Why health care economics is tough

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Re: Why health care economics is tough

New postby foreverlax on Wed May 23, 2018 11:35 am

HooDat wrote:why do we all buy into the notion that the insurance policies need to be fixed? Not all policies, just the one's at the bottom. One of the reason's I liked the concept of ACA, was the standardization of a minimum policy, apples to apples. What good is a bare bones policy if it won't cover some items AND the policy holder winds up needing those items and can't pay the full out of pocket costs?

The problem is with the COST agreed, but while the industry is for profit, how are costs, across the board, going to come down

and bureaucratic delivery of the service. There is a ton of waste here, but not across the board. From my personal experiences, generally the service has been good to great compared to the anecdotes from others who have different providers/insurance policies.

How you pay for it doesn't change what it costs. Have to ponder that some....seems that the cost would go up if there are inefficiencies in the system.
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Re: Why health care economics is tough

New postby jhu72 on Wed May 23, 2018 1:12 pm

SClaxattack wrote:
a fan wrote:Sure. But the same squirrely nonsense happens with regular ol' insurance companies and HMO's, yes?


And with no competition it’ll get worse. I’ll be right back.....

jhu72 wrote:Get a UV (black) light and baby goggles. Does the same thing. In fact this is the way it used to be done. Its the UV light that does the trick. It used to be that this treatment required hospital stay. The invention of the special blanket made it practical for the procedure to be done at home. So like all things new, it is not in the approved list of treatments - at home, but OK in the hospital, because there does not exist a charge code for the at home treatment as one has never existed. Another of advantage of single payer, this only has to be changed in one database, where now every insurer has to change it in their database. Why Tricare is slow to accept is beyond me. The HMO my wife works for does accept it.


You’re kidding, right? Because every young couple has a UV light and baby goggles hanging around their house, know that’s the same thing as what the professional prescribes, and without any medical training between them are willing bet their child’s health on it. And we’re not talking about idiots here. He’s a MAJ, she’s a software development manager, both with masters. Get real.

Now back to afan.

Make insurance a competitive purchase and maybe (to jhu72’s point) the insurer will keep up with technology changes so they know a new alternative procedure exists.

Detach the insurance purchase from employment. If an employer wants to maintain employment competitiveness let them add the insurance costs they save to their employees’ income. Solves lots of problems:

- transferability of plan regardless of employer.
- no more BS re: different charges. If I work for employee X and have the same plan coverages from insurer A as an insured from employer Y, why should the provider get paid two different amounts for the same procedure. Reduces the insurer’s cost of negotiating coverage levels with different employers.
- no connection of an insurance plan to employment allows the insured to shop. No more need to take what you’re given and be happy about it.
- require providers and insurers to publish prices for the common procedures. It still amazes me that the medical industry is the only one in existence where a customer has no idea what they’re getting into before they use a service. He!!, even attorneys will give you an hourly fee in advance.


Purchase of the black light and goggles for at home use would cost much less than the special blanket and the daily hospital room charge. I was only half "kidding". :wink: I am sure your daughter and her husband could handle this technology. The black light bulb can be had at Home Depot, Lowes or Amazon, Ebay or your local pond equipment supplier. You can get the baby goggles from Amazon or Ebay. The UV light should center at about 4500 angstroms. :wink:

Insurers require that a new treatment be found safe and effective before they will reimburse for it. Even though the FDA and the device manufacturer make this determination, all the insurers have their own review committees that have to pass on this before they can make up a charge code for it. Multiply that by the large number of insurance carriers, not surprising years can pass before all insurance carriers consider it a legitimate, reimbursable charge. For Tricare it would seem they have a problem with the technology that some others don't. The device has been in the market for at least 10 years. Interesting that GE markets this product for home use.
Last edited by jhu72 on Wed May 23, 2018 1:42 pm, edited 1 time in total.
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Re: Why health care economics is tough

New postby jhu72 on Wed May 23, 2018 1:37 pm

HooDat wrote:why do we all buy into the notion that the insurance policies need to be fixed? The problem is with the COST and bureaucratic delivery of the service. How you pay for it doesn't change what it costs.

It is crap like this:
jhu72 wrote:because there does not exist a charge code for the at home treatment
that leads to the inefficiencies of health care delivery. Now insurers are part of the problem in that they dictate reimbursement rates, but the root of the problem is the regs, the multitude of service providers with very poor coordination and a complete lack of common sense allowed.


