How can Obamanomics play out?

[birdog1960]

Are we holding all other variables constant?

 

I expect this **** out of Dave. If you were smart enough to get through med school you should be smart enough to understand how empty that statistic is.

what is it about life expectancy thats so difficult for you? sure, you could argue that those getting the best care in the us might live longer than cohorts in say, canada but you'd likely be wrong. and what about the life expectancy of a black male in the us? if i recall correctly it's about 62. the uninsured population of about 40-50 million?- don't think we have a number but i'll wager you 100 it's less than the avg for the entire population of japan.

 

so in this case, the universal care model is ascension, not regression to the mean. i would think anyone accepted to law school could understand that although i understand there are several schools with relatively low admission standards now.

Edited July 11, 2011 by birdog1960

[DC Tom]

so in this case, the universal care model is ascension, not regression to the mean.

 

 

Oh, Christ...here we go...

 

 

That meant nothing. Literally nothing. Less than nothing, in fact. That was too senseless even be wrong, never mind right. "Ascension to the mean?"

[birdog1960]

Oh, Christ...here we go...

 

 

That meant nothing. Literally nothing. Less than nothing, in fact. That was too senseless even be wrong, never mind right. "Ascension to the mean?"

ever heard of speaking figuratively? i thought you had wit...guess i was only 1/2 right.

[Doc]

sure, if the private insurers agree to take the sickest patients and not cherry pick (and that is coming in 2014 when pre-existing conditions go away- just wait for the rationing from anthem, humana and the like when it happens.

 

and no, the us came in 31st in world mortality statistics in the most recent report but spent by far the most. almost every nation ahead of us had govt run healtjhcare, rationing and an emphasis on primary care.

I agree that insurers should not be allowed to cherry pick and/or kick-off expensive subscribers. But removing pre-existing conditions means that you can get insurance only when you need it and drop it when you don't. Insurance is destined to fail that way and the system will collapse quick, especially since everyone is going to be paying the same premium. The fine/penalty/tax for not having insurance is so ridiculously low that it's not a deterrent. And again, mandating people buy insurance is opening the floodgates to unprecedented government intrusion. But if you're fine with that, then you'll be fine with the government telling you what you can and can't do, right?

 

Taking life expectancy by itself without adjusting for the myriad of factors that contribute to it is meaningless. Despite/because of the health care system, Americans take horrible care of themselves, yet expect everything be done for them and it to be done cheaply and perfectly, otherwise they'll sue. So obviously the U.S. spends a ton on health care.

[DC Tom]

ever heard of speaking figuratively? i thought you had wit...guess i was only 1/2 right.

 

I've heard of speaking figuratively; that wasn't it. Generally, "figurative" speech still makes sense. What you posted was just an explicit demonstration of you not knowing what you were talking about.

[birdog1960]

I agree that insurers should not be allowed to cherry pick and/or kick-off expensive subscribers. But removing pre-existing conditions means that you can get insurance only when you need it and drop it when you don't. Insurance is destined to fail that way and the system will collapse quick, especially since everyone is going to be paying the same premium. The fine/penalty/tax for not having insurance is so ridiculously low that it's not a deterrent. And again, mandating people buy insurance is opening the floodgates to unprecedented government intrusion. But if you're fine with that, then you'll be fine with the government telling you what you can and can't do, right?

 

Taking life expectancy by itself without adjusting for the myriad of factors that contribute to it is meaningless. Despite/because of the health care system, Americans take horrible care of themselves, yet expect everything be done for them and it to be done cheaply and perfectly, otherwise they'll sue. So obviously the U.S. spends a ton on health care.

so it follows that the myriad of other factors is an indictment of current american culture...agreed. it appears we also agree that american patients largely can not be counted on to control costs on their own. so, what is the solution? a paradigm shift in the way we practice medicine. we stop treating every minor complaint. we get reimbursed mostly for improving patients wellness. we stop trying to fix things beyond repair. and some times we just say "no". but who is the "decider"? the insurance companies? the govt? the people themselves who we've just concluded are generally incapable? who has the ability to change the culture? maybe we should turn to madison ave to actually do some good for a change.

[Doc]

so it follows that the myriad of other factors is an indictment of current american culture...agreed. it appears we also agree that american patients largely can not be counted on to control costs on their own. so, what is the solution? a paradigm shift in the way we practice medicine. we stop treating every minor complaint. we get reimbursed mostly for improving patients wellness. we stop trying to fix things beyond repair. and some times we just say "no". but who is the "decider"? the insurance companies? the govt? the people themselves who we've just concluded are generally incapable? who has the ability to change the culture? maybe we should turn to madison ave to actually do some good for a change.

