The Thread Where We Debate About Healthcare in America

#527
#527
Supreme Court rules government must pay insurers enrolled in ObamaCare program

The Supreme Court ruled in an 8-1 decision Monday that the federal government must pay out $12 billion to insurers who had enrolled in the Affordable Care Act's "risk corridor" program, reversing a lower court's decision that had left Washington off the hook.

The program limited both profits and losses for insurance companies that offered plans through the online exchange created by the Affordable Care Act – commonly known as ObamaCare – by having certain profits go to the Department of Health and Human Services, which in turn would give money to plans that did not bring in profits. The result was the government owing over $12 billion more than was brought in.

Supreme Court rules government must pay insurers enrolled in ObamaCare program
 
#528
#528
0nelilreb said:
Is that better quality to you ? You are talking about vastly different cultures , societies , populations between the so called “ comparable “ countries . Again is health care too expensive ? Of course it is . Would you choose to have your procedure done outside the US just for the cost difference and knowing the quality is better here ? You’d be an idiot to . I support your free will to do that though . Unlike you , I really mean it when I say splash the gene pool with some bleach . 🤷‍♂️
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The quality isn't better here, that's the point. You picked statistically insignificant areas in which to plant your flag, while ignoring the areas where the United States lags and in some cases very significantly. Does having a higher mortality rate sound 'better' to you?
 
#529
#529
Purple Tiger said:
Profit taking is the #1 reason.
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Supreme Court rules government must pay billions to Obamacare insurers

The 8-1 decision could open the floodgates for federal cash to the insurance industry. Insurers who accused the government of a “bait and switch” claimed they’re owed $12 billion from the Affordable Care Act program. Justice Samuel Alito, in a dissenting opinion, criticized the ruling as effectively providing a massive bailout for the insurance industry.
 
#530
#530
C-south said:
Maybe but I’m not sure. I’m sure they’ve did something to change that too for the people who utilize it for maintenance drugs.
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Optum Rx is the big one, they mail Rx's at set intervals and it's close to wholesale pricing. Of course your insurance will only pay for what's on the carriers formulary as with any other provider.
 
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#531
#531
OHvol40 said:
The “waiting period” narrative is false. The narrative that major surgery outcomes are better is generally false. Each country has its own strengths and weaknesses, but we pay double and don’t receive double the benefit. Don’t believe me on any of it? Check for yourself...
How does the quality of the U.S. healthcare system compare to other countries? - Peterson-Kaiser Health System Tracker
Click to expand...
From your article.

Who is as large as us?
Bench-marking U.S. quality measures against those of similarly large and wealthy countries is one
Click to expand...

All of the links charts fail for the same reason, they picked 11 of the best in the world just to say the US is the worst. And it also hides behind averaging the best of others to beat the US. If you average my 40 time with UTs track team I am sure we are faster than you.

It also assumes that our higher YLL and DALY is a health care issue first. Instead of looking at the demographics and seeing that we are a bunch of fat arses. That's coming from a former 350lb fat arse himself. The obesity factor never gets mentioned as to being part of the why, it's apparently just a failing of our health care that out doctors deal with a worse base than the others. You know instead of it being a problem with the people like me who dont live as healthy as our European neighbors.

How is our admittance rate, being higher, a failure? Seems like its saying we deal with more issues. Again it's not hard to be behind our nations when you drop personal responsibility at the feet of our health care.

The next chart says we are better when it comes to 30 day after heart attacks. By a significant margin, 4.2 vs 6.9. They are 50% worse than us. We can quibble on us being 5_10_20% worse but that seems to stand out.

The next on medical errors seems like a straight forward loss. But I am curious why this is one of the few where they didnt talk about trends in the US vs the competition.

Post op stuff in the next couple are wins for the US. 23%, and 2%. Seems within the margin of error, but we have given some of those to Europe so it seems fair to claim.

Suture breaks is interesting. I know when it has happened to me it was self inflicted, but anecdotal aside it seems we are behind there. I just find it hard to blame health care for this.

I dont know anything about the OBGYN stuff to comment beyond the chart, we are middle of the pack at worst in one category and best in the other. Not a loss or a win for the US.

Cancers is a win for US. Everyone is improving but we are better.

