Americans, How is the ACA affecting you?

Seen something interesting in the news or on the intertubes? Discuss it here.

Moderators: Zamfir, Hawknc, Moderators General, Prelates

User avatar
PinkShinyRose
Posts: 833
Joined: Mon Nov 05, 2012 6:54 pm UTC
Location: the Netherlands

Re: Americans, How is the ACA affecting you?

Postby PinkShinyRose » Wed Oct 02, 2013 12:56 am UTC

cphite wrote:
KnightExemplar wrote:For example, it was recently discovered that mammograms were not useful to patients of age 40 or younger. If we simply enact a policy that stops women from getting mammograms before age 40, then we conserve more resources with minimal risk.


A good friend of mine just celebrated her second cancer-free year since being diagnosed with breast cancer six years ago. She was 31 when she was diagnosed. I've gone to several Komen walks with her; it's pretty startling how many women under the age of 40 you see at those events who are either survivors or currently fighting breast cancer.

The problem isn't mammograms; the problem is that mammograms are ridiculously expensive. Medical procedures in the USA are ridiculously expensive almost across the board, because there is practically zero downward pressure on pricing; and actually some upward pressure. Instead of trying to cherry pick procedures to stop people from getting, we should focus on getting the prices of procedures down to reasonable levels.

Angua wrote:It's weird, I thought that you give ultrasounds to women under 40 because of the difference in consistency of their breast tissue.

Is screening women under 40 a big thing in the US for breast cancer? In the UK it's women over 50 (though any person who has a lump or something suspicious will get fast tracked to a breast clinic no matter the age).

You're right, malignant tumours have a tendency to look somewhat like healthy glandular breast tissue (except for calcifications). So making a mammogram on a pre-menopause woman is like making a picture with a lot of static, the intensity varies somewhat, but it's nearly useless, this has little to do with women getting breast cancer before the age of 40.

There is also a separate issue: diagnosing is mostly determining the odds of it being each of the candidate diseases (or physiological). I.e. if 5% of healthy women get a positive test result, and 80% of women with cancer get the same result, but only 0.1% of the population has cancer a lot of people get the side effects of further testing and perhaps of treatment with sometimes lethal side-effects. The frequency of cancer in women with lumps of a certain consistency is much higher.

Ultra-sound does fix the first issue, but I think it suffers somewhat more from the second issue (reliability).

PS what is the exchange thing? Is it a subsidised insurance program? Why don't clinics like it?

User avatar
addams
Posts: 10009
Joined: Sun Sep 12, 2010 4:44 am UTC
Location: Oregon Coast: 97444

Re: Americans, How is the ACA affecting you?

Postby addams » Wed Oct 02, 2013 3:48 am UTC

It seems ACA is providing me with some strange entertainment.

It is easy to get a screen to produce people saying the ACA is enough to dissolve the US Government.
The sentiment seems to be, "The Government is no good anyway. Kill it before it saves another life."

I have not heard one word about how good we are or how good our nation is. Not one word.
I would like to discuss Patriotism. The quiet kind.
The kind that considers our common past, our common present and our common future.

Patriotism is not a, "I Got Mine; Fuck You." deal. It is now.
At this time in our common history, that is the voice of the Patriot.

If the nation wants to dissolve over a health care plan it should have been a good one.
To have the US whimper into a foot note in the book on World History, is fine.
It should have been for something Noble. NHS would have been nice.

But; No. Our nation is dissolving over the ACA. So sad.

Our nation is not dissolving over the ACA. Our nation has been in decline for nearly 15 years.
The men and woman that have the microphones in Congress are not patriots they are parrots.
They can say the words. They do not know what the words mean.

The talking heads on NEWS are no better. Single payer Health Care would be a better and more noble fight.
Those shills for the insurance companies have the passion of cheep motivational speakers.
Many of us on the other sides do not have that kind of passion.

The ACA is still the same system with a little more oversight and transparency.
The transparency can be fixed with a little Capital investment. It is fairly easy with the internet.

The oversight can be used to prove the system is flawed.
Any mistake can be used by PR to prove the ACA is wrong.
If no mistakes are made, some can be made up.

