Comments on: Perhaps the Most Egregious Statement of the Healthcare Debate http://www.coyoteblog.com/coyote_blog/2009/07/perhaps-the-most-egregious-statement-of-the-healthcare-debate.html Dispatches from a Small Business Sun, 12 Feb 2012 16:41:24 +0000 hourly 1 http://wordpress.org/?v=3.2.1 By: TJ http://www.coyoteblog.com/coyote_blog/2009/07/perhaps-the-most-egregious-statement-of-the-healthcare-debate.html/comment-page-1#comment-21489 TJ Tue, 28 Jul 2009 17:05:37 +0000 http://www.coyoteblog.com/?p=8565#comment-21489 Carrots and sticks work. Eat the carrot. Stick-clobber those who have preventable conditions, like Safeway does, with the incentives built into their self-insurance system. Safeway has kept costs flat for 4 years and counting. (Lots of news on this item.) Safeway tests for 4 conditions which they claim cause 75% of their health care costs - obesity, cholesterol, diabetes, and tobacco. Stupid government rules limit how much they can coerce/reward those who have adverse test results, but Safeway's system is working very well. The liberal goal is not better health, it is the Nanny State - large, porky government. Carrots and sticks work. Eat the carrot. Stick-clobber those who have preventable conditions, like Safeway does, with the incentives built into their self-insurance system. Safeway has kept costs flat for 4 years and counting. (Lots of news on this item.) Safeway tests for 4 conditions which they claim cause 75% of their health care costs – obesity, cholesterol, diabetes, and tobacco. Stupid government rules limit how much they can coerce/reward those who have adverse test results, but Safeway’s system is working very well. The liberal goal is not better health, it is the Nanny State – large, porky government.

]]> By: SBABG.org http://www.coyoteblog.com/coyote_blog/2009/07/perhaps-the-most-egregious-statement-of-the-healthcare-debate.html/comment-page-1#comment-21367 SBABG.org Fri, 24 Jul 2009 18:43:32 +0000 http://www.coyoteblog.com/?p=8565#comment-21367 There are two particularly big fat lies being told in this debate . . . One relates to the 46,000,000 uninsured number that keeps being floated. (it's closer to 18million) The other relates to the claim that "the free market has failed." The market for healthcare in America is free? We've written more about it here: http://www.sbabg.org/2009/07/24/thetwo-biggest-fattest-lies-in-the-health-care-reform-debate/ There are two particularly big fat lies being told in this debate . . .

One relates to the 46,000,000 uninsured number that keeps being floated. (it’s closer to 18million)

The other relates to the claim that “the free market has failed.” The market for healthcare in America is free?

We’ve written more about it here:

http://www.sbabg.org/2009/07/24/thetwo-biggest-fattest-lies-in-the-health-care-reform-debate/

]]> By: Scott http://www.coyoteblog.com/coyote_blog/2009/07/perhaps-the-most-egregious-statement-of-the-healthcare-debate.html/comment-page-1#comment-21344 Scott Fri, 24 Jul 2009 14:53:16 +0000 http://www.coyoteblog.com/?p=8565#comment-21344 Ok, well, I qouted and modified your first paragraph, but it decided not to post it. Here it is If the HMO is only reimbursing you 50% of your “usual and customary” fee, then you set your fee to be 2x what you would have set it at in the absence of the HMO contract. If you didn’t do this you couldn’t break even much less profit. Then, since it’s against your contract to charge another party less than what you charge the HMO, private individuals with another health care/insurance plan (or are "self insured") get screwed big time. Ok, well, I qouted and modified your first paragraph, but it decided not to post it. Here it is

If the HMO is only reimbursing you 50% of your “usual and customary” fee, then you set your fee to be 2x what you would have set it at in the absence of the HMO contract. If you didn’t do this you couldn’t break even much less profit. Then, since it’s against your contract to charge another party less than what you charge the HMO, private individuals with another health care/insurance plan (or are “self insured”) get screwed big time.

]]> By: Scott http://www.coyoteblog.com/coyote_blog/2009/07/perhaps-the-most-egregious-statement-of-the-healthcare-debate.html/comment-page-1#comment-21343 Scott Fri, 24 Jul 2009 14:52:17 +0000 http://www.coyoteblog.com/?p=8565#comment-21343 Bob, you make a very interesting point their at the beginning. Modify a couple words and you could also use it to damn our current HMO/health insurance plans as well. It all leads back to the fact the reason behind rising costs are many and that just replacing the current insurers with the government would realistically change nothing. The offenses would still be the same, they'd just all be coming from one place. Bob, you make a very interesting point their at the beginning. Modify a couple words and you could also use it to damn our current HMO/health insurance plans as well.

