RWs, how do we fix our shitty healthcare system?

[beagle9]

Ok so you hate ObamaCare. Whatever. You hate anything Obama comes up with so you come across like disingenuous douche bags anyway.

How do we fix our healthcare woes? What, exactly, should be done to curb the increasing cost to the consumer of healthcare costs while wages have remained flat? Keep in mind that healthcare costs have been increasing long before ObamaCare. With that in mind, why was our healthcare system ever feasible?

Just agree that legislation is what's needed to cap expenses such as prescriptions. In the end more socialization is what's needed to fix our system. Despite what the Neanderthals on Fox News will tell you, Canada's healthcare system works. 91% of Canadians favor their system over the US's system. Western Europe also has great, affordable healthcare systems.

Change of Subject: Never mind the anecdotes: Do Canadians like their health-care system?

WHO | World Health Organization Assesses the World's Health Systems

"The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18 th . Several small countries – San Marino, Andorra, Malta and Singapore are rated close behind second- placed Italy."

Yes medical care here is sophisticated, but that hardly means jack shit if most Americans can't benefit from it.

We have been answering this question since before Obamacare. Get rid of the regulations that favor the industry and open up health insurance to the forces of the free market. Problem solved.

And how, in anyway, would that lower the cost of medical services like prescriptions?

. My co-workers wife who is insured does not get a prescription card that she could use to get a discount on her prescriptions. Now what is going on here ? He said that they (????), told her that this benefit is ending for all clients now. Not sure how many are affected by this, but why is insurance companies getting worse and worse and worse ? He told me that he remembered when he worked at Tupperware back in the early eighties, and he said the insurance was awesome at that time. What has happened since then ? I remember similar things myself, so yes what happened ? How is it that when a station tries to sell gas for a gross exceedingly expensive amount during an emergency, that the government steps in to lay hefty fines on that station, but when healthcare providers do the same, well how come no one steps into stop that gouging ? Oh and dental insurance really does suck a dry goats teet, because it won't hardly pay much of anything. Dental should be part of healthcare, and not something we have to purchase seperate.

 

[Papageorgio]

Funny...a Liberal is asking Republicans / Conservatives how they are going to fix the shitty health care disaster they - liberals- rammed down the throats of the majority of Americans who opposed it.

Pelosi declared to the GOP and American citizens, 'You don't have the RIGHT to know what's in this shitty legislation until this shitty health care law is passed'... AND NOW the creators of the shitty health care system demand to know how those who have been 'victimized' by this shitty system are going to fix it.

Well one thing is for sure... In general the GOP did nothing to help make the bill a good one. From the start the pouted, dragged their heels, and did what they could to shut down the efforts. It's no surprise it came out full of holes. Think if all that energy was put towards doing their job and giving ideas, input, and strategy to make the bill as good as possible. It's embarrassing how things are running on the hill. I can only hope some miracle changes things for our future.

Was that because Obama told them to ride in the back of the bus? He and the Dems gloated and held the 2008 victory over the GOP and told them that it was there turn. Why would you work with bad leadership?

 

[Slade3200]

Funny...a Liberal is asking Republicans / Conservatives how they are going to fix the shitty health care disaster they - liberals- rammed down the throats of the majority of Americans who opposed it.

Pelosi declared to the GOP and American citizens, 'You don't have the RIGHT to know what's in this shitty legislation until this shitty health care law is passed'... AND NOW the creators of the shitty health care system demand to know how those who have been 'victimized' by this shitty system are going to fix it.

Well one thing is for sure... In general the GOP did nothing to help make the bill a good one. From the start the pouted, dragged their heels, and did what they could to shut down the efforts. It's no surprise it came out full of holes. Think if all that energy was put towards doing their job and giving ideas, input, and strategy to make the bill as good as possible. It's embarrassing how things are running on the hill. I can only hope some miracle changes things for our future.

Was that because Obama told them to ride in the back of the bus? He and the Dems gloated and held the 2008 victory over the GOP and told them that it was there turn. Why would you work with bad leadership?

You work with them because thats your job. You don't pout like a baby and make the situation worse

 

[healthmyths]

Ok so you hate ObamaCare. Whatever. You hate anything Obama comes up with so you come across like disingenuous douche bags anyway.

How do we fix our healthcare woes? What, exactly, should be done to curb the increasing cost to the consumer of healthcare costs while wages have remained flat? Keep in mind that healthcare costs have been increasing long before ObamaCare. With that in mind, why was our healthcare system ever feasible?

Just agree that legislation is what's needed to cap expenses such as prescriptions. In the end more socialization is what's needed to fix our system. Despite what the Neanderthals on Fox News will tell you, Canada's healthcare system works. 91% of Canadians favor their system over the US's system. Western Europe also has great, affordable healthcare systems.

Change of Subject: Never mind the anecdotes: Do Canadians like their health-care system?

WHO | World Health Organization Assesses the World's Health Systems

"The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18 th . Several small countries – San Marino, Andorra, Malta and Singapore are rated close behind second- placed Italy."

