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Unnecessary medical care is harming patients physically and financially (2015)

newyorker.com

51–60 of 256 posts

Re: Unnecessary medical care is harming patients physically and financially (2015)

#51
post #10

Earlier quoted context omitted.

Yeah lets get rid of laws and regulations, that will fix health care prices!!! /s

It actually would. No need for sarcasm on that comment.

I expect most of the laws were put in place to deal with problems in the system, just blindly removing them all on an ideological basis probably isn't a good idea.

Re: Unnecessary medical care is harming patients physically and financially (2015)

#52
post #45

For the physical harming, Nassim N. Taleb wrote a book called "Anti-Fragile" desribing the concept of iatrogenic illness. https://en.wiktionary.org/wiki/iatrogenic An alarming fact was less dying patients when an hospital workers were in a strike action (during 2 weeks).

Johns Hopkins study suggests medical errors are third-leading cause of death in U.S.

https://hub.jhu.edu/2016/05/03/medical-errors-third-leading-...

Re: Unnecessary medical care is harming patients physically and financially (2015)

#53
post #37

I live in a 3rd world country (Sri Lanka). Healthcare is not as advanced as it is in the US, but it is decent for all except the most complicated cases. The vast majority of people use the free services at state hospitals. If you want slightly better care, you can go to a private hospital and still come out with most of your wealth intact. I recently had a minor surgery to remove a conjunctival granuloma from my left…

[deleted]

Re: Unnecessary medical care is harming patients physically and financially (2015)

#54

The article pins part of its argument on the claim that advances in diagnostics have not changed the death rate for (e.g.) breast cancer during the past quarter century, but a superficial search immediately suggests this to be grossly false. "Death rates from female breast cancer dropped 39% from 1989 to 2015." - all other things being equal, it ought to have increased: age is a risk factor for cancers, and we have a…

There are other likely explanations for that data. If more women are getting screened more frequently then their cancers will be detected earlier and improve survival rate. That doesn't mean the diagnostics tools themselves have improved the survival rate, only that the diagnostic tools are now used more frequently.

>If more women are getting screened more frequently then their cancers will be detected earlier and improve survival rate.

Yes, but the article argues directly against this point.

Re: Unnecessary medical care is harming patients physically and financially (2015)

#55

Earlier quoted context omitted.

> I showed up for my intake appointment and the young, rushed doctor said they wouldn't enroll me as an official member "Intake appointment"? "Official member"? What kind of system is this?

Sounds like a typical American family doctor's office? All of them in my area have long waiting lists. You don't just show up at the front door like it's an auto mechanic's shop, you call to schedule your annual physical. They're typically booked solid for a few months in advance. Calling to book an appointment requires being a registered patient or member of that office. If you want to change your primary care physi…

that would be anarchy

Yet it's exactly what we can do in the UK, I remember needing to see a doctor whilst on Holiday in Scotland, I just phoned the local GP and got an appointment the next day.

Re: Unnecessary medical care is harming patients physically and financially (2015)

#56

Earlier quoted context omitted.

Exactly. You have to be an established patient to get some of the benefits, the most important being (IMO) being able to see a doctor within a day or two if you're really sick. (But not emergency room sick)

Even as an existing patient, I’ve been quoted wait times of more than three weeks to see my PCP.

Me too, but it seems like there's a hierarchy depending on what your complaint is. When I needed to schedule a follow-up post-hospital discharge they had no problem getting me in, but when I had other complaints it was see an NP or wait months.

Re: Unnecessary medical care is harming patients physically and financially (2015)

#57
post #45

For the physical harming, Nassim N. Taleb wrote a book called "Anti-Fragile" desribing the concept of iatrogenic illness. https://en.wiktionary.org/wiki/iatrogenic An alarming fact was less dying patients when an hospital workers were in a strike action (during 2 weeks).

Johns Hopkins study suggests medical errors are third-leading cause of death in U.S. https://hub.jhu.edu/2016/05/03/medical-errors-third-leading-...

Really interesting, thx !

Re: Unnecessary medical care is harming patients physically and financially (2015)

#58

Earlier quoted context omitted.

Sounds like a typical American family doctor's office? All of them in my area have long waiting lists. You don't just show up at the front door like it's an auto mechanic's shop, you call to schedule your annual physical. They're typically booked solid for a few months in advance. Calling to book an appointment requires being a registered patient or member of that office. If you want to change your primary care physi…

that would be anarchy Yet it's exactly what we can do in the UK, I remember needing to see a doctor whilst on Holiday in Scotland, I just phoned the local GP and got an appointment the next day.

[deleted]

Re: Unnecessary medical care is harming patients physically and financially (2015)

#59
post #8
post #5

Sounds like another one of those "this is what happens when money (as opposed to patient wellbeing) becomes a driving factor in health care." I remember I tried to find a PCP once and I showed up for my intake appointment and the young, rushed doctor said they wouldn't enroll me as an official member unless I had two intake visits. They were gaming the insurance system.

More like, “what happens when the patient does not directly feel the financial bill and the doctor tries to charge/do unnecessary things to make more money”. This is a direct result of the laws and regulations distorting the market.

Then why do other OECD countries whose systems are much further from a free market not have the same problem but worse?

Re: Unnecessary medical care is harming patients physically and financially (2015)

#60
post #8
post #5

Sounds like another one of those "this is what happens when money (as opposed to patient wellbeing) becomes a driving factor in health care." I remember I tried to find a PCP once and I showed up for my intake appointment and the young, rushed doctor said they wouldn't enroll me as an official member unless I had two intake visits. They were gaming the insurance system.

More like, “what happens when the patient does not directly feel the financial bill and the doctor tries to charge/do unnecessary things to make more money”. This is a direct result of the laws and regulations distorting the market.

Have you heard of the high-complexity drug testing scam? It works like this: at the intake visit the physician has the patient piss in a cup and it gets sent off to a drug testing company somewhere. They run a GC/MS, and then a very substantial bill (~5 kUSD) shows up a few weeks later. It's a stroke of genius, no one is responsible. The physician says "you peed in the cup", the drug testing company says "services were rendered", and the insurance says "out of network".

How is such behaviour encouraged by laws and regulations? It's encouraged by the absence of laws and ethics.

I said to all three "send it to collection, so I can dispute the debt, I'm not going to pay"; eventually the insurance paid at their negotiated rate (~USD 250), which is closer to the cost it takes to provide the unneeded service. It took several hours on the phone to put that matter to sleep.

There need to be some laws, but in the present situation neither the Medical Board nor the Attorney General is interested, consequently it continues.

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