Why are we taking the nation down over something that is so little change?

I know why it is so little change. Any more change might have killed our president.
If the president died to provide us with Universal Single Payer Health Care, then we would have rallied behind his corpse.

He would have been a Hero. And; Then again, maybe not. It is not worth his life to test the system.

If we are not willing to stand with and for each other, ech....
We deserve what we get and that is not going to be very much.

Can you blame us?! We suck. Would you stand up for and with these people?
Yeah. Me, either.
Life is, just, an exchange of electrons; It is up to us to give it meaning.

We are all in The Gutter.
Some of us see The Gutter.
Some of us see The Stars.
by mr. Oscar Wilde.

Those that want to Know; Know.
Those that do not Know; Don't tell them.
They do terrible things to people that Tell Them.

Tyndmyr
Posts: 11443
Joined: Wed Jul 25, 2012 8:38 pm UTC

Re: Americans, How is the ACA affecting you?

Postby Tyndmyr » Wed Oct 02, 2013 4:26 am UTC

As a thought experiment, imagine if buying food at the grocery store was as complicated as paying for medical care. No prices on anything. People in the store would refuse to give you quotes. To check out, you'd have to sign off on a stack of forms. At some point in the future, you may or may not be billed by one or more parties for amounts that cannot be predicted, and are not the same for different people. Add in deductables, insurance, the whole nine yards.

Would it be better than the cash and carry that exists today?

User avatar
sardia
Posts: 6562
Joined: Sat Apr 03, 2010 3:39 am UTC

Re: Americans, How is the ACA affecting you?

Postby sardia » Wed Oct 02, 2013 4:32 am UTC

Tyndmyr wrote:As a thought experiment, imagine if buying food at the grocery store was as complicated as paying for medical care. No prices on anything. People in the store would refuse to give you quotes. To check out, you'd have to sign off on a stack of forms. At some point in the future, you may or may not be billed by one or more parties for amounts that cannot be predicted, and are not the same for different people. Add in deductables, insurance, the whole nine yards.

Would it be better than the cash and carry that exists today?

Now imagine that there's less food then the demand for it, and that everyone is one meal away from starving to death. The only people secure are those who are the 1% who are rich enough to outbid the poor people, who starve to death as they fall through the cracks of the safety net.. Would you still risk using cash to pay for your food?
That's the stupid thing about metaphors, they only help if it's true.

User avatar
CorruptUser
Posts: 10268
Joined: Fri Nov 06, 2009 10:12 pm UTC

Re: Americans, How is the ACA affecting you?

Postby CorruptUser » Wed Oct 02, 2013 2:05 pm UTC

Imagine you don't know how much food you will need either until after you get hungry...

User avatar
folkhero
Posts: 1775
Joined: Fri Aug 01, 2008 3:34 am UTC

Re: Americans, How is the ACA affecting you?

Postby folkhero » Wed Oct 09, 2013 9:55 am UTC

sardia wrote:
Tyndmyr wrote:As a thought experiment, imagine if buying food at the grocery store was as complicated as paying for medical care. No prices on anything. People in the store would refuse to give you quotes. To check out, you'd have to sign off on a stack of forms. At some point in the future, you may or may not be billed by one or more parties for amounts that cannot be predicted, and are not the same for different people. Add in deductables, insurance, the whole nine yards.

Would it be better than the cash and carry that exists today?

Now imagine that there's less food then the demand for it, and that everyone is one meal away from starving to death. The only people secure are those who are the 1% who are rich enough to outbid the poor people, who starve to death as they fall through the cracks of the safety net.. Would you still risk using cash to pay for your food?
That's the stupid thing about metaphors, they only help if it's true.

Well yeah, there is plenty of healthcare that is needed suddenly has catastrophic costs, these procedures/drugs are make an inapt comparison to groceries, they are also the reason health insurance exists in the first place. There is also plenty of healthcare that is routine and fairly predictable and unlikely to bankrupt a typical patient. I don't think too many sexually active young women are shocked that they need to pay for birth control every x unit of time, or too many overweight older men for whom a Lipitor prescription is an unexpected catastrophic cost. This is the bread and butter of the healthcare world and lots more than the top 1% can afford it well enough. Sure we need insurance for the former, but why force everyone to use such an inefficient and confusing system to pay for the later?
To all law enforcement entities, this is not an admission of guilt...

