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It's not medical rationing

Home Forums General Columbus Discussion Everyday Chit Chat It’s not medical rationing

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Viewing 15 posts - 76 through 90 (of 102 total)
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  • #410827
    Jeff Regensburger
    Jeff Regensburger
    Participant

    I posted this a few months back. Was that the article you were thinking of?

    Interesting article just published in the Atlantic Online. It’s pretty even handed. The author comes down on the side of a larger role for consumers, a smaller role for insurance companies, and a place for the government to look after those who can’t afford for themselves.

    [url=http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/]How American Health Care Killed My Father[/url]

    I can’t say that I agreed with everything, but I found it refreshing to see someone write 6 pages on health care reform without constantly referencing socialized medicine, death panels, rationing, government bureaucrats, or any of the other insurance industry code words.

    #410828

    Brent
    Member

    That was an excellent article in The Atlantic. Frontline did a nice piece a year or 2 ago comparing the different health care systems in other advanced democracies. It can be viewed online.

    #410829

    HeySquare
    Participant

    No… I read that one too, but it wasn’t that one. I’m sure Andrew posted it… and I’m pretty sure it was in The Atlantic. It had examples about a county in Texas that has the highest per capita Medicare spending, and an area in (it was either) Oregon or Colorado that has the lowest. There was no difference in the outcome (i.e. there was no evidence that there were improved outcomes for higher spending) between the two areas. They highlighted four or five ways that the one region provided for cost-savings. It included improved techniques for electronic medical records, best practices peer meetings among doctors…

    I also remember that the area in Texas included many doctors consortiums that owned the testing facilities. It was no surprise then, that the amount of testing done in the high-cost county was much much higher than in low cost regions.

    #410830

    columbusfoodie
    Participant

    Brent wrote >>
    That was an excellent article in The Atlantic. Frontline did a nice piece a year or 2 ago comparing the different health care systems in other advanced democracies. It can be viewed online.

    From personal experience, I have experience with health care in a country who has adopted universal health care (Brazil) – the way their system works is that all citizens are automatically covered under SUS, but most also carry private health insurance as well in order to cover the majority of stuff that isn’t covered under the public plan. I was a self pay patient, but had surgery done in a hospital that was public rather than private.

    There was a huge disparity in the care that I got (hospital room with balcony, central air, plasma TV) and that others got – friends of mine there who only had the public plan had to wait 16 hours just to be seen in that same hospital’s emergency room. The reason why our health care costs so much is that the providers pass on the cost of those million dollar MRI machines to the patients. When I did a paper a few years ago comparing pre-and-post Soviet era health care to that of the United States, it was found that by publicizing medicine, virtually everyone got inferior care unless they had the money to get otherwise.

    My point is, what do you guys want to see health care become – a great equalizer so everyone gets the same standard of care, or is it more that you want everyone to have a basic level of care, with those who can afford it having a higher level? If it’s the latter, aren’t we already there?

    #410831
    rus
    rus
    Participant

    HeySquare wrote >>
    No… I read that one too, but it wasn’t that one. I’m sure Andrew posted it… and I’m pretty sure it was in The Atlantic. It had examples about a county in Texas that has the highest per capita Medicare spending, and an area in (it was either) Oregon or Colorado that has the lowest. There was no difference in the outcome (i.e. there was no evidence that there were improved outcomes for higher spending) between the two areas. They highlighted four or five ways that the one region provided for cost-savings. It included improved techniques for electronic medical records, best practices peer meetings among doctors…
    I also remember that the area in Texas included many doctors consortiums that owned the testing facilities. It was no surprise then, that the amount of testing done in the high-cost county was much much higher than in low cost regions.

    Sure it wasn’t the New Yorker?

    http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

    #410832
    Jeff Regensburger
    Jeff Regensburger
    Participant

    HeySquare wrote >>
    No… I read that one too, but it wasn’t that one. I’m sure Andrew posted it… and I’m pretty sure it was in The Atlantic. It had examples about a county in Texas that has the highest per capita Medicare spending, and an area in (it was either) Oregon or Colorado that has the lowest. There was no difference in the outcome (i.e. there was no evidence that there were improved outcomes for higher spending) between the two areas. They highlighted four or five ways that the one region provided for cost-savings. It included improved techniques for electronic medical records, best practices peer meetings among doctors…
    I also remember that the area in Texas included many doctors consortiums that owned the testing facilities. It was no surprise then, that the amount of testing done in the high-cost county was much much higher than in low cost regions.

    I remember that one too now that you mention it. I can’t recall where it came from, but if Andrew posted it I expect he’ll be able to link it again.

    In the meantime, maybe I’ll put my research skills to work and see if I can dredge it up. :)

    #410833

    HeySquare
    Participant

    rus wrote >>

    HeySquare wrote >>
    No… I read that one too, but it wasn’t that one. I’m sure Andrew posted it… and I’m pretty sure it was in The Atlantic. It had examples about a county in Texas that has the highest per capita Medicare spending, and an area in (it was either) Oregon or Colorado that has the lowest. There was no difference in the outcome (i.e. there was no evidence that there were improved outcomes for higher spending) between the two areas. They highlighted four or five ways that the one region provided for cost-savings. It included improved techniques for electronic medical records, best practices peer meetings among doctors…
    I also remember that the area in Texas included many doctors consortiums that owned the testing facilities. It was no surprise then, that the amount of testing done in the high-cost county was much much higher than in low cost regions.