Circulatory is a "loss" because we havent improved as much as the rest 59% vs 66%. This is enough outside the MoE to be counted, but I am not ashamed by single digit losses. Again especially when it comes to something that is a manageable outside of healthcare and we the people fail there.

Respiratory is the biggest loss I have seen ~38%. I would be interested to see more on this as it seems like an obvious weakness.

The nutritional deaths is another oddity in the methodology that stood out. They suddenly expanded out to include our biggest spike, and just say overall our numbers are up from 35 years ago, but down say we are WAY down from 20 years ago.

This was a common problem I saw throughout. They switched between pure numbers, to rates, to trends, and even time periods, depending on whichever generally made the US not look as good. I would appreciate the stastics more if they kept the same metric.

Getting care we are in the pack, not considering that a loss. We are closer to the average than the bottom (6 vs 8). And imo they were a bit funny in what they are reporting in people who needed to see a doctor actually being able to make an appointment. Doesnt say why, availability of the doctor vs availability of the patient. I cant blame healthcare for lifestyles, I know I tend to get sick only when things are hectic, stress. And I assume the considers all the uninsured in the US, that had to hurt our average.

Non emergency ER uses seems like a strange flex to me. I guess they are saying it's bad because they couldnt go to see their PCP trying back to the previous? Again like the above I would be interested in the why here to say if it's on healthcare or the people.

So overall I came out of that feeling better about our healthcare than I did from just reading your posts. And that's with all the slanted metrics I brought up before. And this still ignores that they literally used the US as the cut off to make these comparisons.

There were 18 charts. IMO, based on the charts we were better 6 times, 2 were "irrelevant" imo of which is worse. Appointments, ER usage. 2 assumed dietary problems are healthcare issues, YLL and DALY. So that leaves 8 losses by my count. And some of those losses we were just worse than the average and not "the worst of the top 11".

If we go 6 vs 8 against the averaged best of the healthcare world I consider that a good thing. And hardly something we need to tear down the system for.

All this article did was streghten points I had made earlier on hearts and cancer, and sniffles. I definitely didnt take away that we HAD to make a change from this article. Room for improvement, always. Abandoning the system not at all.
 
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#532
#532
0nelilreb said:
Ok so we are going to ignore the ..30 day post op mortality rate for heart attacks and stokes being lower , the mortality rates for cancer being lower , the post op sepsis rate and the post op blood clot rates both being lower when talking about quality of health care in the US vs other comparable countries ?
Click to expand...

We are very good at prophylaxis for DVT and post-op infection. You are still going to pay more than double for your pre-op ancef/vanco, SCDs, surgical prep, suture, implantables, anesthesia, surgical packs, instrument processing, and skilled labor service. Still, we have a higher mortality rate.
 
#533
#533
Septic said:
The quality isn't better here, that's the point. You picked statistically insignificant areas in which to plant your flag, while ignoring the areas where the United States lags and in some cases very significantly. Does having a higher mortality rate sound 'better' to you?
Click to expand...

It’s insignificant to bean counters , politicians and lawyers . It’s not insignificant to the people making up those categories. “ compatible countries “ is a joke to start with and I listed just some of the reasons why .
 
#534
#534
OHvol40 said:
We are very good at prophylaxis for DVT and post-op infection. You are still going to pay more than double for your pre-op ancef/vanco, SCDs, surgical prep, suture, implantables, anesthesia, surgical packs, instrument processing, and skilled labor service. Still, we have a higher mortality rate.
Click to expand...

To “Compatible “ countries . Smh
 
#535
#535
LouderVol said:
From your article.

Who is as large as us?

All of the links charts fail for the same reason, they picked 11 of the best in the world just to say the US is the worst. And it also hides behind averaging the best of others to beat the US. If you average my 40 time with UTs track team I am sure we are faster than you.

It also assumes that our higher YLL and DALY is a health care issue first. Instead of looking at the demographics and seeing that we are a bunch of fat arses. That's coming from a former 350lb fat arse himself. The obesity factor never gets mentioned as to being part of the why, it's apparently just a failing of our health care that out doctors deal with a worse base than the others. You know instead of it being a problem with the people like me who dont live as healthy as our European neighbors.

