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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

#161

Post by DonnyV »

zoomablemind wrote: post #138
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…

> ...Medicare For All is the better and cheaper way forward. I'm puzzled why the article prefaces one of its rationales with this: '...“With Medicare for All seemingly off the table, our paper suggests we can still tackle administrative costs through structural changes to the payment process,” said Kevin Schulman, MD, MBA, ...' Why is that Medicare for All is off the table?

Thats by design. Every major player is trying to make Medicare For All go away. They don't want to lose there golden egg. Insurance companies, Pharmaceutical companies, Pro Capitalists organizations, Medical device vendors, etc

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

#162

Post by rustybelt »

milliondollar wrote: post #109

Their solution in the TFA is to focus on straight-through billing through standardization of payment mechanisms, arguing that each physician is paying $100K / year. Of course, this also puts the lie to the insurance companies, who are the other side of the transaction and essentially add another 20% in cost just to pay the bill! (Their loss ratios due to medical costs are about 80%.) Insurance companies are basically…

My reaction exactly. This article basically says we can achieve much of the savings of Medicare for all if insurance companies and providers put aside self-interest to voluntarily and in a coordinated manner adopt the aspects of Medicare for all that reduce costs! And if apes had tails they'd be monkeys!

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

#163

Post by coredog64 »

andrewlgood wrote: post #139
NoGravitas wrote: post #118

Earlier quoted context omitted.

> 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.

Silly response. One study found 20.6% of overall medical care was unnecessary. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587107/ Simple example is testing. If free to consumer, they will get too many cat scans and other expensive tests, "just in case."

Testing is “free” to the provider, so they suggest it just in case.

The much maligned HMO was an early attempt at applying market discipline to medical care. Guess what? People hated it.

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

#164

Post by DonnyV »

zanny wrote: post #153
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 th…

Medicare For All is not just an extension of the existing Medicare. It expands it to everyone and fixes some of those holes. Medicaid would still be there for services outside MFA like senior long term care.

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

#165

Post by smnrchrds »

ju-st wrote: post #154
perlgeek wrote: post #79

Earlier quoted context omitted.

... 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.

Is it calculated as a percentage of income? In that case, it is effectively a tax, and like any progressive taxation, higher income individuals pay more.

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

#166

Post by smnrchrds »

zoomablemind wrote: post #138
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…

> ...Medicare For All is the better and cheaper way forward. I'm puzzled why the article prefaces one of its rationales with this: '...“With Medicare for All seemingly off the table, our paper suggests we can still tackle administrative costs through structural changes to the payment process,” said Kevin Schulman, MD, MBA, ...' Why is that Medicare for All is off the table?

> Why is that Medicare for All is off the table?

Perhaps because of this:

https://www.politifact.com/factchecks/2020/mar/10/facebook-p...

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

#167

Post by gowld »

kaesar14 wrote: post #102
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…

Of the people who attempt the pre-med track not all will make it. Forcing students to get an actual Bachelor's degree gives students some fallback. I think really it's just the system was built this way and nobody's going to change it now.

They can switch to a Bachelors when they transfer off the med track.

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

#168

Post by gowld »

andrewlgood wrote: post #139
NoGravitas wrote: post #118

Earlier quoted context omitted.

> 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.

Silly response. One study found 20.6% of overall medical care was unnecessary. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587107/ Simple example is testing. If free to consumer, they will get too many cat scans and other expensive tests, "just in case."

>The most common cited reasons for overtreatment were fear of malpractice (84.7%), patient pressure/request (59.0%), and difficulty accessing medical records (38.2%).

so not relevant to this coversation.

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

#169

Post by dragonwriter »

coredog64 wrote: post #163
andrewlgood wrote: post #139

Earlier quoted context omitted.

Silly response. One study found 20.6% of overall medical care was unnecessary. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5587107/ Simple example is testing. If free to consumer, they will get too many cat scans and other expensive tests, "just in case."

Testing is “free” to the provider, so they suggest it just in case. The much maligned HMO was an early attempt at applying market discipline to medical care. Guess what? People hated it.

> The much maligned HMO was an early attempt at applying market discipline to medical care. Guess what? People hated it.

HMOs remain common, and none of the satsifaction data I can find shows satisfaction with them significantly lower than PPOs or traditional insurance. Not sure why you act like they are something that exist only in the past or universally hated.

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

#170

Post by weasel_words »

tryptophan wrote: post #112
heymijo wrote: post #69

Earlier quoted context omitted.

I just realized Physician Assistants (PAs) and Nurse Practitioners (NPs) have been forgotten in this equation. 126,000 practicing PAs [0] 325,000 licensed NPs [1] 985,000 practicing physicians (MDs and DOs) [2] I know that nurse practitioners are not under the same artificial residency constraints of MDs/DOs. I'm not sure about physician assistants. For someone not in the U.S., NPs and PAs often do the same role as g…

PA/NA education is a complete joke compared to what your average MD gets. They are not qualified to practice as general doctors at all. However, they are really cheap, which is why corporations are pushing them so hard. Substandard care in the name of profits.

Wow I was about to gush about how much I LOVE my NP compared to my old crappy, braindead MDs. I could share stories of how bad MDs are...and the horrors of insurance.

She is sharp as a whip. Smarter and more motivated than ANY MD I've EVER had. Anything she doesn't know about, she researches (on her own time/dime). She prescribes everything - dirt cheap. Lets me text/call/email ANY time. Refers me to a specialist for anything beyond her expertise (just like any MD would!) DIRT CHEAP (eg: MRI for $300, scheduled within a day or two down the street). A single, cheap, monthly fee ($65/mo!) lets me see her any time day and night, ask anything, discuss as long as I like...and I do all these things! No MD going through standard insurance would allow anything even remotely similar.

...I could go on...

imo the NP model is FAR superior than the traditional insurance+MD crap model we have right now. It's one of those things "they" don't want people learning about since it'll crush the traditional way of doing things once people realize how amazing that model is.

Yes I have basic insurance since it's required. And, just in case - she obviously doesn't have an emergency room.

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