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Researchers chart path to drastically lower administrative costs of health care

med.stanford.edu

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Re: Researchers chart path to drastically lower administrative costs of health care

#151

Post by bialpio »

ameister14 wrote: post #141
bialpio wrote: post #89

Earlier quoted context omitted.

> Why? An apples-to-apples comparison would be to see how long it takes to become a general physician after completing secondary school. Because if the requirement in the US is indeed "bachelor's degree required, any will do", then it exists solely for gate-keeping and says nothing about the standards of education. Edit: looking at wiki, the requirements are actually a bit more reasonable, but it does seem strange th…

Some universities in the US offer a 7 year undergrad and medical degree. Those usually have an extremely high GPA requirement but it's possible to do just that.

Interesting, thanks! That's more in line with what I'd expect coming from Poland - medical degree is 6yrs (& is equivalent to Master's, I don't believe you get a Bachelor's degree during those), specialization then takes additional 5-6 years. For context, "normal" degrees are 3y (BSc) + 2y (MSc), which is also 1 year shorter than comparable education in the US. OTOH, I believe there's no such thing as "associate degree", and colleges are more focused from the get-go - you pick your major when applying for college (& the admission criteria are different based on that).

Re: Researchers chart path to drastically lower administrative costs of health care

#152

Post by rscho »

KptMarchewa wrote: post #134
rscho wrote: post #13

Earlier quoted context omitted.

> For example, the US has extremely high standards restricting who can practice medicine compared to the rest of world Rest of the world, yes. Rest of the developed world, not at all. The major difference is that becoming a doc in the US is much more expensive than pretty much anywhere else. You could also argue it's proportionally harder because of the more numerous competitors. But on an absolute level of knowledge…

Isn't the problem that US requires having bachelor's degree before you even can start studying medicine, which effectively makes people start 4 years later?

The question is not "when do you leave school?" it's actually "when are you employable as an independent practitioner?". In my personal experience, it's _much_ easier to get an attending/private practice position in the US at a younger age. Just because the country is huge and lots of places lack docs, probably. Of course, that's my experience and I could be wrong.

Re: Researchers chart path to drastically lower administrative costs of health care

#153

Post by zanny »

DonnyV wrote: post #29

Worthless paper, administrative costs is only a piece of the many issues with US "Healthcare". Medicare For All is the better and cheaper way forward. No one ever talks about what is the value all these Health Insurance companies bring? The whole point of their existence when they were created was to control costs. Obviously they have failed miserably. Medicare For All handles lowering or eliminating student loans fo…

Have you ever actually had someone on medicare navigate healthcare?

Its only partial coverage and the supplemental plans also are partial. Retirees regularly rake up thousands a year in medical expenses on medicare.

If anything we need medicaid for all. Its a total mess with the piecemeal systems that exist, but in PA at least (where I live) medicaid recipients pay like a dollar for basically any service. None of the copay nickle and diming (to the tune of $30 a pop) my grandmother is hounded with constantly.

And even that is a bitter pill. Its giving private insurance companies all the money and power still. The single payer has strong negotiating power but they still have to get someone to insure the citizenry and the cartel of insurers that exist can predate off that and do so eagerly.

Re: Researchers chart path to drastically lower administrative costs of health care

#154

Post by ju-st »

perlgeek wrote: post #79
legulere wrote: post #15

We have standardized health care billing in Germany, both for the around 100 public health insurances and the private ones. We still have a relatively expensive health care system when compared with other European countries.

... and much cheaper than the US, currently.

I pay 759€/month for my German public health insurance while in the US according to Google the average cost of platinum insurance (the best?) is $750/month.

Re: Researchers chart path to drastically lower administrative costs of health care

#155

Post by DonnyV »

NoGravitas wrote: post #118
andrewlgood wrote: post #91

Earlier quoted context omitted.

Free goods have infinite demand. Medicare for All will simply degrade outcomes a lower common denominator. Interestingly, will the government allow private medical practices to exist in a Medicare for All regime? If so, it seems we would simply end up where we are now.

> Free goods have infinite demand. I, too make unnecessary doctor appointments and hospital trips because my insurance covers them. I've developed a paraphilia for having blood drawn, and I'm considering having some perfectly functional limbs amputated.

LOL...love it

Re: Researchers chart path to drastically lower administrative costs of health care

#156

Post by rscho »

triceratops wrote: post #137
rscho wrote: post #132

Earlier quoted context omitted.