How is our admittance rate, being higher, a failure? Seems like its saying we deal with more issues. Again it's not hard to be behind our nations when you drop personal responsibility at the feet of our health care.

The next chart says we are better when it comes to 30 day after heart attacks. By a significant margin, 4.2 vs 6.9. They are 50% worse than us. We can quibble on us being 5_10_20% worse but that seems to stand out.

The next on medical errors seems like a straight forward loss. But I am curious why this is one of the few where they didnt talk about trends in the US vs the competition.

Post op stuff in the next couple are wins for the US. 23%, and 2%. Seems within the margin of error, but we have given some of those to Europe so it seems fair to claim.

Suture breaks is interesting. I know when it has happened to me it was self inflicted, but anecdotal aside it seems we are behind there. I just find it hard to blame health care for this.

I dont know anything about the OBGYN stuff to comment beyond the chart, we are middle of the pack at worst in one category and best in the other. Not a loss or a win for the US.

Cancers is a win for US. Everyone is improving but we are better.

Circulatory is a "loss" because we havent improved as much as the rest 59% vs 66%. This is enough outside the MoE to be counted, but I am not ashamed by single digit losses. Again especially when it comes to something that is a manageable outside of healthcare and we the people fail there.

Respiratory is the biggest loss I have seen ~38%. I would be interested to see more on this as it seems like an obvious weakness.

The nutritional deaths is another oddity in the methodology that stood out. They suddenly expanded out to include our biggest spike, and just say overall our numbers are up from 35 years ago, but down say we are WAY down from 20 years ago.

This was a common problem I saw throughout. They switched between pure numbers, to rates, to trends, and even time periods, depending on whichever generally made the US not look as good. I would appreciate the stastics more if they kept the same metric.

Getting care we are in the pack, not considering that a loss. We are closer to the average than the bottom (6 vs 8). And imo they were a bit funny in what they are reporting in people who needed to see a doctor actually being able to make an appointment. Doesnt say why, availability of the doctor vs availability of the patient. I cant blame healthcare for lifestyles, I know I tend to get sick only when things are hectic, stress. And I assume the considers all the uninsured in the US, that had to hurt our average.

Non emergency ER uses seems like a strange flex to me. I guess they are saying it's bad because they couldnt go to see their PCP trying back to the previous? Again like the above I would be interested in the why here to say if it's on healthcare or the people.

So overall I came out of that feeling better about our healthcare than I did from just reading your posts. And that's with all the slanted metrics I brought up before. And this still ignores that they literally used the US as the cut off to make these comparisons.

There were 18 charts. IMO, based on the charts we were better 6 times, 2 were "irrelevant" imo of which is worse. Appointments, ER usage. 2 assumed dietary problems are healthcare issues, YLL and DALY. So that leaves 8 losses by my count. And some of those losses we were just worse than the average and not "the worst of the top 11".

If we go 6 vs 8 against the averaged best of the healthcare world I consider that a good thing. And hardly something we need to tear down the system for.

All this article did was streghten points I had made earlier on hearts and cancer, and sniffles. I definitely didnt take away that we HAD to make a change from this article. Room for improvement, always. Abandoning the system not at all.
Click to expand...

You know it’s weird, I’m genuinely trying to have a substantive conversation about healthcare so I posted information without bias or slant. I think your first problem is that is exactly what you look for.

The point is that every healthcare system has strengths and room for improvement, but only one charges double.
 
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#537
#537
OHvol40 said:
I know, it’s sad. We’re getting ripped off.
Click to expand...

Sure we are . I never have thought we weren’t . All insurance and health care prices are extremely over priced. Throw in big pharmaceutical and I’ll agree to that also . My dads bill for his monthly Parkinson’s maintenance pharmaceuticals was insane . Just the Stalevo alone made me cringe .
 
#538
#538
OHvol40 said:
The “waiting period” narrative is false. The narrative that major surgery outcomes are better is generally false. Each country has its own strengths and weaknesses, but we pay double and don’t receive double the benefit. Don’t believe me on any of it? Check for yourself...
How does the quality of the U.S. healthcare system compare to other countries? - Peterson-Kaiser Health System Tracker
Click to expand...
Also your link doesnt disprove the waiting period. So I award you no points.
 