Insurance providers and their profits certainly do effect cost. Bigly. :lol:

One of the most costly features of the system is providers dealing with each insurance companies invoicing procedures. There are lots of insurers each with their own procedures and paperwork forms (although generally submitted digitally), charge codes, etc. Insurance invoicing departments are large in hospitals. This is arguably the biggest problem small practices face in their business operation. Standardization of this process is currently optional for insurers. Obamacare attempted to force standardization. Big insurers largely fight this tooth and nail. Not a difficult problem to solve, but it requires insurers to do the work and willingness to be regulated.
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Re: Why health care economics is tough

New postby HooDat on Wed May 23, 2018 2:07 pm

jhu72 wrote:Insurance providers and their profits certainly do effect cost. Bigly. :lol:


very true; I was not meaning to imply otherwise. What I meant was more generous coverages, different deductibles, etc... don't change the actual cost of delivery - which is janked up. And I absolutely agree that one of the main reasons costs are janked up is all the paperwork that has become the defining competitive advantage for healthcare businesses.
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Re: Why health care economics is tough

New postby Trinity on Wed May 23, 2018 3:19 pm

One set of forms for everyone.
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Re: Why health care economics is tough

New postby HooDat on Wed May 23, 2018 3:31 pm

Trinity wrote:One set of forms for everyone.


which is a tremendous use of federal resources. They can establish best practices, drive to consensus on protocols, pricing and paperwork , and then get out of the way - except to make sure we continue to optimize the process.
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Re: Why health care economics is tough

New postby SClaxattack on Wed May 23, 2018 4:45 pm

jhu72 wrote:
SClaxattack wrote:
You’re kidding, right? Because every young couple has a UV light and baby goggles hanging around their house, know that’s the same thing as what the professional prescribes, and without any medical training between them are willing bet their child’s health on it. And we’re not talking about idiots here. He’s a MAJ, she’s a software development manager, both with masters. .


Purchase of the black light and goggles for at home use would cost much less than the special blanket and the daily hospital room charge. I was only half "kidding". :wink: I am sure your daughter and her husband could handle this technology. The black light bulb can be had at Home Depot, Lowes or Amazon, Ebay or your local pond equipment supplier. You can get the baby goggles from Amazon or Ebay. The UV light should center at about 4500 angstroms. :wink: .


I’m not getting your “kidding”, but I am getting a better understanding for an obnoxious, oblivious, “I know science”, insensitive, attitude. Let me get this right - two parents have just been told their newborn has a liver problem. The pediatrician of their two and five yr old children with whom they’ve had a five year relationship says to avoid having their two day old readmitted to the hospital they should rent a readily available device for home use ***that is the IDENTICAL device used at the hospital***. They’ve googled “high infant bilirubin” and every article they find says the risk of improper treatment of this is SEVERE MENTAL ISSUES. And you think an alternative is for this couple to go manage a 2,5 and 2 day old child while driving around to buy a black light at a hardware store they hope carries one, and then order baby goggles through Amazon and hope their Amazon Prime account really delivers the next day so they only postpone important treatment by one day? And to make sure the light centers at 4500 angstroms?

Words can’t express my disgust.
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Re: Why health care economics is tough

New postby Paesan33 on Wed May 30, 2018 12:17 pm

jhu72 wrote:The system is neither fish nor fowl as it stands and that is the fault of Obama for not going all the way in the face of blind irrational republican obstructionism.


so the tax bill in the senate that DJ Trump commented on- the one that went 51-48 on party lines- those are the 48 obstructionists we should pillory???
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Re: Why health care economics is tough

New postby holmes435 on Wed May 30, 2018 11:12 pm

HooDat wrote:
Trinity wrote:One set of forms for everyone.


which is a tremendous use of federal resources. They can establish best practices, drive to consensus on protocols, pricing and paperwork , and then get out of the way - except to make sure we continue to optimize the process.


Isn't the federal government already doing this many times over already? And state governments doing it like 50 different times already?

Medicare, Medicaid, CHIP, Military Health System (DHA, FHP&R, USU, TRICARE, etc), Indian Health Service and more federally? And each state has its own myriad of Medicaid, Medicare and other programs run in coordination or independently from the feds (SHIP)?

