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The PPACA Thread Part III - Let's have a healthy debate!

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  • #76
    Re: The PPACA Thread Part III - Let's have a healthy debate!

    Originally posted by FlagDUDE08 View Post
    It's called a monopoly on ideas. Not sure if you work in any sort of creative outlet or not (I'm in SW development), but if you do, ever notice how ideas you would like to see implemented have to go up a chain of command? Basically the same thing with medical technology. With free range care, where there's no large hierarchial structure and simply a bunch of small entities with a small structure, you can try just about anything you want. Once you start adding that bureaucracy (whether government, commercial, or industrial), you have to go through so many hoops just to try something out. Not to mention, all the other things that are needed, such as FDA approvals (a buck says I get some wise guy turn-of-the-20th-century response about that), making sure it fits within the surprisingly tight confines of ACA "basic coverage" regulations...
    Yeah, there was no bureaucracy in health care before the ACA. You didn't need to get anything approved by the FDA.

    Do you ever have a moment of clarity where you realize that the things that have you so paranoid only exist in your overactive imagination?

    Comment

    • #77
      Re: The PPACA Thread Part III - Let's have a healthy debate!

      Originally posted by FlagDUDE08 View Post
      It's called a monopoly on ideas. Not sure if you work in any sort of creative outlet or not (I'm in SW development), but if you do, ever notice how ideas you would like to see implemented have to go up a chain of command? Basically the same thing with medical technology. With free range care, where there's no large hierarchial structure and simply a bunch of small entities with a small structure, you can try just about anything you want. Once you start adding that bureaucracy (whether government, commercial, or industrial), you have to go through so many hoops just to try something out. Not to mention, all the other things that are needed, such as FDA approvals (a buck says I get some wise guy turn-of-the-20th-century response about that), making sure it fits within the surprisingly tight confines of ACA "basic coverage" regulations...
      As I personally see the steady march of new technology into medicine, I really would have to see some numbers that suggest that the most promising medical technology is being suppressed.

      For a near meaningless anecdote (because hey, I really dislike most of 'em), in the OR today I saw not one, but two novel technologies being implemented. And this is far from an extraordinary day.
      In the immortal words of Jean Paul Sartre, 'Au revoir, gopher'.

      Originally posted by burd
      I look at some people and I just know they do it doggy style. No way they're getting close to my kids.

      Comment

      • #78
        Originally posted by Rover View Post
        I'm brilliant AND I went to a name college, so there's that.
        I thought you went to bu?
        Originally posted by mookie1995
        bc is superior to bu in nearly everything. while it is sad that it has come to it, it's the truth. if bu doesn't like it, improve.
        Rep from Hokydad -"and your an old never been piece of ****"

        Originally Posted by Dirty
        Why is anyone surprised that Old Pio is acting like a grumpy old f^ck? He is a grumpy old f^ck.

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        • #79
          Re: The PPACA Thread Part III - Let's have a healthy debate!

          Originally posted by WisconsinWildcard View Post
          As I personally see the steady march of new technology into medicine, I really would have to see some numbers that suggest that the most promising medical technology is being suppressed.
          I don't think any (sane) person has suggested that technology has been "suppressed." The concern was that our vibrant culture of innovation might stagnate under a centralized command-and-control structure compared to a decentralized entrepreneurial one (the kind that has produced so much of that "steady march of new technology" to which you referred and which has amazed me as well).

          Was it Surowiecki in The Wisdom of Crowds who wrote "while one person might be smarter than anyone else, that person can never be smarter than everyone else" or something like that? Bureaucrats will never produce better results by fiat than a free market will by curiosity and continuous innovation. No one innovates without some kind of incentive to do so, especially if they are punished for "breaking the rules" if they try.
          "Hope is a good thing; maybe the best of things."

          "Beer is a sign that God loves us and wants us to be happy." -- Benjamin Franklin

          "Being Irish, he had an abiding sense of tragedy, which sustained him through temporary periods of joy." -- W. B. Yeats

          "People generally are most impatient with those flaws in others about which they are most ashamed of in themselves." - folk wisdom

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          • #80
            Re: The PPACA Thread Part III - Let's have a healthy debate!

            Originally posted by FreshFish View Post
            The concern was that our vibrant culture of innovation might stagnate under a centralized command-and-control structure compared to a decentralized entrepreneurial one (the kind that has produced so much of that "steady march of new technology" to which you referred and which has amazed me as well).
            Oh, I see that now you're merely concerned () that innovation might stagnate. Before, you had declared that the PPACA is stifling innovation. It's always nice when someone who demands a bit of authority on the subject forces you guys to walk back your BS.

            Comment

            • #81
              Re: The PPACA Thread Part III - Let's have a healthy debate!

              Originally posted by FreshFish View Post
              I don't think any (sane) person has suggested that technology has been "suppressed." The concern was that our vibrant culture of innovation might stagnate under a centralized command-and-control structure compared to a decentralized entrepreneurial one (the kind that has produced so much of that "steady march of new technology" to which you referred and which has amazed me as well).

              Was it Surowiecki in The Wisdom of Crowds who wrote "while one person might be smarter than anyone else, that person can never be smarter than everyone else" or something like that? Bureaucrats will never produce better results by fiat than a free market will by curiosity and continuous innovation. No one innovates without some kind of incentive to do so, especially if they are punished for "breaking the rules" if they try.
              I am just trying to be a bit pragmatic about this. I would argue that if the data behind a device or treatment is strong enough, bureaucracy does not pose a significant burden. I often find those entrepreneurs with weaker data are often the most vocal critics of the FDA. But then again, they have their shareholders to answer to, not ethics or patients.

