Healthcare better worse or same

[Joe Ferguson forever]

16 minutes ago, SoCal Deek said:

Thanks. Who would negotiate the drug prices? I've considered drug prices to be somewhat of a side issue to the core healthcare debate. My personal opinion is that we are way, way over-medicated.

The federal government. A national formulary like the VA and Medicaid use. Preferred drugs would be very inexpensive. Non preferred would be expensive but used at the discretion of the patients and doctors. Market forces would push even these prices down

35 minutes ago, B-Man said:

 

 

As a Registered Nurse for over 40 years I can tell you it is (unfortunately) worse.

 

Medications and diagnostics have improved, but the care a person receives is much worse.

 

I would recommend to anyone that has a loved one in the hospital to have someone stay with them to advocate.

 

 

.

Or get a concierge Doc to do it for u. In this model, the patients are the shareholders as they should be universally 

Edited March 2, 2023 by redtail hawk

[US Egg]

6 minutes ago, Tiberius said:

more people covered by insurance, you know, the obvious thing 

No, I don’t know, but, it is true,  more people are covered, OK, let’s start with that.

 

I am now on Medicare, and being treated for my annoyances that we’re covered previously not by Medicare.

 

My last two hospital stays, I was given the bums rush out the door to deal with post care. Before Medicare, in hospital post care was  thorough, on Medicare, I had to venture out, while still ailing with post op issues. That and other things, made it a dog chasing its tail post treatment.

 

If that, to you, legitimizes blowing smoke up those you believe who are now properly leading the way to care for all, then there’s nothing I could further add to maybe make you reconsider “more are better” with the changes made by your favorite folks leading the way.

[Joe Ferguson forever]

6 minutes ago, I am the egg man said:

No, I don’t know, but, it is true,  more people are covered, OK, let’s start with that.

 

I am now on Medicare, and being treated for my annoyances that we’re covered previously not by Medicare.

 

My last two hospital stays, I was given the bums rush out the door to deal with post care. Before Medicare, in hospital post care was  thorough, on Medicare, I had to venture out, while still ailing with post op issues. That and other things, made it a dog chasing its tail post treatment.

 

If that, to you, legitimizes blowing smoke up those you believe who are now properly leading the way to care for all, then there’s nothing I could further add to maybe make you reconsider “more are better” with the changes made by your favorite folks leading the way.

My experience with peer to peer review with length of stay issues was almost always more positive with Medicare than from private insurers. Would it surprise you to know I got a reprimand from an insurer for telling an insurance peer to F off?  Went right in my circular file. More importantly, I kept the patient in house and insurance ended up paying 

Edited March 2, 2023 by redtail hawk

[US Egg]

3 minutes ago, redtail hawk said:

My experience with peer to peer review with length of stay issues was almost always more positive with Medicare than from private insurers. Would it surprise you to know I got a reprimand from an insurer for telling an insurance peer to F off?  Went right in my circular file. More importantly, I kept the patient in house and insurance ended up paying 

Consider yourself fortunate. Are you implying my pov is BS?

[Joe Ferguson forever]

2 minutes ago, I am the egg man said:

Consider yourself fortunate. Are you implying my pov is BS?

Why fortunate?  And no, I’m giving u my pov. I found this usually worked:”  I’m letting Mrs Smith know that you want her out despite my strong recs against it and rec she make a direct appeal to you”

Edited March 2, 2023 by redtail hawk

[Tiberius]

12 minutes ago, I am the egg man said:

No, I don’t know, but, it is true,  more people are covered, OK, let’s start with that.

 

I am now on Medicare, and being treated for my annoyances that we’re covered previously not by Medicare.

 

My last two hospital stays, I was given the bums rush out the door to deal with post care. Before Medicare, in hospital post care was  thorough, on Medicare, I had to venture out, while still ailing with post op issues. That and other things, made it a dog chasing its tail post treatment.

 

If that, to you, legitimizes blowing smoke up those you believe who are now properly leading the way to care for all, then there’s nothing I could further add to maybe make you reconsider “more are better” with the changes made by your favorite folks leading the way.

My neighbor had cancer and no insurance until Obamacare came along and now she is fully recovered. 

 

Obamacare saves lives 

[leh-nerd skin-erd]

1 hour ago, SoCal Deek said:

Well if insolvency is real, then you can’t stay ahead of the bill collector forever. Someone must have a plan. I’ve often wondered whether at some point the cost simply outpaces American’s ability to pay for it, and the seemingly unlimited level of care rapidly declines. Let’s face it, our standard of care looks nothing like what it did just a few decades ago. When you see a photo of hospital back then, it was pretty much just a bed and a nurse standing by.