At the very least we could roll all public health systems into one, right? That would drastically reduce resources used and bureaucracy across the state and federal government.

I do realize some health issues are more localized than others, but there has to be an easier way even if we don't go full single-payer. We're the most expensive health care system in the world by far, and get less care than many other systems for the price.

Even with a public option, you can still let private insurers and hospitals operate for those who want to pay for additional insurance or care.
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Re: Why health care economics is tough

New postby a fan on Thu Jun 07, 2018 1:39 pm

Aaaaaaand the other shoes for the Trump Tax Cuts are starting to drop......

"Medicare will run out of money sooner than expected, and Social Security's financial problems can't be ignored either, the government said Tuesday in a sobering checkup on programs vital to the middle class.

The report from program trustees says Medicare will become insolvent in 2026 — three years earlier than previously forecast. Its giant trust fund for inpatient care won't be able to fully cover projected medical bills starting at that point.


And my favorite part:

"The Cabinet secretaries for Treasury, Health and Human Services, and Labor usually participate in the annual release of the report on Social Security and Medicare, along with the Social Security commissioner, and take questions from reporters. None of those top officials was present Tuesday; an aide cited scheduling conflicts."

:lol: Gee, are you boys SURE that the tax cuts won't trickle down and "fix" Medicare shortfalls?

And hey: no one at the Water Cooler will need health care when they hit their 60's, right?

Problem? What problem? :roll:

http://www.latimes.com/nation/nationnow ... story.html
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Re: Why health care economics is tough

New postby jhu72 on Thu Jun 07, 2018 2:15 pm

Trinity wrote:One set of forms for everyone.


ACA was going there, giving the market time to adapt. The only people who have a problem with this is the insurance companies.
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Re: Why health care economics is tough

New postby jhu72 on Thu Jun 07, 2018 2:24 pm

a fan wrote:Aaaaaaand the other shoes for the Trump Tax Cuts are starting to drop......

"Medicare will run out of money sooner than expected, and Social Security's financial problems can't be ignored either, the government said Tuesday in a sobering checkup on programs vital to the middle class.

The report from program trustees says Medicare will become insolvent in 2026 — three years earlier than previously forecast. Its giant trust fund for inpatient care won't be able to fully cover projected medical bills starting at that point.


And my favorite part:

"The Cabinet secretaries for Treasury, Health and Human Services, and Labor usually participate in the annual release of the report on Social Security and Medicare, along with the Social Security commissioner, and take questions from reporters. None of those top officials was present Tuesday; an aide cited scheduling conflicts."

:lol: Gee, are you boys SURE that the tax cuts won't trickle down and "fix" Medicare shortfalls?

And hey: no one at the Water Cooler will need health care when they hit their 60's, right?

Problem? What problem? :roll:

http://www.latimes.com/nation/nationnow ... story.html



The Trumpnista aren't concerned with this. We will grow our way out of the problem once the border wall is in place.
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Re: Why health care economics is tough

New postby jhu72 on Thu Jun 07, 2018 3:38 pm

SClaxattack wrote:
jhu72 wrote:
SClaxattack wrote:
You’re kidding, right? Because every young couple has a UV light and baby goggles hanging around their house, know that’s the same thing as what the professional prescribes, and without any medical training between them are willing bet their child’s health on it. And we’re not talking about idiots here. He’s a MAJ, she’s a software development manager, both with masters. .


Purchase of the black light and goggles for at home use would cost much less than the special blanket and the daily hospital room charge. I was only half "kidding". :wink: I am sure your daughter and her husband could handle this technology. The black light bulb can be had at Home Depot, Lowes or Amazon, Ebay or your local pond equipment supplier. You can get the baby goggles from Amazon or Ebay. The UV light should center at about 4500 angstroms. :wink: .


I’m not getting your “kidding”, but I am getting a better understanding for an obnoxious, oblivious, “I know science”, insensitive, attitude. Let me get this right - two parents have just been told their newborn has a liver problem. The pediatrician of their two and five yr old children with whom they’ve had a five year relationship says to avoid having their two day old readmitted to the hospital they should rent a readily available device for home use ***that is the IDENTICAL device used at the hospital***. They’ve googled “high infant bilirubin” and every article they find says the risk of improper treatment of this is SEVERE MENTAL ISSUES. And you think an alternative is for this couple to go manage a 2,5 and 2 day old child while driving around to buy a black light at a hardware store they hope carries one, and then order baby goggles through Amazon and hope their Amazon Prime account really delivers the next day so they only postpone important treatment by one day? And to make sure the light centers at 4500 angstroms?