User avatar
CorruptUser
Posts: 10268
Joined: Fri Nov 06, 2009 10:12 pm UTC

Re: Americans, How is the ACA affecting you?

Postby CorruptUser » Wed Oct 09, 2013 12:23 pm UTC

Because of tax breaks designed for insurance companies. Health Insurance should count as compensation for tax purposes, income taxes lowered accordingly, and there should be a cap to discounts to insurance companies for Rx and Medical care.

Tyndmyr
Posts: 11443
Joined: Wed Jul 25, 2012 8:38 pm UTC

Re: Americans, How is the ACA affecting you?

Postby Tyndmyr » Wed Oct 09, 2013 1:23 pm UTC

folkhero wrote:Well yeah, there is plenty of healthcare that is needed suddenly has catastrophic costs, these procedures/drugs are make an inapt comparison to groceries, they are also the reason health insurance exists in the first place. There is also plenty of healthcare that is routine and fairly predictable and unlikely to bankrupt a typical patient. I don't think too many sexually active young women are shocked that they need to pay for birth control every x unit of time, or too many overweight older men for whom a Lipitor prescription is an unexpected catastrophic cost. This is the bread and butter of the healthcare world and lots more than the top 1% can afford it well enough. Sure we need insurance for the former, but why force everyone to use such an inefficient and confusing system to pay for the later?


While my original point was honestly just "it's no wonder the health care system is broken...if we applied the same constraints to a working system, it'd break too", you bring up an excellent point.

Some medical care is unforeseeable, expensive, and urgent. For the vast majority of people, this is something that is best handled by insurance or a similar plan.

A lot is not. I have general checkups every year. I get a cold or flu once in a while(or I get the flu shot, etc). Some medical care is elective and not particularly urgent(for instance, my tonsillectomy). That doesn't really fit the same model, and if an affordability problem exists, it fits the same model as food.

I also note that by lowering health care costs in general, the latter problems diminish, and a few of the more minor former problems start to slide into the latter. Insurance has an effect on overall cost. Leaving aside the inefficiencies caused by the unshown cost(which can be significant), the insurance company has to pay something for admin costs, and is taking something in profit. It has to add at least something to the overall cost of health care. Using it for unnecessarily small things adds to the overall burden by contributing to cost inflation.

User avatar
Zamfir
I built a novelty castle, the irony was lost on some.
Posts: 7516
Joined: Wed Aug 27, 2008 2:43 pm UTC
Location: Nederland

Re: Americans, How is the ACA affecting you?

Postby Zamfir » Wed Oct 09, 2013 2:00 pm UTC

I don't think too many sexually active young women are shocked that they need to pay for birth control every x unit of time, or too many overweight older men for whom a Lipitor prescription is an unexpected catastrophic cost. This is the bread and butter of the healthcare world and lots more than the top 1% can afford it well enough.


If the cost is low enough that everyone can easily afford it, then it's not a major cost part of health care.

Tyndmyr
Posts: 11443
Joined: Wed Jul 25, 2012 8:38 pm UTC

Re: Americans, How is the ACA affecting you?

Postby Tyndmyr » Wed Oct 09, 2013 2:44 pm UTC

Well, we spend 2.6bil yearly on medical care, and some say that 750m of that was unnecessary.

Now, plenty of the little stuff is still necessary, and plenty of the main cost drivers aren't even accounted for in that breakdown.

For instance, Americans friggin' love specialist doctors. Think about it...if your insurance is paying the fee(minus a flat deductible), for a visit, would you rather see someone who specializes in that area or not? The cost to you is the same. This ALONE makes up a $1,290/capita difference in spending when compared against other first world nations.

So no...the distortions caused by utilizing insurance for frigging everything are not trivial at all. We could seriously reduce health care costs by reducing the reliance on insurance companies and increasing transparency in pricing.

