walrus
Wind up workin' in a gas station
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
Ah, the so called death panel
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America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
- Thread starter moe24
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huskyfan
New member
mookie1995
there's a good buck in that racket.
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
i'd be cool with this if it was elected, like a school board.
i'd be cool with this if it was elected, like a school board.
ExileOnDaytonStreet
Drunkard
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
At least then you'd have a choice over who it is that's going to gouge you for substandard health care. Private health insurance won't be able to give you that.
At least then you'd have a choice over who it is that's going to gouge you for substandard health care. Private health insurance won't be able to give you that.
leswp1
New member
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
How bout that new recommendation re:mammograms. The 'evidence is weak and the studies they used as a basis(from what I am hearing initially) are not the most up to date. The beginning of trying to ration the resources and we don't have a bill to blame.
How bout that new recommendation re:mammograms. The 'evidence is weak and the studies they used as a basis(from what I am hearing initially) are not the most up to date. The beginning of trying to ration the resources and we don't have a bill to blame.
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
Exactly-just the government making the decision that they will not pay for these test in ages 40-49 or more than once every 2 years. This allows the insurance companies to follow suit. I wonder how any tumors will be either missed or allowed to grow for a couple years before discovery. A perfect example of rationing based solely on cost.
Exactly-just the government making the decision that they will not pay for these test in ages 40-49 or more than once every 2 years. This allows the insurance companies to follow suit. I wonder how any tumors will be either missed or allowed to grow for a couple years before discovery. A perfect example of rationing based solely on cost.
mookie1995
there's a good buck in that racket.
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
oh no no no. i want to be on the cmte that decides who dies and who lives.
oh no no no. i want to be on the cmte that decides who dies and who lives.
leswp1
New member
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
Oh no- the recommendation is to wait until 50. The most noxious and fatal lesions ar PRE_MENOPAUSAL!! GRR. My mother would be dead if this was the rule.
Oh no- the recommendation is to wait until 50. The most noxious and fatal lesions ar PRE_MENOPAUSAL!! GRR. My mother would be dead if this was the rule.
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
Les-That is what I was intimating. No more tests for ages 40-49 since the old rule was age 40. I personally know of numerous cases discovered in that age group that would have been in far more trouble.
Les-That is what I was intimating. No more tests for ages 40-49 since the old rule was age 40. I personally know of numerous cases discovered in that age group that would have been in far more trouble.
Patman
Rodent of Unusual Size
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
Les, it was in the stimulus bill. It was termed to better "advise" medical professionals on the "proper" decisions.
Les, it was in the stimulus bill. It was termed to better "advise" medical professionals on the "proper" decisions.
unofan
Well-known member
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
I'm not saying I agree with the government on this one, but anything the government recommends that involves postponing or delaying a test will be spun this way.
It won't matter if 999,999 out of every million people will either not be affected at all or even benefit from the lack of a false positive, the media will find that one person out of the million that had a true positive at the earlier age and shove it in the gov't's face and use it as proof that they should keep testing at the younger age.
To keep playing devil's advocate, even with breast cancer, why is the current standard 40? I'm sure there are women who get breast cancer in their 30's. Why didn't we recommend all 30 year olds get tested?
I'm not saying I agree with the government on this one, but anything the government recommends that involves postponing or delaying a test will be spun this way.
It won't matter if 999,999 out of every million people will either not be affected at all or even benefit from the lack of a false positive, the media will find that one person out of the million that had a true positive at the earlier age and shove it in the gov't's face and use it as proof that they should keep testing at the younger age.
To keep playing devil's advocate, even with breast cancer, why is the current standard 40? I'm sure there are women who get breast cancer in their 30's. Why didn't we recommend all 30 year olds get tested?
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ExileOnDaytonStreet
Drunkard
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
This mammogram thing is absurd, and alltogether counterproductive.
Regulation and government involvement should be done to prevent the insurance companies from slowly making us pay more for less health coverage, its not supposed to speed it up!
This mammogram thing is absurd, and alltogether counterproductive.
Regulation and government involvement should be done to prevent the insurance companies from slowly making us pay more for less health coverage, its not supposed to speed it up!
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
Govt involvement does not equate better care for less money. Removing the profit motive does not mean you lessen the cost of care, nor does it improve the care. Just under half of the hospitals in this country are listed as being not-for-profit. Has there ever been a statistical analysis done to see if they provide better or more efficient care than for-profit hospitals? Do they serve the public at cheaper prices?
In most markets, the profit motive has serves as a vehicle for organizations to reduce cost. They do this because people want their products for the cheapest prices available. If you find that the market-clearing price is $5, but it costs your org $6 to make the item, you'll either have to leave the market or find a way to make the product cheaper.
That principle left the health care industry as we removed the person receiving the service (the patient) from the direct payment for the service. Namely, we've introduced a third-party payer system through mandates, stating that insurance had to cover all sorts of things that were once paid for by the consumer. Prior to that, the individuals (or group policies) could purchase coverage that would only cover the catastrophic events only. That sort of health insurance was slowly regulated away by most states, until we pretty much have either the HMO or the PPO setups you see today.
