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The Cost of an ACL Injury

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Re: The Cost of an ACL Injury

#131

Post by angersock »

dragonwriter wrote: post #127
angersock wrote: post #100

Earlier quoted context omitted.

If I dropped a Linux admin off at a shop which didn't have emacs on their boxen and he refused to work because he might accidentally screw up a config file, he'd be laughed out of the joint. If I dropped a plumber off at a job site and she didn't have a particular type of ergonomic monkey wrench she'd grown accustomed to and said she couldn't do the job, she'd be mocked endlessly. If I dropped a line chef off at a ki…

> If I dropped a Linux admin off at a shop which didn't have emacs on their boxen and he refused to work because he might accidentally screw up a config file, he'd be laughed out of the joint. The kind of errors made by a Linux admin who is more familiar with emacs using vi don't have as much likelihood of ending up with dead customers and massive liability for the Linux admin and/or his employer as the kind of error…

"But somehow I don't think letting surgeons choose the tools used for a particular surgery based on their own expertise and understanding of the needs of the particular surgery, rather than having one standard kit used for all surgeries regardless of the specific details of surgeon and patient, is the difference."

In isolation, your intuition is correct. But, with thousands and thousands of surgeons performing hundreds of thousands of surgeries a year, we end up with a logistical nightmare. This doesn't scale.

It's perhaps not the main difference, but I'm willing to wager it is at the least a symptom of whatever the underlying problem is.

Re: The Cost of an ACL Injury

#132

Post by csense »

jacoblyles wrote: post #97
pyre wrote: post #64

Earlier quoted context omitted.

That's because in Libertarian Utopia everyone of importance will be independently wealthy, and those who aren't, deserve to be trampled by the others. /sarcasm

Libertarians have been complaining about the USA's complicated health bureaucracy for decades. Hell, they've written dozens of books about it. It doesn't take a genius to find perverse incentives in US medical pricing schemes. But don't let me get in the way of your 30 seconds of hate...

Today with the US-based insurance system, there's usually at least one whole employee at every doctor's office whose only job it is to figure out who pays what, and do all the related phone calls and paperwork. For example talking to every patient's insurance company and turning medical procedures into ID numbers.

If the doctor sends you to get lab work, the lab has its own person that fills that role. If the doctor sends you to a specialist, ditto.

Of course the insurance companies have their own hordes of employees who write all the rules of who pays what under what circumstances, keep the books of all the patients' deductibles and all the providers' bills, etc.

None of these employees does anything economically productive. They just move money around.

Obamacare requires that people buy health insurance, which protects this bureaucracy with a legal mandate to purchase their services, and creates more bureaucracy, on the government side, to administer the law.

Re: The Cost of an ACL Injury

#133

Post by pyre »

rexreed wrote: post #130
pyre wrote: post #112

Earlier quoted context omitted.

I've met plenty of people whose political views on health care were along the lines of: Person 1: "You should pay for your own care" Person 2: "What if you are poor and can't?" Person 1: "Sucks to be you." With the possible addendum of: Person 1: "But charity organizations will cover the costs for those that can't pay, because then I can choose of my own will to put money towards the cause." Person 2: "What if not en…

Can the issue of who pays for healthcare be adequately separated from the issue of its cost? I think so -- given how wide the disparity in health COSTS (put aside the payer) are between not only countries, but even counties in the US [1]. It would be great if we can talk about the origin of these health costs without getting entangled into who should be paying them. But maybe that's an impossible task. The Libertaria…

Can (some of) the ballooning costs be attributed to the costs / time investment in medical school? When Ron Paul went to medical school how much did it cost (adjusted for inflation)? How much more knowledge are doctors expected to have now than then?

Re: The Cost of an ACL Injury

#134

Post by graylights »

milesskorpen wrote: post #105
angersock wrote: post #100

Earlier quoted context omitted.

If I dropped a Linux admin off at a shop which didn't have emacs on their boxen and he refused to work because he might accidentally screw up a config file, he'd be laughed out of the joint. If I dropped a plumber off at a job site and she didn't have a particular type of ergonomic monkey wrench she'd grown accustomed to and said she couldn't do the job, she'd be mocked endlessly. If I dropped a line chef off at a ki…

In all your examples, you aren't dealing with a person's health or (potentially) life. The risk-benefit calculation changes (and people become, understandably, somewhat irrational) when the stakes get that high.

