131–140 of 273 posts
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I think this is because we choose to live less healthy lifestyles rather than the quality of medical care. Super size that...
I don't think the lifestyles are all that different between Canada and the US, and the healthcare expenditures in Canada are significantly lower.
Fortunately, Medicare is looking at this problem now. http://www.compassphs.com/blog/health-navigation/medicare-to...
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I'm a Canadian, what's wrong with our system from your perspective? (No system is perfect; there is always room for improvement and trade offs) Just two weeks ago, my wife had an emergency appendectomy. She went to the free clinic first thing Sunday morning as she had terrible pains all night. They immediately referred to the local hospital. She had the ultrasound in the afternoon and Surgery at 3:00pm. She's been of…
>> I'm a Canadian, what's wrong with our system from your perspective? longer wait times for non-emergency treatment and (most of the time) not being able to pay cash and get the procedure done without the wait. personally know ppl in Canada (Toronto, so not some little town in the boonies) who had to wait few months to get an MRI. on the US side - takes 2 weeks or so to get the insurance company's approval (they do…
On the other hand, my experience with the US is that the service is great. They'll even send you for unnecessary tests just because. And it's all pretty fast. But then you have so many people who get nothing at all. And then many of those who do get something are totally bankrupt.
There is no system that can give anyone health care and not have a triage system. So you might have to give up some comfort so your neighbors can live.
I know this will attract a lot of people who have suggestions for healthcare. Let me add my big one: price transparency. I had a simple test the other day. I could not get a price. I could not get a price with my insurance, or without it. I called at least 9 times. I got 5 call backs from people who asked me to schedule the procedure but no price. On the 10th call, I finally got someone to tell me what the out-of-poc…
So now when I'm signing the papers accepting responsibility for the financial obligations if my insurance doesn't, I ask what it's going to cost if my insurance doesn't cover it. The nurses have no idea. It has to get "coded" before it's billed, and then after the bill is declined the coding people can tell me what I owe them. It's ridiculous.
I know this will attract a lot of people who have suggestions for healthcare. Let me add my big one: price transparency. I had a simple test the other day. I could not get a price. I could not get a price with my insurance, or without it. I called at least 9 times. I got 5 call backs from people who asked me to schedule the procedure but no price. On the 10th call, I finally got someone to tell me what the out-of-poc…
An an anecdote: I've been on a high-deductible plan for nearly 13 years. I have been regularly met with shock and incredulity that I could possibly want to know the cost of a procedure. My wife and I have spent, collectively, hours on the telephone trying to get answers. It's particularly galling when we get "guilt trip" treatment for asking about costs for procedures for our young daughter. We have been met with bot…
> ... average number of patients who need to be treated to prevent one additional bad outcome ...
Here is an example for aspirin preventing a first heart attack or stroke (NNT is ~1,667): http://www.thennt.com/nnt/aspirin-to-prevent-a-first-heart-a...
I would like to ditch insurance and find a doctor who would allow me to pay a monthly subscription fee, much like a gym membership, for preventative care. Isn't the primary purpose of insurance for exceptional and accidental situations? If that's true, then why am I using it for predictable monthly expenses?
https://www.youtube.com/watch?v=bGZaRnC1wNg to hear one doctor talk about how this works out in practice.
Google Direct Primary Care + your city/state to see what's available. It's SERIOUSLY better than the mainstream option. I've been doing it for nearly a decade now, and would never go back. Combine it with a cost sharing plan (NOT insurance) such as https://www.libertyhealthshare.org/3-program-options to achieve superior care at lower cost.
I know this will attract a lot of people who have suggestions for healthcare. Let me add my big one: price transparency. I had a simple test the other day. I could not get a price. I could not get a price with my insurance, or without it. I called at least 9 times. I got 5 call backs from people who asked me to schedule the procedure but no price. On the 10th call, I finally got someone to tell me what the out-of-poc…
Doctors have a similar problem: too much uncertainty which can't be eliminated until the treatment is completed. They can't even tell you how much an office visit costs, because of the variability in how much time each patient needs, involvement of nurses and PAs, and any tests that must be performed.
Lab tests are a little better: they tend to take a predictable amount of time to perform, and the analysis is pretty standardized, but there's probably still some variability when the results are not routine. That explains the fairly narrow range you were eventually able to get.
I think we've got the wrong pricing model in mind for healthcare. Instead of itemizing every little action, test, and pill, we should be aggregating these costs. Pay medical professionals fixed salaries, fund institutions using budgets for fixed costs and consumables costs, and pay for it all via taxation as a common good, like public education, libraries, defense, etc.
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What about people who live in food deserts?
What about them? They'll live longer automatically, that's one incentive. Every state should probably require every food related corporation to be a benefit corporation, with clear phrasing that an equal motive to profit for that business is incentivizing customers to eat healthy. If the incentive is just profit, you get crazy things like government subsidized sugar farmers and boner pill pharma.
"And then for poor lifestyle choices like smoking and having a crappy diet, you should either die (seriously) or you should pay the system out of your own pocket to take care of you (start a gofundme, see if anyone cares about your problems)."
What about the people who have a crappy diet not by choice - like people who live in food deserts? Of course, these are the same people who need the most help, so asking them to pay out of pocket is particularly cruel and myopic.
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How rich do you have to be? Why is it not available for the rest of us?
It's not unavailable to the non-rich, just unaffordable.
Children 0-19 years old, $10/month with at least one parent membership
Adults 20-44 years old, $50/month
Adults 45-64 years old, $75/month
Adults 65+ years old, $100/month
Employer groups with 5+ employees, $50/mo/adult