211–220 of 275 posts
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It's kinda ridiculous that because it costs x billion in doctors overcharging, we'll spend 100x on administration to control costs. Cutting off one's nose to spite one's face and all that.
Nobody actually wants to control costs. From doctors to hospitals to insurance companies, everyone but consumers benefit from high prices.
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Because these are world health organisation 'international disease classification' codes that are designed for population health study and happen to be used for insurance billing in the US. There are requirements for some data to be reported to federal and international organisations. For instance, these codes are also used on death certificates I think, so they can track whether a lot of people are dieing of flu (pr…
But if an app developer in a different industry doesn't know the history behind it then a must be worthless.
I’ve lost count of all these times a freshly onboarded dev, replacing the old one, decided the système was needlessly complex, nothing made sense, and it’d be easier to just rebuild everything from the ground up.
Only to end up with a similarly complicated nonsense, because the complexity actually was in the domain, and he knew nothing of it.
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> The more treatments a doctor gives, the more they get paid You could say this 30 years ago, but it's not really the case today. The majority of physicians are now salaried, not independent. And even for many of the ones in independent private practice, the amount they make is not necessarily tied anymore to the services they provide, due to the rise of capitation and other forms of bundled service agreements. Nowad…
This is the basis of all Medicare Advantage Plans, where the physician or their employer gets X$ a month per MAP patient and must pay for most of the cost of care. The insurance company gets to keep most of its share of what Medicare pays. Nice profit ensues for the insurance company.
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You don’t need arbitrary codes to get statistics for something that can be typed in a description field.
I've spent a lot time around people doing statistics for environmental science, especially regulatory compliance around accidentally killing birds and bats. The unfortunate reality for the statisticians is that every tech thinks they're Henry David Thoreau or something. Like, nobody cares if it was a particular large exemplar of a given species, or that it had magnificent plummage, just write down the species of the…
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But then there’s an incentive to be slow
So then you also add a constant per patient, but then there's an incentive to be rushed. Gosh, it seems like profit incentive is a really bad way to run a healthcare system, doesn't it!
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Sure, there are other uses for the data. But the fact remains that generating it isn't free. And changing the coding in and of itself incurs significant administrative cost, so "we've come this far; we might a well just keep going" isn't really a compelling reason to expand ICD.
> Sure, there are other uses for the data. But the fact remains that generating it isn't free. And changing the coding in and of itself incurs significant administrative cost, so "we've come this far; we might a well just keep going" isn't really a compelling reason to expand ICD. The WHO expands and revises ICD all the time - and how it gets used by US health insurance isn’t really a concern of theirs. The WHO has 1…
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> Sure, there are other uses for the data. But the fact remains that generating it isn't free. And changing the coding in and of itself incurs significant administrative cost, so "we've come this far; we might a well just keep going" isn't really a compelling reason to expand ICD. The WHO expands and revises ICD all the time - and how it gets used by US health insurance isn’t really a concern of theirs. The WHO has 1…
Yes, but we're in a thread about health insurance. That that isn't the primary concern of the WHO is beside the point.
The fact that the US chooses to use it for something which was not its originally intended purpose is the fault of the US, not the fault of the ICD. The WHO doesn’t force the US health insurance system to use it, the US could invent its own totally unrelated coding system for that purpose and the WHO wouldn’t care (so long as those codes can be converted to ICD codes for statistical analysis)
There are separate charge codes for everything , and all of those codes need to be reflected in the pricing data. There's a price to slap on a bandaid. There's a price to give someone a Tylenol. Hell, W61.61XA is the medical code for "Bitten by duck, initial encounter." Presumably, this means there's also a code for "Bitten by duck, again." Medical billing is broken , and it's no surprise that the amount of data is o…
Medical billing is broken Is it? Seriously - how do you know ? More specifically: broken compared to what ? What would you replace it with? Be specific, please. Keeping in mind that it's like, an extremely complex domain and all, you know.
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If you need medicine to live, you should pay for it. If you can't, the government should step in. However, making me pay $400 a month for insurance in case I need stitches next month because I have to subsidize your medicine is annoying. I want insurance in case something I don't know about goes wrong. You want something you know you need.
Right, but the government doesn't step in. I've voted for universal healthcare sorry supporting candidates at every local, state, and federal election. I'm sorry that my illness is "annoying" you, but your anger is misplaced. Not that long ago I used to only have insurance for stitches too.
If we want to pay for it via government mandate, fine. Raise taxes. That way during my lower earning years I dont need to artificially pay for it through health "insurance" that isn't really insurance.
There are separate charge codes for everything , and all of those codes need to be reflected in the pricing data. There's a price to slap on a bandaid. There's a price to give someone a Tylenol. Hell, W61.61XA is the medical code for "Bitten by duck, initial encounter." Presumably, this means there's also a code for "Bitten by duck, again." Medical billing is broken , and it's no surprise that the amount of data is o…
Medical billing is broken Is it? Seriously - how do you know ? More specifically: broken compared to what ? What would you replace it with? Be specific, please. Keeping in mind that it's like, an extremely complex domain and all, you know.