IGX

Turdacious wrote:Uh, a huge portion of that cost is because of courts and personal injury lawyers.

Lawsuits and litigation costs are wrapped into ALL consumer products and services, yet I can buy a decent car for as much as my doctor charged me to spend 3 minutes in a CT scan.

From personal experience: There is a high % of people taking ambulance rides to the ER (costing thousands of $$$) who don't need that level of care.

Fact is, the medical establishment in the US charges significantly more for the same treatments, tests, and drugs that are available in other first world countries. In fact, there are shitty little countries with, arguably, better doctors and hospitals than the US.

I think a major issue is the egos of physicians. They view their job as a higher calling, and massive reimbursement as a divine right in the US.

More and more, I like the idea of a low cost, high deductible, catastrophic insurance plan + concierge medicine, paid in cash.

protobuilder wrote:

Turdacious wrote:Uh, a huge portion of that cost is because of courts and personal injury lawyers.

Lawsuits and litigation costs are wrapped into ALL consumer products and services, yet I can buy a decent car for as much as my doctor charged me to spend 3 minutes in a CT scan.

It's a matter of degree. The big spikes in medical care costs have all closely followed big court cases.

My auto insurer has been sued repeatedly, in every jurisdiction in this great land, and has paid millions and millions in verdicts and settlements. Yet I still have pretty cheap insurance and neither cars nor auto insurance rates have skyrocketed like medical costs have.

Charging $5 per tablet of Tylenol and $8 for a roll of toilet paper comes up frequently on reviewed hospital bills.

I would really consider the cost of people using the ER as their main source of medical treatment and not paying a factor.

The administrative costs of running a hospital have skyrocketed too.

Shafpocalypse Now wrote:I would really consider the cost of people using the ER as their main source of medical treatment and not paying a factor.

The administrative costs of running a hospital have skyrocketed too.

We got billed $81 a minute for occupying a surgery room. Not for a surgeon (there wasn't one, and the dentist billed separately). Not for the anesthesitsts (he billed separately too). Not for nurses (the dentist brought 1-2 assistants). Not for general hospital costs (that was another bill). Just for the room. To occupy it.

protobuilder wrote:My auto insurer has been sued repeatedly, in every jurisdiction in this great land, and has paid millions and millions in verdicts and settlements. Yet I still have pretty cheap insurance and neither cars nor auto insurance rates have skyrocketed like medical costs have.

In most cases with auto insurances, the liability is personal (not business)-- and an auto policy explicitly caps the insurance company's liability (usually 25k for higher risk drivers, and 300k for lower risk drivers). Individuals are liable for amounts greater than the cap, and individuals generally don't have deep pockets. Hospitals, where the greatest liability risk lies, have far deeper pockets and greater revenue streams.

The other cost driver related to liability is defensive medicine (i.e. avoiding liability), which is not a real factor in auto insurance.

Also, with auto insurance, the biggest cost is damage to your vehicle-- which is why comprehensive coverage adds more to your auto policy than liability. With medical care, it's almost all liability.

Turdacious wrote:
In most cases with auto insurances, the liability is personal (not business)-- and an auto policy explicitly caps the insurance company's liability (usually 25k for higher risk drivers, and 300k for lower risk drivers). Individuals are liable for amounts greater than the cap, and individuals generally don't have deep pockets. Hospitals, where the greatest liability risk lies, have far deeper pockets and greater revenue streams.

The other cost driver related to liability is defensive medicine, which is not a real factor in auto insurance.

There isn't data that shows it is malpractice insurance and lawyers that drive up costs. Furthermore, based on observation and a lot of data, hospitals should get sued a lot. I see all kinds of poor practices.

nafod wrote:

Turdacious wrote:
In most cases with auto insurances, the liability is personal (not business)-- and an auto policy explicitly caps the insurance company's liability (usually 25k for higher risk drivers, and 300k for lower risk drivers). Individuals are liable for amounts greater than the cap, and individuals generally don't have deep pockets. Hospitals, where the greatest liability risk lies, have far deeper pockets and greater revenue streams.