Well, I can answer that very clearly from personal experience: you are wrong. Medical education is much shorter in the US compared to most western countries. You have to understand that in medicine, school years are not all there is to it. The real issue is when do you get to truly practice without supervision, and that's much earlier in the US. Basically, a short residency and 1-2 years of fellowship and... done! In…

> The real issue is when do you get to truly practice without supervision, and that's much earlier in the US. Is it? If a doctor in the UK can graduate from medical school and practice as a GP 6 years out of secondary school, but for a US doctor it takes 8-9 years, it's not really "earlier". What you're talking about is status within the profession.

For GPs, it may be true. I admit I was speaking from the POV of a specialist.

Re: Researchers chart path to drastically lower administrative costs of health care

#157

Post by DanBC »

238475235243 wrote: post #63
triceratops wrote: post #51

Earlier quoted context omitted.

The rest of your post I agree with but > just make the disease illegal, like ADHD in the UK What in the world are you talking about?[1] 1. https://www.nhs.uk/conditions/attention-deficit-hyperactivit...

You need a psychiatric evaluation for diagnosis, which is exceptionally hard to get. So there's a nice shiny website and then there's the reality. Getting the diagnosis and then medication can literally take years, and it looks like this is on purpose.

No, you don't. For adults it should be either a psychiatrist or a doctor with training and expertise; for children it should be a paediatrician.

https://www.nice.org.uk/guidance/ng87/chapter/Recommendation...

> 1.3.1 A diagnosis of ADHD should only be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD, on the basis of:

Re: Researchers chart path to drastically lower administrative costs of health care

#158

Post by DanBC »

238475235243 wrote: post #40
DonnyV wrote: post #29

Worthless paper, administrative costs is only a piece of the many issues with US "Healthcare". Medicare For All is the better and cheaper way forward. No one ever talks about what is the value all these Health Insurance companies bring? The whole point of their existence when they were created was to control costs. Obviously they have failed miserably. Medicare For All handles lowering or eliminating student loans fo…

Or we could make it legal to open hospitals, or charge differential pricing based on the time of day... you know, basic stuff? Most people have no idea how captured healthcare is. There's no competition, indeed most healthcare is government granted monopolies already. Having lived in countries with "free" healthcare, that isn't all it's cracked up to be either. A good example of cost cutting: just make the disease il…

Prescribing data is open. We can easily see plenty of ADHD meds being prescribed.

Lisdexamfetamine Dimesylate https://openprescribing.net/chemical/0404000U0/

Methylphenidate Hydrochloride https://openprescribing.net/chemical/0404000M0/

Atomoxetine Hydrochloride https://openprescribing.net/chemical/0404000S0/

There are problems with lots of NHS treatment. You don't need to spread misinformation.

Re: Researchers chart path to drastically lower administrative costs of health care

#159

Post by tw04 »

jostmey wrote: post #2

I agree with the three issues they identify driving up costs. But I fear “Medicare for All” won't fix all the issues, which go much deeper. For example, the US has extremely high standards restricting who can practice medicine compared to the rest of world, limiting the supply of doctors and artificially driving up their demand. There is a need for standards, but perhaps the AMA has too much political influence. Like…

>Likewise, manufacturers of medical supplies operate as monopolies because the moat to reach approval is really high.

I can tell you for a fact this simply isn't true. The reason manufacturers of medical supplies operate as a monopoly is because they have turned to acquiring everyone and anyone in the medical supply/device business and there's been 0 opposition to it.

https://www.beckersspine.com/orthopedic-a-spine-device-a-imp...

https://mergr.com/abbott-laboratories-acquisitions#cma-tab

https://www.greenlight.guru/blog/top-100-medical-device-comp...

You can go through the last link which is a list of device manufacturers and look at their acquisitions. They just eat up every small player that shows even a hint of providing competition. Some of them have been averaging an acquisition a month for years.

Re: Researchers chart path to drastically lower administrative costs of health care

#160

Post by coredog64 »

yalogin wrote: post #84

> Estimates suggest that the country wastes more than $265 billion annually due to this administrative complexity, and that the rate of increase in administrative costs has outpaced that of overall health care expenditures This happens for a reason. A 265 Billion industry (however fragmented) has developed to create/maintain and profit off the complexity. I am extremely pessimistic that they will allow this to be fix…

Private insurance companies are already deeply ingrained in Medicare, and I’m not just talking about Medicare Advantage. HHS has 5 or 6 large regional contracts where they have a private insurance company handle most of the administration. Uncle Sugar just pays the bills.

Which isn’t really too much different from private insurance at a large employer: Cigna or whoever just brings admin and a network of providers, while your employer pays the bills out of some actuarially sound pool of money.

Smaller employers can’t usually swing this, and that’s where the crappy rates come from.

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