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I analyzed hospital price lists so you didn't have to

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381–390 of 403 posts

Re: I analyzed hospital price lists so you didn't have to

#381

Earlier quoted context omitted.

No. It's the high profit attracting high incentive to capture the regulation. The goal of the regulation is to increase prices (profit) while preventing other parties from competing on prices

I am always amazed by these "no-regulation" arguers - how are you doing to resolve disputes? Suppose I want to sell my product, and find a company willing to buy, a middle manager signs the contract. When the company recieved my product, it refuses to pay, says this person was not authorised to sign the contract on behalf of the company. Must the company prove the purchase was unauthorised, or must I prove the employ…

They weren't talking about the concept of regulation. Just the reality of the US's ones.

And I think you're talking about contract law, not regulations.

Re: I analyzed hospital price lists so you didn't have to

#382
post #331

Earlier quoted context omitted.

All valid, but you forgot another big story, for another day: "medical billing". This, in my minimally-informed opinion, is the syndicate keeping the fence running. I've had dealings with 4 owners of separate small-to-moderately sized billers and their top-brass all owned > 1 multi-million dollar homes around the world. Also, their toy boxes contained millions in cars, boats & flying machines. It must be nice, but in…

Don't forget the doctors who are part of that syndicate. I'm a professional patient, 99.9% of the doctors I've took treatment from(not U.S.) for major ailments are businessmen masquerading as doctors and I'm not talking about some scrappy hospitals; These are world renowned hospital chains. What happens when you optimize for profit, instead of medical science? Wrong diagnosis and prognosis; I'm a victim of one and it…

Is there any evidence that doctors in other countries have a lower rate of diagnostic errors?

Re: I analyzed hospital price lists so you didn't have to

#383
post #382

Earlier quoted context omitted.

Don't forget the doctors who are part of that syndicate. I'm a professional patient, 99.9% of the doctors I've took treatment from(not U.S.) for major ailments are businessmen masquerading as doctors and I'm not talking about some scrappy hospitals; These are world renowned hospital chains. What happens when you optimize for profit, instead of medical science? Wrong diagnosis and prognosis; I'm a victim of one and it…

Is there any evidence that doctors in other countries have a lower rate of diagnostic errors?

I didn't include 'not U.S' for that but to not have comments suggesting I sue such doctors, hospitals etc.

Re: I analyzed hospital price lists so you didn't have to

#384
post #382

Earlier quoted context omitted.

Don't forget the doctors who are part of that syndicate. I'm a professional patient, 99.9% of the doctors I've took treatment from(not U.S.) for major ailments are businessmen masquerading as doctors and I'm not talking about some scrappy hospitals; These are world renowned hospital chains. What happens when you optimize for profit, instead of medical science? Wrong diagnosis and prognosis; I'm a victim of one and it…

Is there any evidence that doctors in other countries have a lower rate of diagnostic errors?

I trust it will higher, because if patients was not directly killed by them, doctors always get same salary.

Re: I analyzed hospital price lists so you didn't have to

#385

Earlier quoted context omitted.

FWIW, pretty sure duffpkg was involved in the creation of OpenEHR, and therefore probably has heard of it.

but doesn't it solve problems he wrote about (Epic and vendor locking of data?)

Conceptually, yes, it solves a small corner of them.

I'm going to ballpark migrating from Epic to OpenEHR without losing data would probably cost you something around $500/patient. So consider a medium-sized hospital that has 250k patient records. $12.5m project. That takes 2 years. (I'm considering all the places that Epic has custom integrations with other systems, with your insurer, etc, in that $500/patient, which is probably low, but gotta start somewhere). Add in the cost of re-training staff to use the new EMR, finding out after implementation the 'shadow IT' systems like someone exporting data to an excel spreadsheet and then doing a huge workflow on that that no one outside the department really knows about but is absolutely vital to the pharmacy's ability to operate...