              I would also argue that if anything, we should be more stringent moving forward towards approval. Most of the low hanging fruit of modern medicine have been consumed so I think it is reasonable to expect a bit more information into the safety profile before approval. For instance, one would have to clearly demonstrate advantages of a new statin since the ones on the market already have a proven benefit and a well known safety profile. Because of this, the threshold of "you need to be so tall to ride this ride" for new statins should be higher.
              In the immortal words of Jean Paul Sartre, 'Au revoir, gopher'.

              Originally posted by burd
              I look at some people and I just know they do it doggy style. No way they're getting close to my kids.

              Comment

              • #82
                Re: The PPACA Thread Part III - Let's have a healthy debate!

                Originally posted by FreshFish View Post
                one of the biggest problems with PPACA is that it freezes technology into a static model and stifles innovation because of the centralized command-and-control structure.
                Originally posted by FreshFish View Post
                I don't think any (sane) person has suggested that technology has been "suppressed."
                Well, you're right...no sane person has suggested it...

                Comment

                • #83
                  Re: The PPACA Thread Part III - Let's have a healthy debate!

                  An anecdote (I know, I know) that people should look into is the NovoTTF-100A for treatment of GBM. I think it may serve well as a case study for the topic at hand.

                  http://www.fda.gov/MedicalDevices/Pr.../ucm254480.htm

                  It was approved in stages throughout the ACA rollout. It is very expensive (around $20,000 a month) but is able to extend the life of a very untreatable disease (according to best data at this point). It is not covered by insurance automatically but physicians at our institution have had relatively minimal trouble getting it approved for those patients that it should benefit.

                  We had a very good discussion at a recent grand rounds regarding the role of the FDA, company, insurance, hospital, physician, and patient throughout the whole process.
                  In the immortal words of Jean Paul Sartre, 'Au revoir, gopher'.

                  Originally posted by burd
                  I look at some people and I just know they do it doggy style. No way they're getting close to my kids.

                  Comment

                  • #84
                    Re: The PPACA Thread Part III - Let's have a healthy debate!

                    Originally posted by WisconsinWildcard View Post
                    As I personally see the steady march of new technology into medicine, I really would have to see some numbers that suggest that the most promising medical technology is being suppressed.

                    For a near meaningless anecdote (because hey, I really dislike most of 'em), in the OR today I saw not one, but two novel technologies being implemented. And this is far from an extraordinary day.
                    How about dangerous psychedelics being FDA approved, but natural effective cures, such as plants, are being outlawed?

                    Comment

                    • #85
                      Re: The PPACA Thread Part III - Let's have a healthy debate!

                      Originally posted by FlagDUDE08 View Post
                      How about dangerous psychedelics being FDA approved, but natural effective cures, such as plants, are being outlawed?
                      From about the two-minute mark until the four-minute mark, you're Storm.

                      https://www.youtube.com/watch?v=HhGu...=RDHhGuXCuDb1U
                      "The party told you to reject the evidence of your eyes and ears. It was their final, most essential command." George Orwell, 1984

                      "One does not simply walk into Mordor. Its Black Gates are guarded by more than just Orcs. There is evil there that does not sleep, and the Great Eye is ever watchful. It is a barren wasteland, riddled with fire and ash and dust, the very air you breathe is a poisonous fume." Boromir

                      "Good news! We have a delivery." Professor Farnsworth

                      Comment

                      • #86
                        Re: The PPACA Thread Part III - Let's have a healthy debate!

                        Originally posted by Priceless View Post
                        Well, you're right...no sane person has suggested it...
                        I see what you did there.
                        Cornell University
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                        • #87
                          Re: The PPACA Thread Part III - Let's have a healthy debate!

                          Originally posted by WisconsinWildcard View Post
                          An anecdote (I know, I know) that people should look into is the NovoTTF-100A for treatment of GBM. I think it may serve well as a case study for the topic at hand.

                          http://www.fda.gov/MedicalDevices/Pr.../ucm254480.htm

                          It was approved in stages throughout the ACA rollout. It is very expensive (around $20,000 a month) but is able to extend the life of a very untreatable disease (according to best data at this point). It is not covered by insurance automatically but physicians at our institution have had relatively minimal trouble getting it approved for those patients that it should benefit.

                          We had a very good discussion at a recent grand rounds regarding the role of the FDA, company, insurance, hospital, physician, and patient throughout the whole process.
                          Thanks for the link-fascinating. Would of course like it even better if the cost for treatment was well below that number but as usual my biggest concern is addressed, doing what is in the best interest of the patient to relieve or lengthen life.
                          Take the shortest distance to the puck and arrive in ill humor

                          Comment

                          • #88
                            Re: The PPACA Thread Part III - Let's have a healthy debate!

                            Oh right, because PPACA is SOOOOOO affordable.

                            Here's some real numbers from citizens, not just some averages to make the left look good. http://twitchy.com/2015/03/22/insani...s-devastating/

                            Comment

                            • #89
                              Re: The PPACA Thread Part III - Let's have a healthy debate!

                              Originally posted by FlagDUDE08 View Post
                              Oh right, because PPACA is SOOOOOO affordable.

                              Here's some real numbers from citizens, not just some averages to make the left look good. http://twitchy.com/2015/03/22/insani...s-devastating/
                              Definitely a website for the haven't been laid in awhile conservative crowd! I like the discussion of whether Obama is the anti-Christ or merely one of his top agents.
                              Legally drunk???? If its "legal", what's the ------- problem?!? - George Carlin

                              Ever notice how everybody who drives slower than you is an idiot, and everybody who drives faster is a maniac? - George Carlin

                              "I've never seen so much reason and bullsh*t contained in ONE MAN."

                              Comment

                              • #90
                                Re: The PPACA Thread Part III - Let's have a healthy debate!

                                Rover you really make some of the most childish remarks on this site. Really pathetic.
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