Now when Bobby falls down and scrapes his knees, mommy isn't content at just slapping some Neosporin on the knee with a band-aid, it's conceivably a trip to urgent care or the emergency room. Why not? Mommy doesn't have to face the full brunt of the cost. So we see an increase in quantity demanded of health care services.
Obviously, the scraped knee is a bit of an exaggeration, but it's emblematic of why our health care system sees so much traffic, and why prices for services would go up so dramatically. Accordingly, the evil HMOs and PPOs had to step in and find a way to cut costs, so they do those things that les and DrDemento find so aggravating. I'm sure the insurance providers (it's not really insurance at this point, it's more of a pre-paid medical maintenance services contract) have made plenty of mistakes; they are ran by humans.
Now in steps the government, claiming to be the panacea to this issue, willing to take on all comers. What happens? Ask Massachusetts. It's amazing how much of a free good or service people will take - as much as it takes until their marginal utility becomes zero. What happens then? Guidelines are set in place to dictate what sorts of care will be covered, and in what fashion they will be covered, aka "govt rationing."
Markets ration through price - those willing and able to pay will get their services. Those providers will get their pay and in turn be able to actually provide the service. The other part to this is that those who can't pay often still get served, either through third party charities (the Shriner Hospitals, Ronald McDonald House, etc) or through directed discounts and philanthropy given directly by the provider.
It may not be a perfect system, some will still fall through the cracks. but it would be better than what we see currently, or what the government's set to offer. Hell, even the govt has announced that up to 30 million people will still not be covered in this universal health care system. How universal is that? And how's it better than what we already have? And why will it add over $1 trillion beyond what's already being spent annually? Do 10 million newly insured really cost $1 trillion/year? That's $100k/person/year. Ouch.
"You can wish in one hand and crap in the other, and see which one fills up first."
Govt involvement does not equate better care for less money. Removing the profit motive does not mean you lessen the cost of care, nor does it improve the care. Just under half of the hospitals in this country are listed as being not-for-profit. Has there ever been a statistical analysis done to see if they provide better or more efficient care than for-profit hospitals? Do they serve the public at cheaper prices?
In most markets, the profit motive has serves as a vehicle for organizations to reduce cost. They do this because people want their products for the cheapest prices available. If you find that the market-clearing price is $5, but it costs your org $6 to make the item, you'll either have to leave the market or find a way to make the product cheaper.
That principle left the health care industry as we removed the person receiving the service (the patient) from the direct payment for the service. Namely, we've introduced a third-party payer system through mandates, stating that insurance had to cover all sorts of things that were once paid for by the consumer. Prior to that, the individuals (or group policies) could purchase coverage that would only cover the catastrophic events only. That sort of health insurance was slowly regulated away by most states, until we pretty much have either the HMO or the PPO setups you see today.
Now when Bobby falls down and scrapes his knees, mommy isn't content at just slapping some Neosporin on the knee with a band-aid, it's conceivably a trip to urgent care or the emergency room. Why not? Mommy doesn't have to face the full brunt of the cost. So we see an increase in quantity demanded of health care services.
Obviously, the scraped knee is a bit of an exaggeration, but it's emblematic of why our health care system sees so much traffic, and why prices for services would go up so dramatically. Accordingly, the evil HMOs and PPOs had to step in and find a way to cut costs, so they do those things that les and DrDemento find so aggravating. I'm sure the insurance providers (it's not really insurance at this point, it's more of a pre-paid medical maintenance services contract) have made plenty of mistakes; they are ran by humans.
Now in steps the government, claiming to be the panacea to this issue, willing to take on all comers. What happens? Ask Massachusetts. It's amazing how much of a free good or service people will take - as much as it takes until their marginal utility becomes zero. What happens then? Guidelines are set in place to dictate what sorts of care will be covered, and in what fashion they will be covered, aka "govt rationing."
Markets ration through price - those willing and able to pay will get their services. Those providers will get their pay and in turn be able to actually provide the service. The other part to this is that those who can't pay often still get served, either through third party charities (the Shriner Hospitals, Ronald McDonald House, etc) or through directed discounts and philanthropy given directly by the provider.
It may not be a perfect system, some will still fall through the cracks. but it would be better than what we see currently, or what the government's set to offer. Hell, even the govt has announced that up to 30 million people will still not be covered in this universal health care system. How universal is that? And how's it better than what we already have? And why will it add over $1 trillion beyond what's already being spent annually? Do 10 million newly insured really cost $1 trillion/year? That's $100k/person/year. Ouch.
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
Every time I've seen teh $1T figure mentioned, it's been for costs over a 10-year period, not annually. Stilll, $10k per person per year is nothing to sneeze at, either.
leswp1
New member
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
well, you asked-
The current recommendation I go by (I think it is the American CA Society) is a baseline mammo at age 35 and then yearly mammos at age 40. A woman's breasts do not fully mature until about age 32 (I love that little factoid) and before 35 the breast tissue is very dense. Mammograms are more accurate if they have something to compare to. So you get the baseline and then compare subsequent mammos to it. The idea is not to wait until there is a 'lump', but to catch the subtle changes that occur when the cancer is developing. The most virulent (incorrect use of word) cancer is usually pre-menopausal. It is the fastest growing and the kind that is most likely to kill you if not caught early. Considering that the vast majority of breast CA is NOT hereditary how could you possibly stratify risk before age 50. As far as I know there is no absolute list of risk variables other than family history. There have been many postulated lists of risk but no definitive, evidence based ones.