User avatar
Bakemaster
pretty nice future dick
Posts: 8915
Joined: Fri Jul 06, 2007 2:33 pm UTC
Location: One of those hot places

Re: Americans, How is the ACA affecting you?

Postby Bakemaster » Sun Oct 13, 2013 6:00 pm UTC

Anecdotes for OP. At the beginning of 2013, my family's prenatal care became fully covered by our insurance policy, with the exception of medications and medical equipment. Prior to this year, we had a copay every time my wife went in for a prenatal checkup; and by the end of the pregnancy, the doctors were having her in 2-3 times every week. Also, this year our insurer covers (part of) the cost of a breast pump. In all, we spent about $800 out of pocket on drugs and durable medical equipment incidental to her pregnancy (not delivery). EDIT: I don't know what the cost would have been for all that prenatal care without the ACA. If it was just a copay per visit, at least another $800. If we had additional costs for every ultrasound, blood draw, and NST... twice that? Three times? I'm just guessing here. We would not have been able to afford the breast pump, which retails for about $400 (I think it was 75% covered, thanks to the ACA).

The cost of our insurance policy changed because we added our son to the policy. I don't recall any change at the beginning of the year. We now pay roughly $400/month for the base level HMO plan her employer offers.
elasto wrote:When my wife gave birth to our daughter, she had an emergency cesarean with about eight staff in the operating room. She spent a week in hospital and needed many rounds of drugs including an epidural. Total cost? Under $3000.

I tried to look what the cost for the same sort of event in the US would have been and, to the best I could tell it would have been a five figure sum - and not a terribly low five figure sum either.

Datum: My son was born this past July, in a hospital in California. Wife didn't have a caesarian, but she did have an epidural, her delivery was attended by a dozen or so medical staff, and she stayed in the hospital for 4 days along with my son. They were together in a standard room the whole time - he never went to the NICU. Total charges for "inpatient services" (the only item on the bill): $23,600. We are responsible for $1,485 of that cost. Why that particular number? I have no idea. The bill doesn't say, and it's not significantly clarified by our schedule of coverages and copays.
Last edited by Bakemaster on Sun Oct 13, 2013 9:27 pm UTC, edited 1 time in total.
Image
c0 = 2.13085531 × 1014 smoots per fortnight
"Apparently you can't summon an alternate timeline clone of your inner demon, guys! Remember that." —Noc

User avatar
folkhero
Posts: 1775
Joined: Fri Aug 01, 2008 3:34 am UTC

Re: Americans, How is the ACA affecting you?

Postby folkhero » Sun Oct 13, 2013 6:21 pm UTC

Oh yeah, since anecdotes are what this thread is asking for: I'm not affected too much, in the short term. On the other hand my Dad, who works for a small business has learned that the high deductible plan he gets from his work will soon be illegal and an ACA compatible plan will be at least 44% more expensive. This means his employer will have to shop around and if he can't find something more reasonable he will have to lower wages or drop health insurance and let the employees fend for themselves. So much for "if you like your plan you can keep it."
To all law enforcement entities, this is not an admission of guilt...

User avatar
ucim
Posts: 6585
Joined: Fri Sep 28, 2012 3:23 pm UTC
Location: The One True Thread

Re: Americans, How is the ACA affecting you?

Postby ucim » Sun Oct 13, 2013 10:32 pm UTC

Zamfir wrote:If the cost is low enough that everyone can easily afford it, then it's not a major cost part of health care.
It is if everyone gets it. That's the whole idea.

Tyndmar wrote: the main cost drivers aren't even accounted for in that breakdown.

For instance, Americans friggin' love specialist doctors.
What about outcomes? Do specialists actually know more about their specialty than a non-specialist? Does this help improve their ability to deliver appropriate care? If this helps to minimize (somebody else's) suffering, how much extra is that worth (to you)?

The object isn't to reduce health care costs as much as possible - we could do that in a heartbeat by simply denying everybody health care. The object is to find the "right" balance of cost and benefit... where cost is "to me" and benefit is "to somebody else". Or vice versa. You don't know which one it will be when you wake up.

