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Health insurers just published close to a trillion hospital prices

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Re: Health insurers just published close to a trillion hospital prices

#511

Post by pc86 »

kolbe wrote: post #485
pc86 wrote: post #435

Earlier quoted context omitted.

I'll be more clear - doctors have almost no extra or unnecessary training during their residencies. It's all very specialty-driven, or at the very least is specialty-specific public service (e.g. low-income clinics). If anything, the doctors I've spoken to said they should all probably be a year or two longer across the board if only to allow for better work-life balance, but none of them would want to have to go thr…

You realize that 4 years of residency isn't the magical number of the perfect amount? Two could very well be sufficient, and the other two "extra or unnecessary training." Also, you keep ignoring the college requirement, which makes you seem very disingenuous, and if you are a doctor, makes me worry for your patients.

I'm not a doctor, but why would you want a doctor who didn't go to college?

I was pre-med in college and quickly changed after I realized I didn't actually like biochem all that much. Imagine what that would have looked like had I been attending a medical school instead of a "normal" college.

It sounds like what you actually want is an NP or something like that. Which is fine, there are plenty of those around.

Re: Health insurers just published close to a trillion hospital prices

#512

Post by kasey_junk »

tptacek wrote: post #501
dfinninger wrote: post #367

Earlier quoted context omitted.

Well, I'm here in a major metro area of the US and it's 6 months or more for every doctor I try to see. Very difficult to get in to see anyone for anything.

Chicago. My actual GP schedules months out. An appointment with "any doctor in their practice" is within a week. An appointment at their affiliated urgent-care takes hours, usually less. The correct strategy is to get a GP affiliated with an urgent-care, schedule a checkup with the GP, and, meanwhile, just go to the urgent-care for everything; they'll send records over to your doctor if there's anything complicated.

Chicago, I can make a televisit appointment to my primary care doctor typically with 1 day lead times. In person is typically 2 so he can schlep down to his office. He is a single practitioner with part time office and IT help. He recommends going to the minute clinic a block away from my house for most things that I can recognize and only calling him for a yearly consult which is a review of blood tests and a discussion about my health or for something the clinic didn’t figure out.

This seems like a completely reasonable approach and I’m always surprised that it’s not the default.

Re: Health insurers just published close to a trillion hospital prices

#513

Post by kolbe »

pc86 wrote: post #511
kolbe wrote: post #485

Earlier quoted context omitted.

You realize that 4 years of residency isn't the magical number of the perfect amount? Two could very well be sufficient, and the other two "extra or unnecessary training." Also, you keep ignoring the college requirement, which makes you seem very disingenuous, and if you are a doctor, makes me worry for your patients.

I'm not a doctor, but why would you want a doctor who didn't go to college? I was pre-med in college and quickly changed after I realized I didn't actually like biochem all that much. Imagine what that would have looked like had I been attending a medical school instead of a "normal" college. It sounds like what you actually want is an NP or something like that. Which is fine, there are plenty of those around.

What? Why should I care whether or not they went to college? I want them to be able to do their job, and I don't care about prestige whoring over competency.

Maybe if they hadn't required classes that are irrelevant to 95% of doctors (orgo, biochem and pchem), you would have been able to pursue the career you wanted. This is yet more support for the idea my friend who "I should never ever listen to" said about requiring far too much credentialing.

NPs would be fine... if they were allowed to give medical advise. Unfortunately, we still have to pay for someone with 6 years of excess schooling to come in to weigh in officially and to pay a huge premium for it.

Re: Health insurers just published close to a trillion hospital prices

#514

Post by robertlagrant »

granshaw wrote: post #510
smcl wrote: post #415

Earlier quoted context omitted.

I've heard that too, but I have heard on multiple occasions that this will cause a lot of people employed in the field to lose their (sometimes quite well paying) jobs working in billing.

And for some reason it seems like a lot of those jobs are staffed by right leaning people, even if left leaning areas…

What do you mean by left leaning areas?

Re: Health insurers just published close to a trillion hospital prices

#515

Post by heavyset_go »

dominotw wrote: post #464
heavyset_go wrote: post #398

Earlier quoted context omitted.

