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Which firms profit most from America’s health-care system (2018)

economist.com

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Re: Which firms profit most from America’s health-care system (2018)

#151

Post by rumanator »

JamesBarney wrote: post #113
lnsru wrote: post #59

Earlier quoted context omitted.

By fixing nutrition and adding some physical exercises. Though it’s slow, count 1 kg weight loss/week in average.

This is repeated a lot but if you actually look at the research you find that physical exercise has very little effect(except maybe as a preventative). That nutrition in general has a small effect. And dieting has a larger effect but is only temporary, and no dietary interventions have shown any real success over the long term. Bariatric surgery is currently the only real effective treatment. With GLP agonists like s…

> This is repeated a lot but if you actually look at the research you find that physical exercise has very little effect(except maybe as a preventative).

This baseless assertion is simply outright wrong, and utterly absurd on so many levels.

* https://www.acpjournals.org/doi/abs/10.7326/0003-4819-133-2-...

* https://www.nature.com/articles/0800499

Please don't spread misinformation.

Re: Which firms profit most from America’s health-care system (2018)

#152

Post by sushshshsh »

francisofascii wrote: post #99
amanaplanacanal wrote: post #83

Earlier quoted context omitted.

Part of the issue is that the supply of doctors is kept artificially low in the US. Another part is: why the heck do you need an office visit for this? Why can’t you go directly to the lab?

For the record, it was not a brick/mortar office, but a temporary tent set up specifically for Covid testing.

Horrific to be charged that much for a tent visit :(

Re: Which firms profit most from America’s health-care system (2018)

#153

Post by JamesBarney »

rumanator wrote: post #151
JamesBarney wrote: post #113

Earlier quoted context omitted.

This is repeated a lot but if you actually look at the research you find that physical exercise has very little effect(except maybe as a preventative). That nutrition in general has a small effect. And dieting has a larger effect but is only temporary, and no dietary interventions have shown any real success over the long term. Bariatric surgery is currently the only real effective treatment. With GLP agonists like s…

> This is repeated a lot but if you actually look at the research you find that physical exercise has very little effect(except maybe as a preventative). This baseless assertion is simply outright wrong, and utterly absurd on so many levels. * https://www.acpjournals.org/doi/abs/10.7326/0003-4819-133-2-... * https://www.nature.com/articles/0800499 Please don't spread misinformation.

Sorry there was some confusion. By long term I meant 3-10 year follow ups.

Weight loss from diet/exercise will definitely persist for a year or even a couple.

Also specifically about exercise your study says "[Weight] did not change in the exercise without weight loss [group]"

Re: Which firms profit most from America’s health-care system (2018)

#154

Post by lotsofpulp »

Retric wrote: post #150
lotsofpulp wrote: post #147

Earlier quoted context omitted.

Yes, but without single payer, I don’t see a viable alternative to insurance companies or a similar organization double checking a doctor’s billing.

One option is to separate the verification process from the insurance companies. In other words you have some list of pre defined standards that are covered at some rate and then an independent agency applies those standards and looks for fraud. Aka a hospital might negotiate a separate rate for stitches with each company, but they don’t get to decide if it was needed on a case by case basis. Alternatively, apply the…

That function is also performed by insurance companies in the US, sometimes known as managed care organizations. Many large companies self insure and use health insurance companies’ resources to implement their health benefits.

Most, if not all, states outsource the implementation of their Medicaid plans to large insurers like Anthem or UHC or Humana, etc.

Re: Which firms profit most from America’s health-care system (2018)

#155

Post by ntsplnkv2 »

lotsofpulp wrote: post #133
jmeister wrote: post #127

Earlier quoted context omitted.

“You can’t handle the truth!” - Col. Jessup. Look at China’s aggression in the past couple of months, especially with India. It would never have happened 10 or 20 years back with a strong America. Yes, the US does serve as the world’s policeman.

The idea that the US could simply threaten the world’s factory with 4x the population of the US is ludicrous to me. They are top down, focused, and the only problem they had was lack of education, which is solved by time. The only way for the US to have been able to threaten China without using force would have been to sow political discord and break it up into smaller countries. The US has 330M people, mostly gettin…

The US's strength has never solely been about it's individual strength. Together with the EU, Japan, Australia, SE Asian countries in general, it really evens up the numbers game. Plus the US has dominance in its hemisphere.

China has India right next door.

Re: Which firms profit most from America’s health-care system (2018)

#156

Post by Retric »

lotsofpulp wrote: post #154
Retric wrote: post #150

Earlier quoted context omitted.