No, the real solution is to dictate to people how they will have to live (the "personal mandate" is merely a step in that direction, as are the "death panels"), so as to lower health care expenditures for the country. Changing everything else and not the root cause is wholly futile.

 

And who gets to make the decision to say "no?" A doctor? Like Kathleen Sebelius ( )? What if someone is denied care and he/she truly has a problem and dies. Who gets sued? The government? The doctor? Because Obamacare addressed tort reform?

 

The sooner you realize this, bd, the better-off you'll be: Obamacare was designed to further squeeze the salaries of doctors. The problem is, those account for less than 15% of health care expenditures, yet Barry cut deals with the major players/deep pockets and that's why not only will nothing improve, it will get far worse. And again you're laboring under the false delusion that you'll make out on this whole deal, when the reality is your pay will be cut less than specialists' will.

[TPS]

It's one thing to read articles. It's another to actually sit down and talk to company management. How many have you talked to?

Only a handful. I wouldn't trust their responses to make the general case though, as we tend to have similar views. That's why I'd rather trust a national survey that showed lack of demand was the number one reason--that was probably close to a year ago though. That doesn't mean that other factors weren't or aren't causing uncertainty, it's just that "regulations" (including o-care) didn't top the list).

[Magox]

so it follows that the myriad of other factors is an indictment of current american culture...agreed. it appears we also agree that american patients largely can not be counted on to control costs on their own. so, what is the solution? a paradigm shift in the way we practice medicine. we stop treating every minor complaint. we get reimbursed mostly for improving patients wellness. we stop trying to fix things beyond repair. and some times we just say "no". but who is the "decider"? the insurance companies? the govt? the people themselves who we've just concluded are generally incapable? who has the ability to change the culture? maybe we should turn to madison ave to actually do some good for a change.

I actually wouldnt mind a government subsidized health insurance exchange ONLY for patients with pre existing medical conditions. This would do a couple things, one it would cover all these people that were dropped from their private health insurance plans and two it would filter out many sick people off of the private health insurance pools which in turn would lower the cost of health insurance for the rest of the pool.

 

 

This in my view would make a lot of sense. I see it as a win win sort of proposition.

[KD in CA]

really? ever been to a frat party at an upper echelon school?

 

 

Yeah, because frat parties are a excellent measure of how society in general conducts itself.

 

Keep pretending there is no correlation between life choices and financial reward. !@#$ing retard.

 

 

 

 

p.s. I used to run the frat parties.

[birdog1960]

No, the real solution is to dictate to people how they will have to live (the "personal mandate" is merely a step in that direction, as are the "death panels"), so as to lower health care expenditures for the country. Changing everything else and not the root cause is wholly futile.

 

And who gets to make the decision to say "no?" A doctor? Like Kathleen Sebelius ( )? What if someone is denied care and he/she truly has a problem and dies. Who gets sued? The government? The doctor? Because Obamacare addressed tort reform?

 

 

 

right now the insurance co's do this with great frequency. i could give many, many examples of life threatening refusals usually involving length of stay. and when one sticks to his guns you get it from the patient and utiilization review when the insurers refuse the extra hospital days. in my experience, i'm put in this situation much more often from private insurers than medicare/medicaid. and the private insurers are immune from liability in such cases by current law.. really, how could it be any more of a squeeze than this? and if refusal of certain care was within defined standards (as defined by the govt _ meaning teams of experts such as occurs in the uk) then the squeeze is gone. the safe harbor has been built. that level of care becomes what's anticipated and expected, customary and reasonable.

 

 

 

 

The sooner you realize this, bd, the better-off you'll be: Obamacare was designed to further squeeze the salaries of doctors. The problem is, those account for less than 15% of health care expenditures, yet Barry cut deals with the major players/deep pockets and that's why not only will nothing improve, it will get far worse. And again you're laboring under the false delusion that you'll make out on this whole deal, when the reality is your pay will be cut less than specialists' will.

 

i wouldn't be overly upset with this outcome.

 

 

 

 

 

 

p.s. I used to run the frat parties.

how cool!

[Rob's House]

what is it about life expectancy thats so difficult for you? sure, you could argue that those getting the best care in the us might live longer than cohorts in say, canada but you'd likely be wrong. and what about the life expectancy of a black male in the us? if i recall correctly it's about 62. the uninsured population of about 40-50 million?- don't think we have a number but i'll wager you 100 it's less than the avg for the entire population of japan.