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#539
#539
0nelilreb said:
It’s insignificant to bean counters , politicians and lawyers . It’s not insignificant to the people making up those categories. “ compatible countries “ is a joke to start with and I listed just some of the reasons why .
Click to expand...

LOL, no the cherry picked areas that you noted were absolutely insignificant statistically. Meanwhile you completely ignored areas where the US lags behind our peers in other ways, you know like mortality.
 
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#541
#541
0nelilreb said:
Sure we are . I never have thought we weren’t . All insurance and health care prices are extremely over priced. Throw in big pharmaceutical and I’ll agree to that also . My dads bill for his monthly Parkinson’s maintenance pharmaceuticals was insane . Just the Stalevo alone made me cringe .
Click to expand...

Yep. Too many people doing the right thing, living a good life, working hard, building a nest egg and watching it evaporate because of illness just to boost the bottom line of healthcare corps. It’s immoral. I always wondered why we need these huge “administrative” branches of healthcare companies full of non-healthcare workers with MBAs drawing large paychecks. They are there just to ensure maximum profitability to the detriment of patients and clinical employees.
 
#543
#543
Septic said:
LOL, no the cherry picked areas that you noted were absolutely insignificant. Meanwhile you completely ignored areas where the US lags behind our peers in other ways, you know like mortality.
Click to expand...

You ignore the fact that peers aren’t really “comparable “ countries to us . You can’t say we have a comparable country to ones that aren’t at all , then quote stats to prove our mortality rate is higher than theirs and not base it on individual groupings . That’s just ridiculous.
 
#547
#547
OHvol40 said:
You know it’s weird, I’m genuinely trying to have a substantive conversation about healthcare so I posted information without bias or slant. I think your first problem is that is exactly what you look for.

The point is that every healthcare system has strengths and room for improvement, but only one charges double.
Click to expand...
No. You cant keep ignoring the tax rate, and the fact that several of those are or have been under water.

I literally just went thru your link and responded point by point. That's not bias. And I pulled my wins losses from the chart. Even if you want to count my 4 irrelevant as losses that's 6 to 12. For number 11 against the averaged top 10, that's not bad, and actually far better than I expected.

Taking the 10 best, ignoring that we are often in that 10, and comparing us to it is slanted to make a point that we are worse. Which is part of why I said it was biased.

Changing metrics raises a question doesnt it? And it's not like they were breaking down pure numbers to current rates, to rates of change, to time periods. They were going thru there and changing the comparison on pretty much every chart. Why? Why not just keep it as current rate? Seems like it was done in order to highlight how the US was worse instead of taking an objective look at all the data.

I dont know of any objective metric that does something like that.

And I dont actually see you disagreeing with my breakdown. Did you look at the data and go "wow this has to change"?
 
#549
#549
OHvol40 said:
I know, it’s sad. We’re getting ripped off.
Click to expand...

As CEO at UNITEDHEALTH GROUP INC, David S. Wichmann made $18,107,356 in total compensation in 2018.

Michigan Blue Cross CEO's $19.2M pay is higher than Ford



As a business man, good for these guys - these guys are producing revenue and deserve to be rewarded for their leadership. On the other, ripping off Americans through the guise of 'better' healthcare is horsesht. Every year they increase cost and decrease coverage and we lap it up, shovel the money into their coffers because as a society we've bought the narrative that the rest of the advanced world is wrong and we'll all die if we do anything different.

We're a society of sheep who listen to their paid spokesmen in Congress and the Senate.
 
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#550
#550
LouderVol said:
Deflection. No points.
Click to expand...

It's been addressed, I'm not requesting the points - I'm taking them.

Mortality amenable to healthcare is a measure of the rates of death considered preventable by timely and effective care. While the health care system might not be expected to prevent death in all instances, differences in amendable mortality indicate how effectively health care is delivered. The Healthcare Access and Quality (HAQ) Index is based on amenable mortality and uses age-standardized, risk-standardized mortality rates for 32 causes that timely and effective health care could potentially prevent. Based on data from the Global Burden of Disease Study, the HAQ Index is scaled from 0 to 100: lower scores indicate high mortality rates for causes amenable to health care, while higher scores indicate lower mortality rates and thus better quality of and access to health care. The U.S. ranks last among comparable countries on the HAQ index with a score of 88.7.
Click to expand...
 
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