And if a soldier gets to a new unit and they assign him a weapon he's not familiar with? The military definitely deals with life and death stakes.

Their solution: Frequent and continuous training.

What kind of ongoing training do hospitals offer their doctors? Who trains doctors on new equipment in hospitals? (honest questions)

Re: The Cost of an ACL Injury

#136

Post by ams6110 »

I wonder how the cost would compare at a special-purpose orthopedic surgery center vs. a general hospital? I actually thought that otherwise healthy people are encouraged to utilize specialty facilities rather than hospitals as they can be optimized to the procedures performed, and may have lower risk of post-op infections.

Re: The Cost of an ACL Injury

#137

Post by rexreed »

pyre wrote: post #133
rexreed wrote: post #130

Earlier quoted context omitted.

Can the issue of who pays for healthcare be adequately separated from the issue of its cost? I think so -- given how wide the disparity in health COSTS (put aside the payer) are between not only countries, but even counties in the US [1]. It would be great if we can talk about the origin of these health costs without getting entangled into who should be paying them. But maybe that's an impossible task. The Libertaria…

Can (some of) the ballooning costs be attributed to the costs / time investment in medical school? When Ron Paul went to medical school how much did it cost (adjusted for inflation)? How much more knowledge are doctors expected to have now than then?

Maybe, but not any significant part. As evidenced by this post, only a small portion of the costs are attributable to the work performed by the surgeon. The majority of costs are allocated to facility costs (whose increases in price are not related to tuition costs) and equipment.

Indeed, if there was such a direct correlation between the two, the easiest way to control healthcare costs would be to reduce doctoral school tuition rates. Clearly, this is not a viable solution here because the two are not directly correlated.

Now, it is true that Tuition Costs have risen at a much higher rate since 1960 than Health Care costs on a percentage basis compared to inflation [1] [2] [3], but in aggregate the actual health care costs on a per-individual basis dwarf total tuition costs as part of household income [4].

[1] https://lh3.ggpht.com/-dqm5PIPoC58/Ti8HKy2jjrI/AAAAAAAAPgU/W...

[2] http://chartingtheeconomy.com/wp-content/uploads/2009/04/hea...

[3] http://cdn.theatlanticwire.com/img/upload/2011/08/aw-chart-c...

[4] http://static2.businessinsider.com/image/4d775519ccd1d571150...

Re: The Cost of an ACL Injury

#138

Post by greedo »

dclowd9901 wrote: post #114
rayiner wrote: post #82

Earlier quoted context omitted.

Medical liability costs are about $55 billion in the U.S., or about 2.4% of overall costs: http://www.hsph.harvard.edu/news/press-releases/medical-liab... . There are debates about how much "defensive medicine" adds to the cost, but those aren't all that relevant here since the costs presented are exclusive of additional tests, etc.

Overall costs: 2.291 Trillion $7,638 per person per year. That just can't be right. I and 90% of the people I know haven't made a significant trip to the dr or hospital in years. Where the fuck is that money going?

Cancer elevates cost dramatically. I had cancer at age 41; I kept track of the full costs (not what my insurance negotiated downward) but stopped after my surgery, chemo and radiation treatment passed the $500k mark. I still go in for tests on an annual basis, so my guesstimate is that my total cost just for my cancer has probably surpassed $1 million. Even if that got negotiated down to $100K, that's still a lot. All it takes is one life threatening event, or a chronic condition to skew things out of what we would normally think is "normal" and rational in expenditures.

P.S. Thanks to my excellent doctors, Nathan Green and Richard Pitsch...

Re: The Cost of an ACL Injury

#140

Post by angersock »

graylights wrote: post #134
milesskorpen wrote: post #105

Earlier quoted context omitted.

In all your examples, you aren't dealing with a person's health or (potentially) life. The risk-benefit calculation changes (and people become, understandably, somewhat irrational) when the stakes get that high.

And if a soldier gets to a new unit and they assign him a weapon he's not familiar with? The military definitely deals with life and death stakes. Their solution: Frequent and continuous training. What kind of ongoing training do hospitals offer their doctors? Who trains doctors on new equipment in hospitals? (honest questions)

" Who trains doctors on new equipment in hospitals?"

Dirty secret. Equipment vendors. Ditto for pharmaceuticals.

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