If we have all these women with very nasy, involved cancers instead of the little lumpectomy kind the cost of treatment would be significantly higher and the risk of death for those women who would be caught later would be extremely high. The survival rate of women who get premenopausal breast CA that is caught on exam rather than mammo is not good which has been what has driven the push for earlier mammos. The deathrate from breast CA dropped correlated to the institution of early mammo (I remember seeing this in nursing school when they showed the graph of deaths from breast CA before and after screening was instituted). Pretty sure most countries with socialized medicine do not use the guideline they are proposing for us.
When I was watching yesterday the prominent breast CA researchers are howling about it being based on evidence garnered from studies in the 1970s when mammos were less accurate etc.
*I may be a bit biased, my grandmother died of premnopausal breast CA, my mother got it and lived because she got screened. I, for reasons you may imagine, pay pretty close attention to what ever they say about breast CA research.
Interestingly, there was a movement a few years ago to decrease mammos after 50 to a longer interval because those tended to be slower growing and treatment was less time sensitive.
well, you asked-
The current recommendation I go by (I think it is the American CA Society) is a baseline mammo at age 35 and then yearly mammos at age 40. A woman's breasts do not fully mature until about age 32 (I love that little factoid) and before 35 the breast tissue is very dense. Mammograms are more accurate if they have something to compare to. So you get the baseline and then compare subsequent mammos to it. The idea is not to wait until there is a 'lump', but to catch the subtle changes that occur when the cancer is developing. The most virulent (incorrect use of word) cancer is usually pre-menopausal. It is the fastest growing and the kind that is most likely to kill you if not caught early. Considering that the vast majority of breast CA is NOT hereditary how could you possibly stratify risk before age 50. As far as I know there is no absolute list of risk variables other than family history. There have been many postulated lists of risk but no definitive, evidence based ones.
If we have all these women with very nasy, involved cancers instead of the little lumpectomy kind the cost of treatment would be significantly higher and the risk of death for those women who would be caught later would be extremely high. The survival rate of women who get premenopausal breast CA that is caught on exam rather than mammo is not good which has been what has driven the push for earlier mammos. The deathrate from breast CA dropped correlated to the institution of early mammo (I remember seeing this in nursing school when they showed the graph of deaths from breast CA before and after screening was instituted). Pretty sure most countries with socialized medicine do not use the guideline they are proposing for us.
When I was watching yesterday the prominent breast CA researchers are howling about it being based on evidence garnered from studies in the 1970s when mammos were less accurate etc.
*I may be a bit biased, my grandmother died of premnopausal breast CA, my mother got it and lived because she got screened. I, for reasons you may imagine, pay pretty close attention to what ever they say about breast CA research.
Interestingly, there was a movement a few years ago to decrease mammos after 50 to a longer interval because those tended to be slower growing and treatment was less time sensitive.
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Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
Eloquently stated Les-add to this that one of the most aggressive breast tumors is the Phylloides type-which, you guessed it has peak incidence and potential for death in the age group 40-50. The government is wonderful at coming up with reasons that explain their actions but some of us in medicine still look at the facts.
Eloquently stated Les-add to this that one of the most aggressive breast tumors is the Phylloides type-which, you guessed it has peak incidence and potential for death in the age group 40-50. The government is wonderful at coming up with reasons that explain their actions but some of us in medicine still look at the facts.
leswp1
New member
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
A point that should be made, as I have heard this commission labelled as Obama's- This commission has been around for years. They were the ones that had recommended less mammos after 50 a few yrs ago. Pretty much make recommendations that cause controversy with almost every thing they recommend it seems. Supposedly evidence based medicine but not sure how they figure that.
The numbers I saw quoted today- deaths prevented 40-49--1:~1900(rough #, I can't recall exact #s) and 50+-- 1:~1400. Pretty arbitrary cut off for 500 people difference.
A point that should be made, as I have heard this commission labelled as Obama's- This commission has been around for years. They were the ones that had recommended less mammos after 50 a few yrs ago. Pretty much make recommendations that cause controversy with almost every thing they recommend it seems. Supposedly evidence based medicine but not sure how they figure that.
The numbers I saw quoted today- deaths prevented 40-49--1:~1900(rough #, I can't recall exact #s) and 50+-- 1:~1400. Pretty arbitrary cut off for 500 people difference.
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
I guess I will have to get used to these arbitrary cut offs in deciding who I can save.
I guess I will have to get used to these arbitrary cut offs in deciding who I can save.
unofan
Well-known member
Re: America's Affordable Health Choices Act of 2009 - Part 2 - Deathers vs. Commies
Right, cause there aren't any arbitrary cutoffs under the current system...
Right, cause there aren't any arbitrary cutoffs under the current system...
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