101–110 of 130 posts
Earlier quoted context omitted.
Awesome. I can't change my decision for another year, and then only to Blue Cross. Are they also terrible?
Right now I'm on the hook for 5 figures with BC/BS for my son's birth expenses, because HR screwed up his application. It's a Kafkaesque byzantine labyrinth of red tape and buck passing. I'm not sure they're evil, just bureaucratic.
Earlier quoted context omitted.
What floors me is how no one has disrupted this field yet. I have seen a few ground zero startups trying to disrupt healthcare. Make it more effecient, cut out fraud, etc but so far no one is making a dent. Why is it so hard for some smart young folks to come along and hammer out solutions to accomplish less fraud, easier, and faster to use systems etc? It seems like it's really REALLY hard to bust up this abortion w…
With specific exceptions (medical devices - those Rascal ads are there for a reason) there generally isn't a ton of fraud. What there is is a lot of middlemen each taking their own cut, which cumulatively adds up to a lot of overhead. It's the "efficiency" part that you mention. Efficiency is a tough nut to crack but there are organizations like Kaiser Permanente that have been very successful with a vertical integra…
Suffice it to say he was impressively unsuccessful, but it gives very interesting insight into how and why the problem is so complex, just from a consumer's perspective.
[1] https://www.vox.com/2016/5/5/11591592/birth-cost-hospital-bi...
None of scenarios can diminish just how awful this is of course. There are some things you can get wrong on that envelope that are bad, but not really livelihood threatening. This is life changing for a huge number of people I'm sure, and the companies involved should be held accountable for the breach.
Note that the USPS also scans and stores images of the front and back of all mail it delivers, even if you don't opt in for their digital delivery service[0]. So this means that the USPS - and anybody else with access to their images, which includes law enforcement - now knows the HIV status of these people. [0] http://www.nytimes.com/2013/08/03/us/postal-service-confirms...
Earlier quoted context omitted.
If you know how to "don't take no for an answer" I'll say optimistically, you'll be alright. My experience with my wife's health care (Aetna) has been that she will call, try to get an issue resolved, be told "there is no resolution possible" enough times by enough different people that she is ready to give up. Then we call together, and suddenly the story changes. The particular issue we were dealing with, is not re…
What floors me is how no one has disrupted this field yet. I have seen a few ground zero startups trying to disrupt healthcare. Make it more effecient, cut out fraud, etc but so far no one is making a dent. Why is it so hard for some smart young folks to come along and hammer out solutions to accomplish less fraud, easier, and faster to use systems etc? It seems like it's really REALLY hard to bust up this abortion w…
Oh neat, I just signed up for Aetna (first time working in America since ACA). Is this normal for them? Am I an idiot?
You shouldn't be downvoted for normal and reasonable questions, or even for self doubt. Aetna is terrible. The lobby against healthcare reform at every turn. They didn't want obamacare/ACA they didn't want to compete accross state lines, they want to be able to exempt people from pre-existing conditions, they want to give people the run-around. They are not trustworthy and they are run by bad people. (don't beat up o…
Note that the USPS also scans and stores images of the front and back of all mail it delivers, even if you don't opt in for their digital delivery service[0]. So this means that the USPS - and anybody else with access to their images, which includes law enforcement - now knows the HIV status of these people. [0] http://www.nytimes.com/2013/08/03/us/postal-service-confirms...
Scarier point: USPS probably knows without that. If these letters are sent out in batches and the envelopes/timing/vender is unique, then all it takes is knowing that 1 letter is abut HIV and then you know all of them are without ever seeing the content.
Earlier quoted context omitted.
The difference is that those systems goes to great lengths to ensure that the decision is done based on clinical needs and objective measures of what achieves the most patient benefit for the available money. As a result it is very transparent what is sacrificed - e.g. you can find NICE [1] documentation on evaluations of individual drugs and treatments and their benefits, and documentation of the decision making pro…
> As a result it is very transparent what is sacrificed - e.g. you can find NICE [1] documentation on evaluations of individual drugs and treatments and their benefits, and documentation of the decision making processes of the NHS trusts, so they can be debated and used as a basis for deciding funding, or you're free to sign on to additional private cover if the exemptions worry you. The decisions that NICE makes are…
And, as pointed out, people additionally have the option of taking out additional coverage, which as it happens also provide us with a good idea of to what extent people feel the NHS is sufficient. Typically only around 10% take up private insurance, mostly as a perk offered by some employers.
The availability of that as a (quite cheap) "escape hatch" is quite interesting in that respect. Especially given that the average person in the UK pay far less towards the NHS than the average American pay for healthcare via taxes and health insurance - you can sign up for high end private insurance in the UK and still end up paying less.
> They're doing the same thing that insurers do - make decisions about treatments based on objective measures of clinical outcomes, subject to a finite budget.
NICE's recommendations are not subject to the NHS budget. They are independent for a reason. Cost efficiency of a treatment enters into their assessments, but they do not have final say on which treatments are offered. They make recommendations based on the clinical need and document efficacy, outcomes and costs. It's up to the NHS to then allocate funds accordingly.
> Ironically, this entire thread is about HIV, and HIV treatment and prevention are one area in which the NHS falls drastically short of what's available in the US
I don't know the details of this, but find it curious given that some quick searches indicate that the HIV/AIDS death rate in the US per 100,000 is a larger factor above the UK than the prevalence rate.
Of course that could be for other reasons than treatment.
I know there's been some debate over funding of preventative treatments (with the NHS finally deciding to fund trials), but that was over responsibility largely (preventative measures is in general a council responsibility), but if anything the fact that the NHS decided to start trials after public debate seems to me a pretty good demonstration of what I'm saying.
The system is not perfect, but it's open, transparent and subject to democratic control.
Earlier quoted context omitted.
In most developed nations outside America, a doctor's opinion carries more administrative weight. There may be an administrator, but if a doctor says a procedure is to be done, the payment can generally follow. A doctor is like an officer in that regard. In America, the insurance company and their payment policies carry more weight than the doctor's decisions. This matters a great deal if you have a traumatic acciden…
> In most developed nations outside America, a doctor's opinion carries more administrative weight. In America, the insurance company and their payment policies carry more weight than the doctor's decisions. No, in most developed nations other than the US, the doctor has approximately the same power that they do in the US. The difference is that, under capitated systems or systems like the NHS (which is not actually…