One option is to separate the verification process from the insurance companies. In other words you have some list of pre defined standards that are covered at some rate and then an independent agency applies those standards and looks for fraud. Aka a hospital might negotiate a separate rate for stitches with each company, but they don’t get to decide if it was needed on a case by case basis. Alternatively, apply the…

That function is also performed by insurance companies in the US, sometimes known as managed care organizations. Many large companies self insure and use health insurance companies’ resources to implement their health benefits. Most, if not all, states outsource the implementation of their Medicaid plans to large insurers like Anthem or UHC or Humana, etc.

An agency outsourcing that function to a private company for all care in a state does not invalidate the savings. It’s a question of efficiency and conflict of interest not inherently a government function.

That said, outsourcing them back to the same insurance companies which also offer plans has major issues.

Re: Which firms profit most from America’s health-care system (2018)

#157

Post by rumanator »

JamesBarney wrote: post #153
rumanator wrote: post #151

Earlier quoted context omitted.

> This is repeated a lot but if you actually look at the research you find that physical exercise has very little effect(except maybe as a preventative). This baseless assertion is simply outright wrong, and utterly absurd on so many levels. * https://www.acpjournals.org/doi/abs/10.7326/0003-4819-133-2-... * https://www.nature.com/articles/0800499 Please don't spread misinformation.

Sorry there was some confusion. By long term I meant 3-10 year follow ups. Weight loss from diet/exercise will definitely persist for a year or even a couple. Also specifically about exercise your study says "[Weight] did not change in the exercise without weight loss [group]"

> Sorry there was some confusion. By long term I meant 3-10 year follow ups.

That only happens if the patient relapses into his previous unhealthy lifestyle.

You can't simply follow a poor high calory diet and a sedentary lifestyle and still expect zero consequences from your actions. If your problem is behavioral then you fix it by fixing the problems in your behavior.

Re: Which firms profit most from America’s health-care system (2018)

#159

Post by NicoJuicy »

mardifoufs wrote: post #124
NicoJuicy wrote: post #76

Earlier quoted context omitted.

Belgium On your own initiative ( partially paid back): - 9.6€ for the Covid test - 17 € for the doctor visit By Government: - fully paid back by our health care, including doctor visit I love transparent pricing :)

But the highest COVID death rate in the western world! You gain some, you lose some I guess :)

That's a non-issue.

Belgium counts any suspected Covid death as a confirmed one, so we have approx. 2* as much deaths in statistics.

It's mentioned a lot, but I guess not everyone knows ;)

Re: Which firms profit most from America’s health-care system (2018)

#160

Post by DougWebb »

refurb wrote: post #122
DougWebb wrote: post #82

Earlier quoted context omitted.

Patients do not need to be informed of new drugs, and never were until pharmaceutical companies lobbied Congress to remove the ban on direct advertising, which had been put in place as a consumer protection law due to 19th century "snake oil" salesmen/con-men. For doctors, a monthly publication of drugs currently in development, their status, and their uses would be adequate. It'd be much better for doctors to get th…

If you want to know why DTC is allowed in the US, you should read the FDA studies on it. https://www.fda.gov/drugs/drug-information-consumers/impact-... The FDA identified several benefits of DTC ads.

That article provides pretty strong evidence that DTC ads, overall, are bad for patients:

58 percent [of physicians surveyed] agreed strongly that DTC ads make the drugs seem better than they really are.

Physicians thought the ads did not convey information about risks and benefits equally well. Seventy-eight percent of physicians believe their patients understand the possible benefits of the drug very well or somewhat, compared to 40 percent who believe their patients understand the possible risks, and 65 percent believe DTC ads confuse patients about the relative risks and benefits of prescription drugs. In addition, about 75 percent of physicians surveyed believed that DTC ads cause patients to think that the drug works better than it does, and many physicians felt some pressure to prescribe something when patients mentioned DTC ads.

Eight percent of physicians said they felt very pressured to prescribe the specific brand-name drug when asked.

Doctors believe that patients understand that they need to consult a health care professional about appropriate treatment. Eighty-two percent responded either "very well" or "somewhat" when asked whether they believe that their patients understand that only a doctor can decide whether a drug is right for them.

Note the last point means that 18% of the doctors believed that their patients thought they knew better than the doctor about whether or not a drug is right for them.

The few positive aspects, about patients being better informed about drug therapies that might help them, could be solved by making the monthly journal info I described available online. People go to Google and type in their symptoms and/or the name of their disease if they know it, and end up on sites like drugs.com and webmd.com. If Google were indexing the journal I described, and those other sites pulled from it too (publishing license should allow that, as it would be publicly funded), then patients would see all of the good information about the drugs, without the advertising bias.

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