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About that "World's Best Healthcare System" the U.S. is supposed to have...

Most malpractice suits are dismissed. Most of the rest are won by the physician. There are relatively few large payouts. But that does not mean that all these frivolous lawsuits are cost free. Almost all doctors will be sured at least once during their careers. Defending groundless suits costs the physicians a lot, lot of money (that eventually comes from payments made on behalf of patients), a lot of time, and a lot of headaches. They really do bend over backwards to avoid them, and that includes a lot of defensive medicine that costs a lot.

http://abcnews.go.com/Health/risk-malpractice-claims-high-physicians/story?id=14327391
 
As usual tjmd cannot read. The part in red directly addresses defensive medicine. Even with that it's only 2.4% of costs.

The reality is malpractice insurance premium rates are a total fraud.
 
$60 billion is a lot and that is the very low end of the estimates. Others estimate many times that amount.

http://www.jacksonhealthcare.com/media/8968/defensivemedicine_ebook_final.pdf

I have no idea if med mal insurance premiums are fraudulent but I know that some companies are run by physician's groups themselves who probably do not want to pay more than they have to pay. I do think defensive medicine is a factor in increasing medical costs. It is hard to estimate how much extra money physicians spend on unnecessary tests because they are afraid of not being able to defend a decision in court.
 
$60B is a lot in the abstract. $60B out of $3T is 2%. Even if insurance companies only take 10-15% out of the $3T for their costs, the cost of having middlemen is 500-750% of the cost of defensive medicine.

71, here's NPR's take. http://www.npr.org/blogs/health/201...e-not-as-much-as-the-doctor-ordered-after-all

RE: Malpractice rates- if payouts are dropping or at worst static, there is no justification for increasing premiums at the rates they are.
 
tjcmd said:
Every law makes it worse, ONW. Every government intervention makes it worse. I'm sure the 1973 HMO is no different. I don't know how anyone could get stuck on that particular one, but rave on.
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Well because it's the most important f'ing one relevant to this issue, but rave on.
 
I'm a radiation oncologist, so that hits very close to home for me. I'll try and come back and give my full thoughts later, but the article is very fair. People got greedy with protons. There are clear advantages in certain situations (many pediatric tumors, for example). But many centers were built with a business model that centered on treating prostate cancer as the main source of revenue at historic reimbursement rates, which was/is completely inappropriate, imo. There was a window when good comparative effectiveness research could have been done with favorable reimbursement rates, but the field did a poor job of taking advantage of it and now insurers are (understandably) starting to balk at paying 2.5x the dollars for no proven benefit. I think what will likely happen is billing will get scaled back to a level comparable to the accepted standard of care (IMRT, in the case of prostate cancer) to allow for the studies to proceed, and centers will have to eat the difference, at least for now.
 
Good, but not perfect, article here highlighting the adversarial nature between physicians and hospitals/administration in the US.

How to Discourage a Doctor

I've met the author and heard him speak a number of times. There's probably a touch of embellishment here, but I think his overall point pretty much hits the mark.
 
In depth study on infant mortality characteristics finds that differences in reporting (i.e., the US reports live births that other countries report as stillbirths) have an impact, but even adjusting for that impact infant mortality in the US is nearly twice as high as peer countries. Why? Because poor children in the US die at a much higher rate in their first year than poor children in peer countries. The study does not draw conclusions as to the causes of this discrepancy. Personally, I think it's rather obvious - poor children in the US simply do not have the same access to health care as poor children in our peer countries.

http://theincidentaleconomist.com/wordpress/so-why-is-our-infant-mortality-so-bad/
 
That article compares the U.S to Austria and Finland. Cherrypick much? Those are not our "peer countries" with respect to pretty much anything, especially related to our collective genetic/healthcare makeup. But it boasts a link to some stats, so millennials will bite.
 
Deacon923 said:
In depth study on infant mortality characteristics finds that differences in reporting (i.e., the US reports live births that other countries report as stillbirths) have an impact, but even adjusting for that impact infant mortality in the US is nearly twice as high as peer countries. Why? Because poor children in the US die at a much higher rate in their first year than poor children in peer countries. The study does not draw conclusions as to the causes of this discrepancy. Personally, I think it's rather obvious - poor children in the US simply do not have the same access to health care as poor children in our peer countries.

http://theincidentaleconomist.com/wordpress/so-why-is-our-infant-mortality-so-bad/
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#bootstraps
 
2&2 Slider To Leyritz said:
That article compares the U.S to Austria and Finland. Cherrypick much? Those are not our "peer countries" with respect to pretty much anything, especially related to our collective genetic/healthcare makeup. But it boasts a link to some stats, so millennials will bite.
Click to expand...

I live in Austria - there's no reason the United States of America, the wealthiest, most powerful nation in the world - should not be a "peer country" when it comes to the health of our citizens.


And yes, Austrian health care (and general social services) are light years ahead of the United States. Living here for a few years is a pretty eye opening experience of what life can actually be like.
 
Here we go with the "genetic" argument again, which 2&2 has posted about 4 times in this thread as though it's a real thing, without of course any kind of link to back it up. 8.8% of Austria's population is foreign born, one of the highest rates in Europe.http://en.wikipedia.org/wiki/Demographics_of_Austria

The important thing about this infant mortality study is that (i) it adjusts for differences in reporting live vs. still births, which is the #1 justification that US health system defenders always bring up, and (ii) it isolates the major difference in infant mortality to poor children in their first year of life (after they have left the hospital). The clear implication is that our system does not do nearly as good a job as peer countries in delivering health care to poor mothers and their infants.
 
So, again, just because nobody else has the common sense that I do to be able to spot a pretty blatant issue when trying to compare US healthcare to healthcare in other countries, that means that the theory is trash? It isn't my fault that the people running these "studies" are (a) going into it with an agenda, and (b) idiots.
Is this type of study within Ph's wheelhouse? He should run with it and make his career. I'll give him all the credit.
 
vadimivich said:
I live in Austria - there's no reason the United States of America, the wealthiest, most powerful nation in the world - should not be a "peer country" when it comes to the health of our citizens.


And yes, Austrian health care (and general social services) are light years ahead of the United States. Living here for a few years is a pretty eye opening experience of what life can actually be like.
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What does wealth have to do with genetics?
 
2&2 Slider To Leyritz said:
So, again, just because nobody else has the common sense that I do to be able to spot a pretty blatant issue when trying to compare US healthcare to healthcare in other countries, that means that the theory is trash? It isn't my fault that the people running these "studies" are (a) going into it with an agenda, and (b) idiots.
Is this type of study within Ph's wheelhouse? He should run with it and make his career. I'll give him all the credit.
Click to expand...

This has got to be a top 10 all time 2&2 post. Quoted for posterity.
 
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