Jose
Order of the Sillies, Honoris Causam - bestowed by charlie_grumbles on NP 859 * OTTscar winner: Wordsmith - bestowed by yappobiscuts and the OTT on NP 1832 * Ecclesiastical Calendar of the Order of the Holy Contradiction * Please help addams if you can. She needs all of us.

User avatar
CorruptUser
Posts: 10268
Joined: Fri Nov 06, 2009 10:12 pm UTC

Re: Americans, How is the ACA affecting you?

Postby CorruptUser » Sun Oct 13, 2013 10:40 pm UTC

Specialists do know what they are doing. The problem is that, depending whom you ask, literally half of what they do is of no net benefit (or worse, a detriment) to the patient only because the lawyers say they have to. 1 in 100,000 chance of patient having bos Taurus excrementum? If you didn't test for that you may liable, even if the test costs $200 and keeps the patient in the hospital another day and increase the risk of catching something from another patient.

User avatar
Sizik
Posts: 1224
Joined: Wed Aug 27, 2008 3:48 am UTC

Re: Americans, How is the ACA affecting you?

Postby Sizik » Mon Oct 14, 2013 2:44 am UTC

CorruptUser wrote:bos Taurus excrementum?


I ended up googling that, before I realized it was just fake-Latin BS.
gmalivuk wrote:
King Author wrote:If space (rather, distance) is an illusion, it'd be possible for one meta-me to experience both body's sensory inputs.
Yes. And if wishes were horses, wishing wells would fill up very quickly with drowned horses.

User avatar
ucim
Posts: 6585
Joined: Fri Sep 28, 2012 3:23 pm UTC
Location: The One True Thread

Re: Americans, How is the ACA affecting you?

Postby ucim » Mon Oct 14, 2013 2:45 am UTC

CorruptUser wrote:only because the lawyers say they have to
Then this does not demonstrate a problem with the health care system. It doesn't even really demonstrate a problem with the legal system. Rather, it demonstrates a problem with the value system people have, that they insist on trying their best to find somebody else to blame... and in all fairness they only need to do it because the other party is probably doing the same thing.

Defensive offense is a problem whose solution is not evident.

Jose
Order of the Sillies, Honoris Causam - bestowed by charlie_grumbles on NP 859 * OTTscar winner: Wordsmith - bestowed by yappobiscuts and the OTT on NP 1832 * Ecclesiastical Calendar of the Order of the Holy Contradiction * Please help addams if you can. She needs all of us.

User avatar
Diadem
Posts: 5654
Joined: Wed Jun 11, 2008 11:03 am UTC
Location: The Netherlands

Re: Americans, How is the ACA affecting you?

Postby Diadem » Mon Oct 14, 2013 7:43 am UTC

ucim wrote:
Tyndmar wrote:For instance, Americans friggin' love specialist doctors.
What about outcomes? Do specialists actually know more about their specialty than a non-specialist? Does this help improve their ability to deliver appropriate care? If this helps to minimize (somebody else's) suffering, how much extra is that worth (to you)?

Specialists know more about their specialty than non-specialists, obviously. The problem is they know less about everything else. So while, compared to a generalist, they may notice the very rare medical conditions related to their specialty, they might miss the common ones not related to their specialty.

A good general practitioner can identify almost all problems accurately enough to at least be able to send you to the right specialist. I mean sure we all know the horror stories about general practitioners missing rare conditions, but the thing with rare conditions is that they are rare.
It's one of those irregular verbs, isn't it? I have an independent mind, you are an eccentric, he is round the twist
- Bernard Woolley in Yes, Prime Minister

User avatar
CorruptUser
Posts: 10268
Joined: Fri Nov 06, 2009 10:12 pm UTC

Re: Americans, How is the ACA affecting you?

Postby CorruptUser » Mon Oct 14, 2013 12:41 pm UTC

Sizik wrote:
CorruptUser wrote:bos Taurus excrementum?


I ended up googling that, before I realized it was just fake-Latin BS.


Not quite fake. I should probably make those jokes less subtle though. Bulle Shitte?

