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A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

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Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#81

Post by [deleted] »

tertius wrote: post #54
fao_ wrote: post #48

Earlier quoted context omitted.

> The reason has to do with the construction of the healthcare industry. Lots of regulations. Lots of middlemen. Laws designed to destroy innovation. Very little transparency for costs and outcomes. Or the reason has to do with the fact that the people that need these treatments are willing to pay any price for it because their life literally depends on it. I don't see why regulations, and laws "designed to destroy i…

> Or the reason has to do with the fact that the people that need these treatments are willing to pay any price for it because their life literally depends on it. Largely the end user does not pay full price and relies on negotiation by an insurance company. Have you seen what doctors charge these days? Those are all fake numbers.

[deleted]

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#82

Post by AdmiralAsshat »

oldandtired wrote: post #9

A former travelling companion (on a long distance train trip) moved from Head of R&D for an advertising agency into working in the medical technology industry. After six months or so, he returned to his former job of head of R&D at the advertising agency. When quizzed by the staff at the advertising agency as to why he came back to such a corrupt industry. His comment was that advertising were little children in term…

It doesn't surprise me.

I did several weeks of physical therapy for back pain. The PT suggested that I get a TENS Unit for pain. She said, "It costs about $800, but don't worry, your insurance will cover it with no copay to you."

Additionally, the pad refills were free and paid by insurance (they stop being adhesive after so many uses). And so for several months I had sales rep calling me once every few weeks, asking if I needed more pads. Again, it cost me nothing, so I'm sure this is a useful service for senior citizens who otherwise might run out--but I'm also positive that this guy was massively upselling the stuff to insurance, or he would not have been so persistent.

I spoke later to my parents, who also had one, and asked them where they got theirs. They said they paid about $50 at Wal-Mart. A cursory look on Amazon reveals similar pricing.[0]

I don't care how much more effective the professional-grade one is, I doubt it could be 20x more effective, and yet it is 20x the price.

[0]https://www.amazon.com/s/ref=nb_sb_noss_2?url=search-alias%3...

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#83

Post by coredog64 »

brightball wrote: post #68
zxcmx wrote: post #43

Earlier quoted context omitted.

I find it really interesting that we don't have, for example, a cheaper way of doing front-line health care than teaching people to diagnose every possible ailment. Similarly that that the mechanics of surgery aren't considered a manual skill practicable in a largely assembly line fashion. Apparently, everyone gets artisanal health care, regardless of the level of complication (or not) of their condition. Nothing wro…

It's a valid concern and this is where the free market aspects really come into play. If a school opened up with the goal of training people to diagnose and treat cold and flu symptoms, so that the graduates could diagnose those symptoms and their severity, then recommend a course of care or call in a prescription...here are the potential barriers. 1. Insurance companies wouldn't pay for it at all because those gradu…

LNPs have the ability to write prescriptions for low schedule drugs. That's pretty much the basis of those tiny clinics in retail stores.

More movement in that direction could lower health care costs, or at least improve utilization.

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#84

Post by timthelion »

vxNsr wrote: post #70
timthelion wrote: post #25

Meanwhile in the Czech Republic, for caa 50$ a month (for a person making minimum wage, it's double that for median wage workers) there is no copay on anything and the insurance covers everything including sex change surgery (but not facelifts and dental)...

I always chuckle when I see people compare what amount to 3rd world countries with the US system, my mother was trained and worked in Moscow's largest hospital. The shenanigans that went on there, the level of training and expected knowledge of staff, the baseline expected standard of care all don't even hold a candle to what she had to reach to be considered competent in the US. On top of that I don't know if this a…

I honestly don't know how mixed ancestry and the difficulty of producing actuary tables actually affects whether a system can function. Statistically, over a population of that size, it is a wash and the worse that can happen, is that there would be a procentual change in the overall cost. Furthermore, the French have had a mixed populace for many decades [1] and their system still works (though it is different than that of the Czech Republic and Germany).

The Czech Republic places 33rd by life expectancy, behind the US by just half a year [2], so if the health care in Czechia is on the level of a 3rd world country than so is the US'.

[1] https://en.wikipedia.org/wiki/Demographics_of_France#Before_... [2] https://en.wikipedia.org/wiki/List_of_countries_by_life_expe...

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#85

Post by timthelion »

ada1981 wrote: post #50

You may want to screen / sort customers based on Attachment style.. it's been found folks with anxious attachment visit the doctor more often and use more resources - but they visit for things that are non-issues, basically they are going for the relationship.

In Czechia, where there is no co-pay, for a while, a co-pay of $1 was instated, not to help pay for services, but to "prevent seniors from comming just to chat".

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#86

Post by brightball »

coredog64 wrote: post #83
brightball wrote: post #68

Earlier quoted context omitted.

It's a valid concern and this is where the free market aspects really come into play. If a school opened up with the goal of training people to diagnose and treat cold and flu symptoms, so that the graduates could diagnose those symptoms and their severity, then recommend a course of care or call in a prescription...here are the potential barriers. 1. Insurance companies wouldn't pay for it at all because those gradu…

LNPs have the ability to write prescriptions for low schedule drugs. That's pretty much the basis of those tiny clinics in retail stores. More movement in that direction could lower health care costs, or at least improve utilization.

Agreed and much needed.

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#87

Post by ams6110 »

distances wrote: post #33
dr_ wrote: post #27

The affordable care act has enrolled millions on to some kind of health insurance plan. Even if you are stuck with a high deductible plan, oftentimes that annual check up (preventive care) is fully covered without requiring a deductible payment. And, of course, if you are on Medicaid - you have Medicaid. If you are relatively young and/or healthy, that's all you would really need. As a result, their patient populatio…

Being from Europe, the concept of annual check ups sounds very wasteful. Is this what everyone does in the US? As far as I see it, schools should teach enough to keep you in a good baseline health and doctors are available if something comes up. What is done in a normal annual check up?

I haven't been to a doctor for a "check-up" since I was a kid. Probably been nearly four decades now.

I think for growing kids it's probably a good thing -- if nothing else to be sure you're on schedule for various vaccines.

As an adult, I have regular dental care but I do not see an MD unless I am sick or injured. And "sick" does not include colds/sore throat -- there are good OTC meds for that.

For most people, if you feel "normal", aren't gaining or losing weight unexpectedly, don't tire more easily than normal, your blood pressure is OK, etc. your health is likely fine.

Re: A Pioneer in 'Flat-Fee Primary Care' Had to Close Its Clinics

#90

Post by germanier »

distances wrote: post #33
dr_ wrote: post #27

The affordable care act has enrolled millions on to some kind of health insurance plan. Even if you are stuck with a high deductible plan, oftentimes that annual check up (preventive care) is fully covered without requiring a deductible payment. And, of course, if you are on Medicaid - you have Medicaid. If you are relatively young and/or healthy, that's all you would really need. As a result, their patient populatio…

Being from Europe, the concept of annual check ups sounds very wasteful. Is this what everyone does in the US? As far as I see it, schools should teach enough to keep you in a good baseline health and doctors are available if something comes up. What is done in a normal annual check up?

In Germany everybody over 35 is advised to do such a check-up every two years, plus a bunch of different cancer screenings and twice-yearly dental examinations. I would say about a third of the people actually use those offerings.
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