It all leads back to the fact the reason behind rising costs are many and that just replacing the current insurers with the government would realistically change nothing. The offenses would still be the same, they’d just all be coming from one place.

]]> By: Bob Smith http://www.coyoteblog.com/coyote_blog/2009/07/perhaps-the-most-egregious-statement-of-the-healthcare-debate.html/comment-page-1#comment-21330 Bob Smith Fri, 24 Jul 2009 07:38:18 +0000 http://www.coyoteblog.com/?p=8565#comment-21330 Part of the reason things cost so much is that government subsidizes it, and also sets reimbursement rates. If the government is only reimbursing you 50% of your "usual and customary" fee, then you set your fee to be 2x what you would have set it at in the absence of the government rule. If you didn't do this you couldn't break even much less profit. Then, since it's illegal to charge a private party less than what you charge the government, private insurers and the self-insured get screwed big time. It isn't strictly true to say that technology has made things more expensive. Anybody remember the term "exploratory surgery"? With imaging equipment on hand they don't have to do that much anymore. When I was a kid, I got into a serious accident. I had to have my spleen removed. The scar is about 10 inches where they gutted my like a fish to do the exploratory plus splenectomy. I spent a week in the hospital recovering, and another couple of weeks before I could do much of anything without it hurting like heck. Total time out of school was more than a month. Nowadays that would probably be done laparoscopically. Only a couple of 2 cm scars and I would have been out of the hospital in 2 days with a lot less pain to boot. Much, much cheaper overall. A previous poster mentioned prostate cancer. One of the things that pisses me off is that hardly any research is being done on nerve-preserving surgical techniques. A lot of doctors really don't seem to give a damn that it's 50/50 whether you'll be both incontinent and impotent after prostectomy. I don't see that kind of casual attitude towards the side effects of treatment for female-specific cancers. Part of the reason things cost so much is that government subsidizes it, and also sets reimbursement rates. If the government is only reimbursing you 50% of your “usual and customary” fee, then you set your fee to be 2x what you would have set it at in the absence of the government rule. If you didn’t do this you couldn’t break even much less profit. Then, since it’s illegal to charge a private party less than what you charge the government, private insurers and the self-insured get screwed big time.

It isn’t strictly true to say that technology has made things more expensive. Anybody remember the term “exploratory surgery”? With imaging equipment on hand they don’t have to do that much anymore. When I was a kid, I got into a serious accident. I had to have my spleen removed. The scar is about 10 inches where they gutted my like a fish to do the exploratory plus splenectomy. I spent a week in the hospital recovering, and another couple of weeks before I could do much of anything without it hurting like heck. Total time out of school was more than a month. Nowadays that would probably be done laparoscopically. Only a couple of 2 cm scars and I would have been out of the hospital in 2 days with a lot less pain to boot. Much, much cheaper overall.

A previous poster mentioned prostate cancer. One of the things that pisses me off is that hardly any research is being done on nerve-preserving surgical techniques. A lot of doctors really don’t seem to give a damn that it’s 50/50 whether you’ll be both incontinent and impotent after prostectomy. I don’t see that kind of casual attitude towards the side effects of treatment for female-specific cancers.

]]> By: Mike Walsh http://www.coyoteblog.com/coyote_blog/2009/07/perhaps-the-most-egregious-statement-of-the-healthcare-debate.html/comment-page-1#comment-21324 Mike Walsh Fri, 24 Jul 2009 03:00:18 +0000 http://www.coyoteblog.com/?p=8565#comment-21324 I found an interesting article by Leonard Peikoff. If anybody remembers him, he was Ayn Rand"s close friend. The article is called "Is Health Care A Right?" He wrote it back when the Clinton administration was trying to mess with health care. It holds more true today than it did then. I have it posted on my blog in my sig. Anybody can repost it anywhere as long as it stays intact at the author's request. I would urge everybody to copy and paste it and send it along to everyone you know. I found an interesting article by Leonard Peikoff. If anybody remembers him, he was Ayn Rand”s close friend. The article is called “Is Health Care A Right?” He wrote it back when the Clinton administration was trying to mess with health care. It holds more true today than it did then. I have it posted on my blog in my sig. Anybody can repost it anywhere as long as it stays intact at the author’s request. I would urge everybody to copy and paste it and send it along to everyone you know.

]]> By: Methinks http://www.coyoteblog.com/coyote_blog/2009/07/perhaps-the-most-egregious-statement-of-the-healthcare-debate.html/comment-page-1#comment-21319 Methinks Fri, 24 Jul 2009 00:39:47 +0000 http://www.coyoteblog.com/?p=8565#comment-21319 Davidcobb, I think my response to NormD should provide as much of an answer as I can give you. Davidcobb,

I think my response to NormD should provide as much of an answer as I can give you.