The other cost driver related to liability is defensive medicine, which is not a real factor in auto insurance.

There isn't data that shows it is malpractice insurance and lawyers that drive up costs. Furthermore, based on observation and a lot of data, hospitals should get sued a lot. I see all kinds of poor practices.

There's a lot of data. One example:


http://content.healthaffairs.org/conten ... l.pdf+html

But let's get back to the current discussion about poor practice:

Incompetence, deception, and lack of accountability doomed the Obamacare rollout. That's old news. What's new? The nagging durability of the White House's incompetence, deception, and lack of accountability.

1. The Washington Post reported on Sunday that the Obama administration will consider the new online marketplace a success if 80 percent of users can buy health insurance. That is absurd. First, it's another broken promise. The president and his advisers responded to the disastrous rollout last month by vowing to deliver an Amazon.com-quality website by the end of November. (If history remembers President Obama for one thing, other than his barrier-breaking 2008 election, it might be the outsized and unmet expectations that paved the path of his presidency.) Second, in what other line of work is 20 percent failure considered a success? If one out of every five meals served by a restaurant is inedible, the joint goes out of business.

http://www.nationaljournal.com/white-ho ... t-20131118

Turdacious wrote:

nafod wrote:

Turdacious wrote:
In most cases with auto insurances, the liability is personal (not business)-- and an auto policy explicitly caps the insurance company's liability (usually 25k for higher risk drivers, and 300k for lower risk drivers). Individuals are liable for amounts greater than the cap, and individuals generally don't have deep pockets. Hospitals, where the greatest liability risk lies, have far deeper pockets and greater revenue streams.

The other cost driver related to liability is defensive medicine, which is not a real factor in auto insurance.

There isn't data that shows it is malpractice insurance and lawyers that drive up costs. Furthermore, based on observation and a lot of data, hospitals should get sued a lot. I see all kinds of poor practices.

There's a lot of data. One example:


http://content.healthaffairs.org/conten ... l.pdf+html

So for doctors who saw their malpractice insurance cut in half, there was still a 25% growth in costs?

Another reason for rising malpractice costs may be that we're becoming more aware of medical mistakes.

It seems that every time researchers estimate how often a medical mistake contributes to a hospital patient's death, the numbers come out worse.

In 1999, the Institute of Medicine published the famous "To Err Is Human" report, which dropped a bombshell on the medical community by reporting that up to 98,000 people a year die because of mistakes in hospitals. The number was initially disputed, but is now widely accepted by doctors and hospital officials — and quoted ubiquitously in the media.

In 2010, the Office of Inspector General for the Department of Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.

Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death.

That would make medical errors the third-leading cause of death in America, behind heart disease, which is the first, and cancer, which is second.

http://www.npr.org/blogs/health/2013/09 ... -hospitals

My wife spends 13 hours/day with her mother in Johns Hopkins (the #1 hospital in DA WORLD) and notes all kinds of slipping through the cracks. Everything from standard procedures done differently by different docs and nurses, to confusion on dosages, to missing obvious issues with patient condition. She and her sister are forceful advocates who have led to improved care, for sure. All this, after the reason she is there in the first place is because they perforated her innards while doing an outpatient endoscopy. Now 85 days in the hospital and many more to come. Medicare, i,e,, the taxpayer, is picking up the tab, and 85 days is a shit-ton of money already. Not to mention three surgeries and a ton of imaging procedures.

If aviation was done as professionally as medicine, we'd be splashing planes left and right, I am certain of it. No checklists, everyone makes up their own procedures, no NTSB to create a learning process, just depending on the threat of lawsuits to force the system to improve. Until tort reform.

nafod wrote: If aviation was done as professionally as medicine, we'd be splashing planes left and right, I am certain of it. No checklists,

"The Checklist Manifesto" is written by a surgeon who adapted aviation checklists to the hospital scenario.

nafod wrote:So for doctors who saw their malpractice insurance cut in half, there was still a 25% growth in costs?