 

so in this case, the universal care model is ascension, not regression to the mean. i would think anyone accepted to law school could understand that although i understand there are several schools with relatively low admission standards now.

I think you struggle with the concepts of correlation & causation.

[birdog1960]

I think you struggle with the concepts of correlation & causation.

i might appreciate your argument more if the us was 4th or 5th in the world but THIRTY FIRST? right down there with third world countries. regardless of the reasons, how can anyone deny that there is much wrong with our system?

[pBills]

Yeah, because frat parties are a excellent measure of how society in general conducts itself.

 

Keep pretending there is no correlation between life choices and financial reward. !@#$ing retard.

 

 

 

 

p.s. I used to run the frat parties.

 

 

Does that mean you spanked other guys with paddles?

[Rob's House]

i might appreciate your argument more if the us was 4th or 5th in the world but THIRTY FIRST? right down there with third world countries. regardless of the reasons, how can anyone deny that there is much wrong with our system?

That's like looking at a study that shows Prius owners tend to have lower electric bills and concluding that the car must be responsible for the difference without even considering other explanations, like the kind of people who would buy a hybrid are more likely to be into energy conservation in their home too.

[birdog1960]

That's like looking at a study that shows Prius owners tend to have lower electric bills and concluding that the car must be responsible for the difference without even considering other explanations, like the kind of people who would buy a hybrid are more likely to be into energy conservation in their home too.

no, it's like looking at reliability data for priuses and deciding to buy one because the data is good. then looking at jeeps and deciding to never buy one. there may be other reasons for differences in their holding value, requiring repairs and staying on the road but regardless, most people would be wise to buy the prius.

[DC Tom]

no, it's like looking at reliability data for priuses and deciding to buy one because the data is good. then looking at jeeps and deciding to never buy one. there may be other reasons for differences in their holding value, requiring repairs and staying on the road but regardless, most people would be wise to buy the prius.

 

It's more like looking at the mortality rate for the US and deciding to ascend to the mean by not eating at McDonalds three times a week.

 

 

 

You can't possibly be this ignorant about basic statistics and be an actual medical practicioner. What do you do, really? Homeopathic remedies? Touch therapist? You psychically adjust people's chi for them?

[birdog1960]

It's more like looking at the mortality rate for the US and deciding to ascend to the mean by not eating at McDonalds three times a week.

 

 

 

You can't possibly be this ignorant about basic statistics and be an actual medical practicioner. What do you do, really? Homeopathic remedies? Touch therapist? You psychically adjust people's chi for them?

i'm a board certified internist. the boards in which i recently recertified include a section on medical statistics. i did just fine in that section - things like positive predictive value, prevalence, measuring testing precision and accuracy, sensitivity and specificity. and i'm pretty sure the authors of the study on mortality that i'm referring to included a few statisticians. read the paper's conclusions. i'm sure you'll convince yourself they have an agenda.

[Booster4324]

i'm a board certified internist. the boards in which i recently recertified include a section on medical statistics. i did just fine in that section - things like positive predictive value, prevalence, measuring testing precision and accuracy, sensitivity and specificity. and i'm pretty sure the authors of the study on mortality that i'm referring to included a few statisticians. read the paper's conclusions. i'm sure you'll convince yourself they have an agenda.

 

To prevent confusion, I am going to say early on here, internist is not the same as intern.

[DC Tom]

i'm a board certified internist. the boards in which i recently recertified include a section on medical statistics. i did just fine in that section - things like positive predictive value, prevalence, measuring testing precision and accuracy, sensitivity and specificity. and i'm pretty sure the authors of the study on mortality that i'm referring to included a few statisticians. read the paper's conclusions. i'm sure you'll convince yourself they have an agenda.

 

When you say you're an internist, are you "speaking figuratively" again?

 

Because when you argue that, because the US is 31st in mortality statistics, yet first in health care spending, therefore the solution is government regulation and control of health care because "that's what the countries ahead of us do", and completely ignore such simple facts such as the number one cause of death in the US - cardiovascular disease - is almost directly lifestyle-related, one can only conclude that you have absolutely no clue what you're talking about, and no real ability to put together anything resembling a coherent thought. You'd do better arguing that the government should regulate what people eat - that would go much further towards reducing health care costs and increasing lifespan than regulating health care would.