Yes medical care here is sophisticated, but that hardly means jack shit if most Americans can't benefit from it.

We have been answering this question since before Obamacare. Get rid of the regulations that favor the industry and open up health insurance to the forces of the free market. Problem solved.

And how, in anyway, would that lower the cost of medical services like prescriptions?

. My co-workers wife who is insured does not get a prescription card that she could use to get a discount on her prescriptions. Now what is going on here ? He said that they (????), told her that this benefit is ending for all clients now. Not sure how many are affected by this, but why is insurance companies getting worse and worse and worse ? He told me that he remembered when he worked at Tupperware back in the early eighties, and he said the insurance was awesome at that time. What has happened since then ? I remember similar things myself, so yes what happened ? How is it that when a station tries to sell gas for a gross exceedingly expensive amount during an emergency, that the government steps in to lay hefty fines on that station, but when healthcare providers do the same, well how come no one steps into stop that gouging ? Oh and dental insurance really does suck a dry goats teet, because it won't hardly pay much of anything. Dental should be part of healthcare, and not something we have to purchase seperate.

Obamacare forcing "pre-existing conditions"!
Obamacare NOT doing any tort reform as he is a lawyer and lawyers cause doctors to spend $850 billion a year wastefully on "defensive medicine" which the insurance companies pay and hence raise the premiums.

If the same rules that apply to doctors at the VA for example where they can't be sued due to a 1946 Federal Tort Act was implemented for all doctors, the $850 billion a year in defensive medicine claims would drop. THEN this is what most people don't know is STATE insurance regulators have to give approval for premiums.
These are based on a ratio known as Medical Loss Ratio. This is the percent of claims as of premiums. NOW under ACA insurance companies must be at
85% of premiums for claims.
Reduce the $850 billion a year in wasted defensive medicine claims by 20% or more and lower premiums because they have to keep at 85%.
READ THIS STUDY!! http://www.jacksonhealthcare.com/media/8968/defensivemedicine_ebook_final.pdf

In other words if the $850 billion a year spent by insurance companies on duplicate tests,etc. is reduced PREMIUMS have to be reduced.

 

[Slade3200]

Ok so you hate ObamaCare. Whatever. You hate anything Obama comes up with so you come across like disingenuous douche bags anyway.

How do we fix our healthcare woes? What, exactly, should be done to curb the increasing cost to the consumer of healthcare costs while wages have remained flat? Keep in mind that healthcare costs have been increasing long before ObamaCare. With that in mind, why was our healthcare system ever feasible?

Just agree that legislation is what's needed to cap expenses such as prescriptions. In the end more socialization is what's needed to fix our system. Despite what the Neanderthals on Fox News will tell you, Canada's healthcare system works. 91% of Canadians favor their system over the US's system. Western Europe also has great, affordable healthcare systems.

Change of Subject: Never mind the anecdotes: Do Canadians like their health-care system?

WHO | World Health Organization Assesses the World's Health Systems

"The U.S. health system spends a higher portion of its gross domestic product than any other country but ranks 37 out of 191 countries according to its performance, the report finds. The United Kingdom, which spends just six percent of GDP on health services, ranks 18 th . Several small countries – San Marino, Andorra, Malta and Singapore are rated close behind second- placed Italy."

Yes medical care here is sophisticated, but that hardly means jack shit if most Americans can't benefit from it.

We have been answering this question since before Obamacare. Get rid of the regulations that favor the industry and open up health insurance to the forces of the free market. Problem solved.

And how, in anyway, would that lower the cost of medical services like prescriptions?

. My co-workers wife who is insured does not get a prescription card that she could use to get a discount on her prescriptions. Now what is going on here ? He said that they (????), told her that this benefit is ending for all clients now. Not sure how many are affected by this, but why is insurance companies getting worse and worse and worse ? He told me that he remembered when he worked at Tupperware back in the early eighties, and he said the insurance was awesome at that time. What has happened since then ? I remember similar things myself, so yes what happened ? How is it that when a station tries to sell gas for a gross exceedingly expensive amount during an emergency, that the government steps in to lay hefty fines on that station, but when healthcare providers do the same, well how come no one steps into stop that gouging ? Oh and dental insurance really does suck a dry goats teet, because it won't hardly pay much of anything. Dental should be part of healthcare, and not something we have to purchase seperate.

Obamacare forcing "pre-existing conditions"!
Obamacare NOT doing any tort reform as he is a lawyer and lawyers cause doctors to spend $850 billion a year wastefully on "defensive medicine" which the insurance companies pay and hence raise the premiums.

If the same rules that apply to doctors at the VA for example where they can't be sued due to a 1946 Federal Tort Act was implemented for all doctors, the $850 billion a year in defensive medicine claims would drop. THEN this is what most people don't know is STATE insurance regulators have to give approval for premiums.
These are based on a ratio known as Medical Loss Ratio. This is the percent of claims as of premiums. NOW under ACA insurance companies must be at
85% of premiums for claims.
Reduce the $850 billion a year in wasted defensive medicine claims by 20% or more and lower premiums because they have to keep at 85%.
READ THIS STUDY!! http://www.jacksonhealthcare.com/media/8968/defensivemedicine_ebook_final.pdf

In other words if the $850 billion a year spent by insurance companies on duplicate tests,etc. is reduced PREMIUMS have to be reduced.