]]> By: davidcobb http://www.coyoteblog.com/coyote_blog/2009/07/perhaps-the-most-egregious-statement-of-the-healthcare-debate.html/comment-page-1#comment-21314 davidcobb Thu, 23 Jul 2009 23:27:45 +0000 http://www.coyoteblog.com/?p=8565#comment-21314 methinks and ed fargler Explain to me why a five cent squeeze bottle filled with water(saline nasal spray) cost four dollars a bottle. Why use plavix instead of aspirin when plavix has more side effects and cost much more. A minor eye infection just cost me a months worth of food. we need to look at why it cost so much because if it were cheap we wouldn't need insurance. methinks and ed fargler
Explain to me why a five cent squeeze bottle filled with water(saline nasal spray) cost four dollars a bottle. Why use plavix instead of aspirin when plavix has more side effects and cost much more. A minor eye infection just cost me a months worth of food. we need to look at why it cost so much because if it were cheap we wouldn’t need insurance.

]]> By: Dr. T http://www.coyoteblog.com/coyote_blog/2009/07/perhaps-the-most-egregious-statement-of-the-healthcare-debate.html/comment-page-1#comment-21312 Dr. T Thu, 23 Jul 2009 22:51:43 +0000 http://www.coyoteblog.com/?p=8565#comment-21312 Allen: Here's an engineering-type answer to your question about doing too much medically. The problem is signal-to-noise ratio. Doctors need to see clear signals. But, with every exam, every lab test, every imaging procedure, the potential for noise increases. Reference ranges for tests are typically established by testing healthy people and using the middle 95% of results. That means, by definition, 2.5% of healthy people will have 'abnormal' high results and 2.5% will have 'abnormal' low results. If a doctor orders dozens of tests and imaging procedures on a fully healthy person, numerous tests will be abnormal. None of those abnormal results will be significant. When you do the same thing on a sick patient, you get true abnormals from the illness (signal) and false abnormals from the statistical odds of being just outside the reference range (noise). Not all doctors are great at separating signal from noise, and they often rely on more tests related to each abnormal finding. This generates more signal but also generates more noise. Overutilization also is a problem when resources are scarce. Pathologists keep tight rein on blood product usage because there are barely enough platelets and red blood cell units. Overutilization of drugs is a problem because every drug has side-effects and because drugs can interfere with each other (and with lab tests). Allen: Here’s an engineering-type answer to your question about doing too much medically. The problem is signal-to-noise ratio. Doctors need to see clear signals. But, with every exam, every lab test, every imaging procedure, the potential for noise increases. Reference ranges for tests are typically established by testing healthy people and using the middle 95% of results. That means, by definition, 2.5% of healthy people will have ‘abnormal’ high results and 2.5% will have ‘abnormal’ low results. If a doctor orders dozens of tests and imaging procedures on a fully healthy person, numerous tests will be abnormal. None of those abnormal results will be significant. When you do the same thing on a sick patient, you get true abnormals from the illness (signal) and false abnormals from the statistical odds of being just outside the reference range (noise). Not all doctors are great at separating signal from noise, and they often rely on more tests related to each abnormal finding. This generates more signal but also generates more noise.

Overutilization also is a problem when resources are scarce. Pathologists keep tight rein on blood product usage because there are barely enough platelets and red blood cell units. Overutilization of drugs is a problem because every drug has side-effects and because drugs can interfere with each other (and with lab tests).

]]> By: Methinks http://www.coyoteblog.com/coyote_blog/2009/07/perhaps-the-most-egregious-statement-of-the-healthcare-debate.html/comment-page-1#comment-21288 Methinks Thu, 23 Jul 2009 17:35:45 +0000 http://www.coyoteblog.com/?p=8565#comment-21288 Reading the posts here, I think most people will notice a very simple thing: in a socialist system, individual life has no meaning. You are not a person but a cog in wheel. A brick in the wall. You are replaceable and your only value is your ability to serve the State and the value of your life is decided by the state. Why not forced labour? Your individual wants and needs are irrelevant. That's the slippery slope America is on. And people wonder why I and every other Soviet immigrant of long extraction in this country is warning that you are turning into us. They will keep telling us that until they die on waiting lists or are drafted against their will into Obama's "youth community service" as slave "volunteers". It'll be too late. Reading the posts here, I think most people will notice a very simple thing: in a socialist system, individual life has no meaning. You are not a person but a cog in wheel. A brick in the wall. You are replaceable and your only value is your ability to serve the State and the value of your life is decided by the state. Why not forced labour? Your individual wants and needs are irrelevant. That’s the slippery slope America is on.

And people wonder why I and every other Soviet immigrant of long extraction in this country is warning that you are turning into us. They will keep telling us that until they die on waiting lists or are drafted against their will into Obama’s “youth community service” as slave “volunteers”. It’ll be too late.

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