I think insolvency for the average American is real, for most businesses it real, for the federal/state government it’s business as usual.  
 

I agree on the standard of care though.  

[US Egg]

9 minutes ago, redtail hawk said:

Why fortunate?  And no, I’m giving u my pov. I found this usually worked:”  I’m letting Mrs Smith know that you want her out despite my strong recs against it and rec she make a direct appeal to you”

Again, glad you’re are happy with the care now offered by Uncle Sam. I to, am glad that this country has, in spite of the maladies of the times, able to confront health woes for its growing constituents.

11 minutes ago, Tiberius said:

My neighbor had cancer and no insurance until Obamacare came along and now she is fully recovered. 

 

Obamacare saves lives 

Glad to hear your neighbor is fully recovered from cancer.

 

My wife went through a cancer bout, ‘17-‘20, I can’t compare it as a then and now health care issue and hoping I never do.

 

I only have my comparable issues, which I previously cited.

 

 

[T&C]

1 hour ago, Tiberius said:

more people covered by insurance, you know, the obvious thing 

Obama care is backwards. People who make less pay more and those who make above a certain number pay nothing. That above number is low too, like 30k a year.

[Over 29 years of fanhood]

12 hours ago, redtail hawk said:

Corporate medicine has destroyed quality.  You're probably more likely to see a mid level than an MD in an ER or primary care office.  Then get referred all over the place for simple stuff that they should be able to take care of.  And tested to bankruptcy cuz tests are a money maker and the way they now usually make diagnoses.  Oh, and your "provider" might look up from the keyboard once or twice in a visit.  What do I know?...I'm a dinosaur.

yeah and the primary care physician gatekeepers have been just less and less impressive through the years. The specialization it’s like a union shop. 
 

It’s not just that it is corporate medicine… it’s also this halfway house idea where it’s kinda government and kinda of corporate. And the AMA is a cartel. That’s just a fact. 
 

So it’s all the downside of capitalism (profiteering, treatment vs cure, collusion, cost cutting) and all the downside of government bureaucracy (inefficient, no customer service, bloated monopolistic pricing) 

Little to none of the upside for either 

[\GoBillsInDallas/]

2 hours ago, B-Man said:

As a Registered Nurse for over 40 years

 

 

[Tommy Callahan]

All I know is its an effing shame one pays 30G for a decent plan in a high cost state like NY.  only to have to spend thousands more if they have to use it.

 

 

 

 

[Joe Ferguson forever]

23 minutes ago, Over 29 years of fanhood said:

yeah and the primary care physician gatekeepers have been just less and less impressive through the years. The specialization it’s like a union shop. 
 

It’s not just that it is corporate medicine… it’s also this halfway house idea where it’s kinda government and kinda of corporate. And the AMA is a cartel. That’s just a fact. 
 

So it’s all the downside of capitalism (profiteering, treatment vs cure, collusion, cost cutting) and all the downside of government bureaucracy (inefficient, no customer service, bloated monopolistic pricing) 

Little to none of the upside for either 

Partly because pay disparity is crazy between specialists and generalists and doesn't attract kids with 6 figure debt.  So much less well equipped (was gonna say ill equipped but I've known some good ones) are filling the void at less than 1/2 the salary.   It actually takes a vast knowledge base to be a good primary care doc.  Alternatively, they can refer everything more than a cold (and try to leave an urgent care or teledoc session without an antibiotic even tho the most like dx is viral - don't want to pi$$ off the pt telling him the truth and it takes longer to explain)).  I have hematologist friend that told me most of his referrals are for "anemia" with no or little prior work up

 

Not been a member of the AMA since automatic, free membership in med school.  I'm not sure who they represent but no where near as much clout as the hospital systems, insurance giants and big pharma

Edited March 2, 2023 by redtail hawk

[Over 29 years of fanhood]

21 minutes ago, redtail hawk said:

Partly because pay disparity is crazy between specialists and generalists and doesn't attract kids with 6 figure debt.  So much less well equipped (was gonna say ill equipped but I've known some good ones) are filling the void at less than 1/2 the salary.   It actually takes a vast knowledge base to be a good primary care doc.  Alternatively, they can refer everything more than a cold (and try to leave an urgent care or teledoc session without an antibiotic even tho the most like dx is viral - don't want to pi$$ off the pt telling him the truth and it takes longer to explain)).  I have hematologist friend that told me most of his referrals are for "anemia" with no or little prior work up

 

Not been a member of the AMA since automatic, free membership in med school.  I'm not sure who they represent but no where near as much clout as the hospital systems, insurance giants and big pharma

They control the supply of physicians right? 
 