    Sure it wasn’t the New Yorker?
    http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande

    That’s it. Thanks!

    #410834

    Brent
    Member

    HeySquare, you’re thinking of Atul Gawande’s ”The Cost Conundrum” in the New Yorker last summer.

    Gawande is easily the best medical writer available right now. His books are great but his articles in the New Yorker are better. I strongly recommended everyone spend some time looking through those archives.

    #410835
    rus
    rus
    Participant

    columbusfoodie wrote >>
    When I did a paper a few years ago comparing pre-and-post Soviet era health care to that of the United States, it was found that by publicizing medicine, virtually everyone got inferior care unless they had the money to get otherwise.

    With limited resources expanded over a large population, virtually everyone getting inferior care seems a reasonable outcome, doesn’t it?

    #410836

    HeySquare
    Participant

    rus wrote >>

    columbusfoodie wrote >>
    When I did a paper a few years ago comparing pre-and-post Soviet era health care to that of the United States, it was found that by publicizing medicine, virtually everyone got inferior care unless they had the money to get otherwise.

    With limited resources expanded over a large population, virtually everyone getting inferior care seems a reasonable outcome, doesn’t it?

    Rus, you have this habit of framing “questions” in such a way as to lead someone to a conclusion that you appear to see as inescapable.

    How you frame the question profoundly affects its shape and meaning.

    The Gawande article makes a creditible argument that it isn’t resources or funding that make the result, it is how effectively that funding is applied.

    #410837
    rus
    rus
    Participant

    HeySquare wrote >>

    rus wrote >>

    columbusfoodie wrote >>
    When I did a paper a few years ago comparing pre-and-post Soviet era health care to that of the United States, it was found that by publicizing medicine, virtually everyone got inferior care unless they had the money to get otherwise.

    With limited resources expanded over a large population, virtually everyone getting inferior care seems a reasonable outcome, doesn’t it?

    Rus, you have this habit of framing “questions” in such a way as to lead someone to a conclusion that you appear to see as inescapable.
    How you frame the question profoundly affects its shape and meaning.
    The Gawande article makes a creditible argument that it isn’t resources or funding that make the result, it is how effectively that funding is applied.

    Even with perfectly effective application, there’s still only so much to go around, yes?

    I mean, that’s the point. If we as a society had limitless resources to devote to health care ( or military spending, or welfare payments, or $government_program ) then we wouldn’t be discussing this.

    #410838

    HeySquare
    Participant

    rus wrote >>

    HeySquare wrote >>

    rus wrote >>

    columbusfoodie wrote >>
    When I did a paper a few years ago comparing pre-and-post Soviet era health care to that of the United States, it was found that by publicizing medicine, virtually everyone got inferior care unless they had the money to get otherwise.

    With limited resources expanded over a large population, virtually everyone getting inferior care seems a reasonable outcome, doesn’t it?

    Rus, you have this habit of framing “questions” in such a way as to lead someone to a conclusion that you appear to see as inescapable.
    How you frame the question profoundly affects its shape and meaning.
    The Gawande article makes a creditible argument that it isn’t resources or funding that make the result, it is how effectively that funding is applied.

    Even with perfectly effective application, there’s still only so much to go around, yes?
    I mean, that’s the point. If we as a society had limitless resources to devote to health care ( or military spending, or welfare payments, or $government_program ) then we wouldn’t be discussing this.

    What exactly does that have to do with the Soviet health care model, which you quoted in your post? Or were you implying that the Soviet model was a perfectly effective application?

    You quote X. You posit question Y. By doing those two things in the same post, you imply there is a relationship or a causation. And by doing it in this thread, you imply that there is some connection to the topic at hand.

    “Only so much to go around”: only so much what? Medicare dollars? If that is the “much” you are refering to, then sure… this country needs to find a way to manage costs associated with medicare in this country.

    I find myself agreeing with the author of that article that neither privitazing nor publicizing health care insurance in this country is likely to fix the problem.

    #410839

    HeySquare
    Participant

    Tenzo wrote >>

    Andrew Hall wrote >>
    All too often. We daily see docs who keep doing what they’ve been doing for years with no regard for new information.
    A.

    Really?
    If you have seen this then just choose a new doctor.

    Hmmm, it is just that easy, hunh?

    When it takes 6 to 8 weeks to schedule an appointment with a specialist, you don’t change so readily.

    If you are really sick… that wait can feel like a lifetime. When people brag about how “fast” the American system is, well… it didn’t feel like that to me.

    #410840
    rus
    rus
    Participant

    HeySquare wrote >>

    “Only so much to go around”: only so much what? Medicare dollars? If that is the “much” you are refering to, then sure… this country needs to find a way to manage costs associated with medicare in this country.

    Not so much medicare dollars per se, but resources available for health care more generally.

    I get the sense that there’s a lot of treatment options that are more expensive than their benefit.

    #410841

    Parker
    Participant

    Obamacare is like Reaganomics. They are shorthand. We pack them with whatever meaning we want to send and the listener imports whatever meaning they want to hear.

    I think the whole “repeal” Obamacare” is pretty silly. Once the hearings start and people see what is in the legislation most will find things they like and the hearings will backfire.

    Doctors will not quit in droves. Some may retire – fine, let them, good riddance. Where are they going to go? Canada? Europe? HA!

Viewing 15 posts - 76 through 90 (of 102 total)

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