" is absurd.. of course its cost effective. Detecting people that are in the early stages of illness and preventing them from having dire and expensive complications is preventative medicine.

Its so simple, I don't know how else to explain it buck. I mean think about it.. if you are testing people.. what are looking for? Abnormalities that indicate disease. Which means that person is not healthy. And why would you test people? When they have indicators of a problem or some significant high risk.