I agree the problems are numerous.

 

many years ago I interviewed at a medical device company. Ended up going a different way but one of the things that caught me during my interview prep was their marketing budget exceeded their R&D budget.  I ask why and got some weaselly answers about training seminars. But it turned out these were really just all expense paid mega vacations for doctors and regulators to encourage them to push the products.

 

they were just priming the distribution channels. 
 

Same way big pharma will tell you drug prices are high to fund R&D. But how much do they spend on these high end commercial campaigns? I see 1-2 drug commercials per break when watch network TV. 
 

This seems newer as well. I don’t remember this kind of thing 20 years ago. 

[Joe Ferguson forever]

6 minutes ago, Over 29 years of fanhood said:

They control the supply of physicians right? 
 

 

They actual;ly don't.  I believe the American Assoc of Medical colleges does.  on my way out or I'd look

[leh-nerd skin-erd]

9 hours ago, redtail hawk said:

Why fortunate?  And no, I’m giving u my pov. I found this usually worked:”  I’m letting Mrs Smith know that you want her out despite my strong recs against it and rec she make a direct appeal to you”

Interesting, though we’ve been through some challenging times recently.  A loved one was admitted to a hospital due to internal bleeding.  The doc ordered a colonoscopy, prep was completed including an awful lot of cajoling to drink the large volume of swill required for prep.  Appointment time for early the next day comes and goes, and goes until ultimately it’s discovered the appointment was never scheduled.  
 

It makes you wonder…if you’ve got internal bleeding (passed out in his Internist’s office), and a colonoscopy gets f’d up, what about all the little things missed collectively in a large hospital? 
 

Flip side, to be fair, a leaking aortic aneurysm was discovered and some amazing medical personnel saved his life a few years back.  
 

 

 

[leh-nerd skin-erd]

1 minute ago, redtail hawk said:

yup, my mother in law had a scope in the UK.  found 3 abnormalities which i questioned.  Biopsies inconclusive.  Died less than a year after from brain mets.  Marcus Welby is dead worldwide.  I hate it.

Sorry to hear about your m-I-l, my amazing, wonderful, sweet, crazy and delightfully loyal mother-in-law is dealing with dementia and that’s been no picnic with the medical professionals.  At some points it seems you have to walk on egg shells to get a favorable result.  She ran out of meds at one point (lots going on in the hh, confusion between caregivers and her hubby/children) and my wife called to beg for a new supply.  After a couple “she’s gotta come in, see you in 90 days” and surly staff members, she was able to get a short term supply and an earlier appointment.  
 

Again, to be fair, others have been great. 
 

With your mother-in-law, though, was it incompetence or just pure bad luck the cancer was missed? 

[T master]

The "Affordable Health Care act" fixed all of our problems that was a great accomplishment for the President FREE HEALTH CARE FOR EVERY BODY YES FREE !! 

 

To bad every body else health care that actually has to pay for stout of their personal checking account each month has to pay double so the others can get their "Free Healthcare" Isn't it a wonderful thing the "AFFORDABLE Healthcare Act" ...

[Precision]

I think the topic question, "Is healthcare better, worse, or the same?" depends on your economic and personal circumstance.

 

My family has a good plan which has comprehensive coverage but is costly.  Some might argue we pay too much but weighing the importance of healthcare, our income and other expenses I feel it is acceptable. 

 

I feel the personal circumstance is on individuals to be an advocate for themselves/families when navigating insurance and the healthcare system.  Insurance companies are businesses, and their goal is to reduce costs.  Just like you wouldn't pay MSRP for a vehicle you should be prepared to fight to get the healthcare you deserve.  If you are not satisfied with a doctor or diagnosis you need to be able to stand up for yourself.  I live in NH but see a specialist who practices in MA and is a clinical instructor at Harvard Medical School.  Our insurance didn't want to provide that referral, but I was a PITA and made it happen.

 

To answer the question, I think medical technology has improved, individuals with money and willpower can receive better care than any time in history.  For the majority of the middle class, I feel it has gotten worse.  I don't have experience here, but I believe things may have improved for lower wage earners/ACA recipients. 

[B-Man]

 

 

EVERYTHING IS GOING SWIMMINGLY: 

 

Staffing shortage in healthcare affecting more Americans.

 

https://www.upi.com/Health_News/2023/03/10/healthcare-understaffing-worries-Americans/3091678456942/

 

 

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