User avatar
CorruptUser
Posts: 10268
Joined: Fri Nov 06, 2009 10:12 pm UTC

Re: Americans, How is the ACA affecting you?

Postby CorruptUser » Mon Oct 14, 2013 12:57 pm UTC

ucim wrote:
CorruptUser wrote:only because the lawyers say they have to
Then this does not demonstrate a problem with the health care system. It doesn't even really demonstrate a problem with the legal system. Rather, it demonstrates a problem with the value system people have, that they insist on trying their best to find somebody else to blame... and in all fairness they only need to do it because the other party is probably doing the same thing.

Defensive offense is a problem whose solution is not evident.

Jose


There are several possibilities I know of. My favorite being capping damages like Worker's Comp.

User avatar
ucim
Posts: 6585
Joined: Fri Sep 28, 2012 3:23 pm UTC
Location: The One True Thread

Re: Americans, How is the ACA affecting you?

Postby ucim » Tue Oct 15, 2013 2:18 am UTC

CorruptUser wrote:There are several possibilities I know of. My favorite being capping damages like Worker's Comp.
But if the cap is too low, actual damages can easily be much greater than the cap (encouraging/rewarding behavior that risks others), and if the cap is too high, it does not actually serve to inhibit suits. Finding the balance is easy, of course. I just need a number that's greater than seven, and less than four.

Jose
Order of the Sillies, Honoris Causam - bestowed by charlie_grumbles on NP 859 * OTTscar winner: Wordsmith - bestowed by yappobiscuts and the OTT on NP 1832 * Ecclesiastical Calendar of the Order of the Holy Contradiction * Please help addams if you can. She needs all of us.

User avatar
addams
Posts: 10009
Joined: Sun Sep 12, 2010 4:44 am UTC
Location: Oregon Coast: 97444

Re: Americans, How is the ACA affecting you?

Postby addams » Tue Oct 15, 2013 5:34 am UTC

Diadem wrote:
ucim wrote:
Tyndmar wrote:For instance, Americans friggin' love specialist doctors.
What about outcomes? Do specialists actually know more about their specialty than a non-specialist? Does this help improve their ability to deliver appropriate care? If this helps to minimize (somebody else's) suffering, how much extra is that worth (to you)?

Specialists know more about their specialty than non-specialists, obviously. The problem is they know less about everything else. So while, compared to a generalist, they may notice the very rare medical conditions related to their specialty, they might miss the common ones not related to their specialty.

A good general practitioner can identify almost all problems accurately enough to at least be able to send you to the right specialist. I mean sure we all know the horror stories about general practitioners missing rare conditions, but the thing with rare conditions is that they are rare.

Well written.
This is true.

When practiced correctly medical care will not put an end to diseases, disorders, disabilities and death.
We have many good people with such good tools. This is the 21st century.

We can care for one another with intelligence, dignity and joy.
You know this true. Your little butterfly says you are in the Netherlands.

My nation seems to be stuck in a Time Warp. One man dwells in Light. He gets The World's Best Care.
He enjoys organ transplants and the wealth of a God. His name is Dick. so appropriate.

Another man dies of a simple untreated infection while a third succumbs to hypothermia
while begging to supplement his $500.00 social security payment.
How is the ACA affecting me? I don't know.

Yesterday a woman died while receiving the best care money could buy.
I survived being refused the cheapest care I could request. (shrug)

Some shit does not make sense.
We spend a lot of money to refuse one another care.
How does that make sense?
Life is, just, an exchange of electrons; It is up to us to give it meaning.

We are all in The Gutter.
Some of us see The Gutter.
Some of us see The Stars.
by mr. Oscar Wilde.

Those that want to Know; Know.
Those that do not Know; Don't tell them.
They do terrible things to people that Tell Them.

elasto
Posts: 3574
Joined: Mon May 10, 2010 1:53 am UTC

Re: Americans, How is the ACA affecting you?

Postby elasto » Tue Oct 15, 2013 5:57 am UTC

ucim wrote:But if the cap is too low, actual damages can easily be much greater than the cap (encouraging/rewarding behavior that risks others), and if the cap is too high, it does not actually serve to inhibit suits.