Another reason for rising malpractice costs may be that we're becoming more aware of medical mistakes.

It seems that every time researchers estimate how often a medical mistake contributes to a hospital patient's death, the numbers come out worse.

In 1999, the Institute of Medicine published the famous "To Err Is Human" report, which dropped a bombshell on the medical community by reporting that up to 98,000 people a year die because of mistakes in hospitals. The number was initially disputed, but is now widely accepted by doctors and hospital officials — and quoted ubiquitously in the media.

In 2010, the Office of Inspector General for the Department of Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.

Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death.

That would make medical errors the third-leading cause of death in America, behind heart disease, which is the first, and cancer, which is second.

http://www.npr.org/blogs/health/2013/09 ... -hospitals

My wife spends 13 hours/day with her mother in Johns Hopkins (the #1 hospital in DA WORLD) and notes all kinds of slipping through the cracks. Everything from standard procedures done differently by different docs and nurses, to confusion on dosages, to missing obvious issues with patient condition. She and her sister are forceful advocates who have led to improved care, for sure. All this, after the reason she is there in the first place is because they perforated her innards while doing an outpatient endoscopy. Now 85 days in the hospital and many more to come. Medicare, i,e,, the taxpayer, is picking up the tab, and 85 days is a shit-ton of money already. Not to mention three surgeries and a ton of imaging procedures.

If aviation was done as professionally as medicine, we'd be splashing planes left and right, I am certain of it. No checklists, everyone makes up their own procedures, no NTSB to create a learning process, just depending on the threat of lawsuits to force the system to improve. Until tort reform.

And Obamacare has a mechanism that's supposed to help with the situation your MIL is facing (which happens far too often)-- the IPAB. Guess what-- still unfilled.

johno wrote:From personal experience: There is a high % of people taking ambulance rides to the ER (costing thousands of $$$) who don't need that level of care.

90% of EMS rides, nailed it.

Ambulance ride is what? 2-3k?

Of which Dunn gets $15. Or so.

Yet he's the man saving your life.

EMT companies are run by cunts

johno wrote:

nafod wrote: If aviation was done as professionally as medicine, we'd be splashing planes left and right, I am certain of it. No checklists,

"The Checklist Manifesto" is written by a surgeon who adapted aviation checklists to the hospital scenario.

Yup. They probably cited a study where they adopted checklists for PIC line insertions at a hospital and reduced resulting infections to zero. Yet I see no checklists anywhere. We have some docs and nurses where I ski patrol, and I we argue about it frequently.

The Obama administration brought in a private consulting team to independently assess how the federal online health insurance enrollment system was developing, according to a newly disclosed document, and in late March received a clear warning that its Oct. 1 launch was fraught with risks.

The analysis by McKinsey & Co. foreshadowed many of the problems that have dogged HealthCare.gov since its rollout, including the facts that the call-in centers would not work properly if the online system was malfunctioning and that insufficient testing would make it difficult to fix problems after the launch.

http://www.washingtonpost.com/politics/ ... litics_pop

Nothing to see here.

Medical prices have skyrocketed ever since people stopped paying cash and started using govt programs or insurance to pay. Doctors/Hospitals started charging the most they possibly could because they KNOW they're getting paid most of the time. Same reason it pays to own housing projects- the govt is paying, so you know you'll get your money

[youtube]http://www.youtube.com/watch?v=n1oPktLLrmQ[/youtube]

Things are going Super Duper Awesome when one of the few people that could get on the Obamacare website and get signed up; can't afford Obamacare.

Great News central Planners! Obamacare website only needs to 30-40% complete!

[youtube]http://www.youtube.com/watch?v=6WzE3naHcq4[/youtube]

[youtube]http://www.youtube.com/watch?v=yQN_xQS5lb8[/youtube]

Roll da windows up and shit!