OpenEHR can help address some things for one part of the system. But that is like saying fixing OpenSSL bugs will make all the internet secure.

Re: I analyzed hospital price lists so you didn't have to

#386

Earlier quoted context omitted.

Back when I was leaving school and looking for a job, I came across Epic and MUMPS. From what I read, MUMPS is actually very performant. Although other companies use it, Epic is the giant. Epic was considered a decent company to work at - good reviews, good work/life balance. The downside is mastering technologies that no one else would value. Or so everyone thought. The reality was that if you become well versed in…

> Epic was considered a decent company to work at heard this is no longer the case with the pandemic. Apparently the CEO had some questionable perspectives on COVID for someone who managed health tech. None of my friends who had jobs there made it through covid without quitting or watching their team quit. Anecdotally, their recruiting is a mess and the IQ test type interviewing is very common for them instead of FAA…

What do you find to be a mess about weird IQ tests compared to FAANG interviews?

From my brief time working there, it seems their recruitment pipeline is wonky for the devs while the support staff are open to applicants of any and all backgrounds (provided they can pass the IQ tests)

Re: I analyzed hospital price lists so you didn't have to

#387
post #65

Wrote Hacking Healthcare for O'Reilly, created ClearHealth/HealthCloud open source EMR, managed health systems for 15+ years, blah, blah, blah. It is very good there is are the transparency regulations. It is worth briefly explaining some of the reasons why many facitilities are having a hard time complying. There are some bad actors, absolutely true. However "Hanlons Razor" -- never attribute to malice that which is…

Would rewriting healthcare systems in enterprise Java or modern JS or Clojure actually improve them any compared to MUMPS? From my brief experience, the #1 MUMPS problem is that the syntax makes Perl and regex look legible. The two points that I miss in modern languages are:

1. There is absolutely nothing special you need to do when handling values out of the database compared to in-memory values 2. The nested data structure—it's like a nested Python dict, except each level can contain a value and children.

Re: I analyzed hospital price lists so you didn't have to

#388
post #65

Wrote Hacking Healthcare for O'Reilly, created ClearHealth/HealthCloud open source EMR, managed health systems for 15+ years, blah, blah, blah. It is very good there is are the transparency regulations. It is worth briefly explaining some of the reasons why many facitilities are having a hard time complying. There are some bad actors, absolutely true. However "Hanlons Razor" -- never attribute to malice that which is…

If ever there was a need for an antitrust litigation and investigation such as United States vs. Microsoft (see below), then "Epic Systems" (see below) would seem like a corporation that needs to be investigated, penalized and broken into tiny pieces to prevent its predatory practises. https://en.wikipedia.org/wiki/United_States_v._Microsoft_Cor... . https://en.wikipedia.org/wiki/Epic_Systems

What kind of pieces should it be broken into?

Re: I analyzed hospital price lists so you didn't have to

#389

Earlier quoted context omitted.

Yeah, I tried all of that. I'll spare you the details, but things just lined up in a way that made me ineligible for COBRA, but the insurance that I had at my previous employer was absolute trash and they wouldn't have covered a single thing anyway. It was the only option given aside from Kaiser (my Kaiser saga is an even longer story), and even before this emergency it covered almost nothing. My prescriptions seemed…

> hospital won't negotiate with 1st parties Talk to an FCRA lawyer. There are certain notices that if you send them and they are ignored can let you remove the lines from your credit report should they mark them as defaulted on. They will likely also help if the hospital chooses to sue.

I very much appreciate the tip, I'll check that out. Thank you! It's amazing how much time and work I've put into this and more info just keeps coming up. Crazy thing for people to navigate.

Re: I analyzed hospital price lists so you didn't have to

#390
post #382

Earlier quoted context omitted.

Is there any evidence that doctors in other countries have a lower rate of diagnostic errors?

I trust it will higher, because if patients was not directly killed by them, doctors always get same salary.

Huh?
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