Obviously actual damages should not be capped, only punitive damages*.

Losing your medical licence should ultimately be what dissuades a doctor from acting negligently - and that should be a determination of a Medical Council not a court. And not ordering a test to check for a one-in-a-hundred-million possibility should not count as negligence medically - despite perhaps being worthy of a legal payout.

*My personal preference is for punitive damages to not go to the claimant, either: They should go into some kind of general pot - eg. funding legal aid. In the context of this discussion that would dissuade people without any provable damages from making a claim, since they can't hope for a lottery win on the punitive damages. However, they could still make a complaint to the Medical Council and get the doctor struck off.

Seems to me like the best of all worlds.

Tyndmyr
Posts: 11443
Joined: Wed Jul 25, 2012 8:38 pm UTC

Re: Americans, How is the ACA affecting you?

Postby Tyndmyr » Wed Oct 16, 2013 8:03 pm UTC

ucim wrote:
Tyndmyr wrote: the main cost drivers aren't even accounted for in that breakdown.

For instance, Americans friggin' love specialist doctors.
What about outcomes? Do specialists actually know more about their specialty than a non-specialist? Does this help improve their ability to deliver appropriate care? If this helps to minimize (somebody else's) suffering, how much extra is that worth (to you)?

The object isn't to reduce health care costs as much as possible - we could do that in a heartbeat by simply denying everybody health care. The object is to find the "right" balance of cost and benefit... where cost is "to me" and benefit is "to somebody else". Or vice versa. You don't know which one it will be when you wake up.

Jose


In order, yes, specialists can be expected to know more about their specialty than non-specialists.

Sometimes it helps, sometimes it doesn't. It's case by case. Generally, if it is about something in their specialty, they are superior. If not, not.

As for how much extra it's worth...that also depends. Going to see an ear, nose and throat doctor for an average cold? Probably a waste of time. Going to see them for sleep apnea? Could save your life. When costs are rarely visible, and effects are uncertain, are you surprised that people sometimes choose poorly?

User avatar
ucim
Posts: 6585
Joined: Fri Sep 28, 2012 3:23 pm UTC
Location: The One True Thread

Re: Americans, How is the ACA affecting you?

Postby ucim » Fri Oct 18, 2013 5:27 am UTC

elasto wrote:Losing your medical licence should ultimately be what dissuades a doctor from acting negligently - and that should be a determination of a Medical Council not a court.
Isn't that giving the horse the keys to the barn? (I also have a similar issue with "jury of one's peers", as it doesn't consider "jury of the victim's peers".)

In terms of medical costs, medical insurance is a big part of it, but how much of that is due to punitive damages, and how much to the propensity of juries to be sympathetic? And why shouldn't they be? Much of the damages due to malpractice are not fungible. People's lives are destroyed, sometimes.

As for the value of a specialist... yes, you are all right. (That is, I agree.) :) But "Americans love specialists" is spoken as if it were a Bad Thing, and that is yet to be shown. Specialists have value. I'm not convinced that we are using them inappropriately.

Jose
Order of the Sillies, Honoris Causam - bestowed by charlie_grumbles on NP 859 * OTTscar winner: Wordsmith - bestowed by yappobiscuts and the OTT on NP 1832 * Ecclesiastical Calendar of the Order of the Holy Contradiction * Please help addams if you can. She needs all of us.

Tyndmyr
Posts: 11443
Joined: Wed Jul 25, 2012 8:38 pm UTC

Re: Americans, How is the ACA affecting you?

Postby Tyndmyr » Fri Oct 18, 2013 9:40 am UTC

Well, if we're using them inappropriately, then, at minimum, it's needless cost.

If we're using them appropriately, then everyone else is way under-utilizing them.

Either way, it's a huge source of additional cost that won't be fixed by simply changing payment models...you need to actually change usage patterns to address it. This is a common thread wending it's way through most of our cost issues.


Return to “News & Articles”

Who is online

Users browsing this forum: No registered users and 21 guests