Metabolic syndrome is often a side effect of medication or symptom of other diseases that can't be fixed with lifestyle modifications alone. For example, there are a lot of people on psychiatric medications that can cause metabolic syndrome as a primary side effect.

> is often Would be interesting to know how often.

Tens of millions of people in the US take atypical antipsychotics and antidepressants that cause metabolic syndrome as a very common side effect.

Re: Health insurers just published close to a trillion hospital prices

#516

Post by mattewong »

easrng wrote: post #72
A4ET8a8uTh0 wrote: post #50

Earlier quoted context omitted.

In their defense, if it was anything but CSV files, they would be accused of making it too complicated/locking into proprietary formats and so on. I can't say CSV would be my first choice, but I don't really want to think what the alternative would be.

NDJSON? Sqlite?

All this banter arguing over CSV, JSON, sqlite seems unnecessary when you can just push format X through a pipe and get whichever format Y you want back out: https://github.com/liquidaty/zsv/blob/main/docs/csv_json_sql...

(disclaimer: I'm one of the zsv authors)

Re: Health insurers just published close to a trillion hospital prices

#517

Post by Vecr »

robertlagrant wrote: post #514
granshaw wrote: post #510

Earlier quoted context omitted.

And for some reason it seems like a lot of those jobs are staffed by right leaning people, even if left leaning areas…

What do you mean by left leaning areas?

Probably they mean most cities, look at the voting statistics in various somewhat recent elections. If you don't buy the left/right dem/repub mapping, you can look at the various stances of the actual local officials elected.

Re: Health insurers just published close to a trillion hospital prices

#518

Post by narrator »

thewebcount wrote: post #341
narrator wrote: post #85

Earlier quoted context omitted.

What do you think about how Kaiser has handled the whole thing? The insurance company employing the doctors and just paying them a standard salary seems to create all the right incentives.

My experience in talking to people with chronic conditions that aren’t easily treatable is that Kaiser’s model works great until anything that’s slightly out of the ordinary happens, and then it falls apart. If you’re a zebra (as in “when you hear hooves, think horses, not zebras”), their model is pretty horrible.

The best thing about Kaiser, IMHO, is there is never a surprise out-of-network astronomical charge on the bill as I've seen with regular insurance.

Re: Health insurers just published close to a trillion hospital prices

#519

Post by JosephGuerra »

trashtester wrote: post #401
jjeaff wrote: post #335

Earlier quoted context omitted.

I don't think driving is merely to avoid physical expenditure. Driving is a result of rural and suburban living as well as poor urban planning. Lots more people would walk or bike if it was reasonably feasible.

I suspect it's a bit of a chicken/egg problem (based on my opservations from visiting the US). Even in suburban areas there seems to be roads everywhere, often very hard to cross without a car. Where I live in Europe, the expectation is that the kids will walk or take the bike to school. 95% of the paths they need to travel is covered by walkways (usually separated from the roads, and in many cases with dedicated bik…

Where i live in the suburbs we don't even have sidewalks ffs. I live about 3 blocks from my kids' school, yet they are driven or take the bus to school because kids are not allowed to bike or walk to elementary or middle school, unfortunately.

wow, didn't realize so much of EU can afford electric vehicles. They are more expensive over here in the U.S. - especially compared to a decent used car. Is this a function of the cost of fuel being much higher over there? Or are there subsidies for purchasing electric or something else?

Re: Health insurers just published close to a trillion hospital prices

#520

Post by amanaplanacanal »

anonu wrote: post #233
e_i_pi_2 wrote: post #71

Earlier quoted context omitted.

Do you consider the amount that the US spends per capita on healthcare relative to other countries for the same standard of care a "failure" of the healthcare industry? Or is there some other reason healthcare "just costs more" here? Also wondering what you think a solution is - single-payer for better and simpler price negotiations, or some other approach? My main concern is if we're spending 20% of GDP on something…

There's many things wrong with US healthcare. But somehow the USA comes up with the the first vaccines for the coronavirus and if you want any sort of complex procedure you travel to the US to get it. So maybe thats where the extra cost goes? To drive research, and support the infrastructure that creates good to better health outcomes on average vs the rest of the world. Saying something is a failure just because it…

Vaccines for the COVID were developed simultaneously in multiple countries.
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