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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

#81

Post by mr_woozy »

HDMI_Cable wrote: post #33
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…

It really is harder in the US. The standards are much higher in the US than anywhere else. The US only accepts doctors who went to Canadian or American medical schools. And then on top of that, it is much harder to get into a medical school here in NA than practically anywhere else, except maybe India. I know that in the UK you can go directly from high school, meanwhile in the US & Canada you need a 515 MCAT, 3.7 GP…

>The US only accepts doctors who went to Canadian or American medical schools.

The fuck are you on about? Why would you think this?

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

#82

Post by signal11 »

alistairSH wrote: post #58
HDMI_Cable wrote: post #33

Earlier quoted context omitted.

It really is harder in the US. The standards are much higher in the US than anywhere else. The US only accepts doctors who went to Canadian or American medical schools. And then on top of that, it is much harder to get into a medical school here in NA than practically anywhere else, except maybe India. I know that in the UK you can go directly from high school, meanwhile in the US & Canada you need a 515 MCAT, 3.7 GP…

The US only accepts doctors who went to Canadian or American medical schools. That's absolutely not true. Foreign medical graduates do have to take the US board exams, complete a US-based residency, and possibly take additional courses to fill educational gaps, but they absolutely can practice in the US with a foreign medical degree.

Here's an article that describes the pathway by which foreign doctors can get a medical license in the US: https://www.voanews.com/student-union/how-indian-doctors-get...

In brief, they have to sit the MLE (medical licensing exams), but the real hurdle is getting into a US-based residency program beforehand. In practice, this means only the best candidates tend to make it.

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

#83

Post by JamesBarney »

alistairSH wrote: post #58
HDMI_Cable wrote: post #33

Earlier quoted context omitted.

It really is harder in the US. The standards are much higher in the US than anywhere else. The US only accepts doctors who went to Canadian or American medical schools. And then on top of that, it is much harder to get into a medical school here in NA than practically anywhere else, except maybe India. I know that in the UK you can go directly from high school, meanwhile in the US & Canada you need a 515 MCAT, 3.7 GP…

The US only accepts doctors who went to Canadian or American medical schools. That's absolutely not true. Foreign medical graduates do have to take the US board exams, complete a US-based residency, and possibly take additional courses to fill educational gaps, but they absolutely can practice in the US with a foreign medical degree.

-> complete a US-based residency

This is the kicker. There are incredibly difficult to get, they are incredibly stressful, and it's another 3-5 years of your life.

If you allowed any non-us developers to practice in the US but you made them work a 5 year 80hr/week internship for 1/6th of what professional developers made first, that basically bans non-us developers from writing code in the U.S.

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

#84

Post by yalogin »

> 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 fixed. It might be just too big to fail at this point. However, it might plague "medicare for all" systems too, unless it's completely a separate system somehow. These entities will make every effort to get into the "medicare for all" flows as well.

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

#85

Post by cortesoft »

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.

The alternative take is that ADHD is over diagnosed in the United States.

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

#86

Post by andrewlgood »

tgb wrote: post #7
syops wrote: post #3

Earlier quoted context omitted.

The bottleneck is not the number of people with an MD. The bottleneck is the number of residency programs. These are funded by Medicare and I believe they are not profitable for hospitals.

There's some good reason to think that residencies are profitable: in 2019, 550 of them were auctioned off for $55 million in a controversial bankruptcy case. https://www.inquirer.com/business/hahnemann-university-hospi...

It is not that the residencies themselves are profitable. It is that medical schools need to be able to provide residency slots to their students to have an effective program. Definitely an issue for newly formed for-profit medical schools.

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

#87

Post by benlivengood »

bilbo0s wrote: post #75
nitwit005 wrote: post #62

Even fairly mundane steps like assigning people uniform medical record numbers, so that every single organization doesn't need its own system, is a heated political issue in the US: https://ehrintelligence.com/news/house-votes-to-overturn-nat...

That's because companies like Epic exist. Their entire business is fixing impedance mismatches. Your implicated solution is to eliminate impedance mismatches. Do you think the major med tech firms will be for or against that? What do you think their lobbyists will recommend?

I'd lay the blame closer to interface engine companies (whose job is often to disambiguate MR#) and individual practices (who don't want the overhead of working with centralized MR# source of truth) since Epic makes an entire EHR and can almost certainly interface with any ADT (admit, discharge, transfer) system as a source of truth for medical records.

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

#88

Post by andrewlgood »

taurath wrote: post #6

Can anyone grok what the actual proposed reforms are? It’s missing from the article.

By analogy, automobiles would be cheaper if you could only by green sedans using an online portal. Sure it would be less expensive, but you also eliminate many choices.

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

#89

Post by bialpio »

triceratops wrote: post #65
jimnotgym wrote: post #48

Earlier quoted context omitted.

Citation definitely needed here And just to be sure, I would like you to start from the beginning of the person's medical training and not include the gatekeeping bit of having to get a bachelors in a random subject unrelated to medicine. I note this Wikipedia article that suggests 4 years messed school plus 1 year internship could get me a license in the US. That sounds like Western Europe to me. Or India... https:/…

> I would like you to start from the beginning of the person's medical training and not include the gatekeeping bit of having to get a bachelors in a random subject unrelated to medicine. Why? An apples-to-apples comparison would be to see how long it takes to become a general physician after completing secondary school. In the UK or India it's something like 5.5-6 years.[1] In the US it's 3-4 years of "pre-med", the…

> 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 that they are not just rolled into the first year (or two) of medical degree. Why force people to finish undergrad studies if only a few courses are relevant?

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

#90

Post by fuzzer37 »

> A new analysis by Stanford researchers suggests the health care industry can reap many of the economic benefits of a “Medicare for All” program through incremental changes to the private health care market.

Why not just implement Medicare for All, instead of trying to band-aid the private healthcare market?

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