Words can’t express my disgust.


And smoking may cause cancer, and does so at a higher rate than jaundice turns out to be something serious in newborns. 99.99+% of all cases would (and do in most of the rest of the world) clear themselves up with NO physician intervention in at most a week or two, more frequently a couple days. Jaundice is very common in newborns. Unless the newborn is extremely pre-mature (a month or more), there is little likelihood of untreated jaundice causing any longterm harm. The UV treatment is a prophylactic - that is billable. With a nice margin.

I can understand as a new parent (or grandparent) that there is a concern. I had two with jaundice, one was two weeks pre-mature and one a week late, one treated (needlessly in retrospect according to my wife - pediatrician), cleared up in 3 days (two under the lights) and one went untreated and the condition cleared up in 2 days. Deliveries were at different hospitals.

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Re: Why health care economics is tough

New postby jhu72 on Thu Jun 07, 2018 3:41 pm

Paesan33 wrote:
jhu72 wrote:The system is neither fish nor fowl as it stands and that is the fault of Obama for not going all the way in the face of blind irrational republican obstructionism.


so the tax bill in the senate that DJ Trump commented on- the one that went 51-48 on party lines- those are the 48 obstructionists we should pillory???


I have no idea what you are talking about.
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Re: Why health care economics is tough

New postby randyrad on Thu Jun 07, 2018 4:40 pm

Coming soon -- how to do your own brain surgery with a mirror & everyday tools purchased at Home Depot.
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Re: Why health care economics is tough

New postby CU77 on Fri Jun 08, 2018 10:31 pm

the Justice Department announced late Thursday that it won’t defend a core ACA provision in court: the guarantee of coverage for preexisting conditions.

https://www.theatlantic.com/politics/ar ... oj/562442/

So if you have a pre-existing condition and need to buy health insurance, Trump just threw you under the bus.
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Re: Why health care economics is tough

New postby Paesan33 on Thu Jun 14, 2018 1:18 pm

jhu72 wrote:
Paesan33 wrote:
jhu72 wrote:The system is neither fish nor fowl as it stands and that is the fault of Obama for not going all the way in the face of blind irrational republican obstructionism.


so the tax bill in the senate that DJ Trump commented on- the one that went 51-48 on party lines- those are the 48 obstructionists we should pillory???


I have no idea what you are talking about.


im talking about the leopold principle.

when republicans voted in the bill- and 48 non-republicans voted against it, was that obstruction? it's a yes/no answer, from you.
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Re: Why health care economics is tough

New postby dislaxxic on Wed Jul 18, 2018 10:42 am

Meanwhile, back in actual "POLICYLAND", Trump and the Republicans continue to be the WORST THING EVAH when it comes to healthcare policy. After beating that issue absolutely to DEATH during the Obama years, promising OVER and OVER to repeal, replace and "give us something much, much cheaper and much, much better"...

Instead, we get Trump’s migrant fiasco diverts millions from health programs

Further:

Americans are starting to suffer from Trump’s health-care sabotage

Trump's new insurance rules are panned by nearly every healthcare group that submitted formal comments

Small businesses hurt from Trump's health-care sabotage

Broken Promises. More Lies. Monkey Wrench President bringing down America.

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Re: Why health care economics is tough

New postby fattylax on Wed Jul 18, 2018 11:26 am

a fan wrote:
This whole "government is the enemy" crap needs to stop...because eventually, someone like Ted Cruz or Paul Ryan will finally do what those folks are asking, and cut the cord.

Rural America would be finished, as would all rural States.

l.


You keep repeating this, yet agree with fatty that Hopkins/Harvard/Stanford cartel gets billions from the government. Same for our killing machine manufacturers, especially in California. How it that VA hospital coming along in Auroa, Colorado coming along?
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exactly

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Re: Why health care economics is tough

New postby frmanfan on Wed Jul 18, 2018 12:25 pm

randyrad wrote:Coming soon -- how to do your own brain surgery with a mirror & everyday tools purchased at Home Depot.


This just might explain fatty's posts. :clap:
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