Sounds like a great savings... What do we do to solve problems around malpractice. If a doctors carelessness jepordizes you or a loved ones health or life... What keeps them accountable?

 

[Papageorgio]

Funny...a Liberal is asking Republicans / Conservatives how they are going to fix the shitty health care disaster they - liberals- rammed down the throats of the majority of Americans who opposed it.

Pelosi declared to the GOP and American citizens, 'You don't have the RIGHT to know what's in this shitty legislation until this shitty health care law is passed'... AND NOW the creators of the shitty health care system demand to know how those who have been 'victimized' by this shitty system are going to fix it.

Well one thing is for sure... In general the GOP did nothing to help make the bill a good one. From the start the pouted, dragged their heels, and did what they could to shut down the efforts. It's no surprise it came out full of holes. Think if all that energy was put towards doing their job and giving ideas, input, and strategy to make the bill as good as possible. It's embarrassing how things are running on the hill. I can only hope some miracle changes things for our future.

Was that because Obama told them to ride in the back of the bus? He and the Dems gloated and held the 2008 victory over the GOP and told them that it was there turn. Why would you work with bad leadership?

You work with them because thats your job. You don't pout like a baby and make the situation worse

It's not your job, your job is to represent the people that elected them. The Republicans were told by the Democrats they didn't need any votes.

Also the Republicans wanted tort reform and intranet carriers to cross state lines. That didn't happen.

I saw no scenario that would improve the health care system with more government involvement. Still don't.

 

[Slade3200]

Funny...a Liberal is asking Republicans / Conservatives how they are going to fix the shitty health care disaster they - liberals- rammed down the throats of the majority of Americans who opposed it.

Pelosi declared to the GOP and American citizens, 'You don't have the RIGHT to know what's in this shitty legislation until this shitty health care law is passed'... AND NOW the creators of the shitty health care system demand to know how those who have been 'victimized' by this shitty system are going to fix it.

Well one thing is for sure... In general the GOP did nothing to help make the bill a good one. From the start the pouted, dragged their heels, and did what they could to shut down the efforts. It's no surprise it came out full of holes. Think if all that energy was put towards doing their job and giving ideas, input, and strategy to make the bill as good as possible. It's embarrassing how things are running on the hill. I can only hope some miracle changes things for our future.

Was that because Obama told them to ride in the back of the bus? He and the Dems gloated and held the 2008 victory over the GOP and told them that it was there turn. Why would you work with bad leadership?

You work with them because thats your job. You don't pout like a baby and make the situation worse

It's not your job, your job is to represent the people that elected them. The Republicans were told by the Democrats they didn't need any votes.

I saw no scenario that would improve the health care system with more government involvement. Still don't.

I started a thread a few days ago about that... Jist is, people are uninformed idiots! Our elected officials are there to present the concerns and opinions of the people they represent but ultimately their job is to gather information, work together, and make SMART decisions that progresses our country towards a positive direction.

Voice of the idiots... I mean "people"

 

[Papageorgio]

Funny...a Liberal is asking Republicans / Conservatives how they are going to fix the shitty health care disaster they - liberals- rammed down the throats of the majority of Americans who opposed it.

Pelosi declared to the GOP and American citizens, 'You don't have the RIGHT to know what's in this shitty legislation until this shitty health care law is passed'... AND NOW the creators of the shitty health care system demand to know how those who have been 'victimized' by this shitty system are going to fix it.

Well one thing is for sure... In general the GOP did nothing to help make the bill a good one. From the start the pouted, dragged their heels, and did what they could to shut down the efforts. It's no surprise it came out full of holes. Think if all that energy was put towards doing their job and giving ideas, input, and strategy to make the bill as good as possible. It's embarrassing how things are running on the hill. I can only hope some miracle changes things for our future.

Was that because Obama told them to ride in the back of the bus? He and the Dems gloated and held the 2008 victory over the GOP and told them that it was there turn. Why would you work with bad leadership?

You work with them because thats your job. You don't pout like a baby and make the situation worse

It's not your job, your job is to represent the people that elected them. The Republicans were told by the Democrats they didn't need any votes.

I saw no scenario that would improve the health care system with more government involvement. Still don't.

I started a thread a few days ago about that... Jist is, people are uninformed idiots! Our elected officials are there to present the concerns and opinions of the people they represent but ultimately their job is to gather information, work together, and make SMART decisions that progresses our country towards a positive direction.

Voice of the idiots... I mean "people"

Calling people idiots, great way to reach out across the aisle. I am not a Cruz fan but you have failed to show how reaching across the aisle would have changed health care when many GOP ideas were not accepted from the start.

 

[Flopper]

They get lots of info from the hospitals and Big Pharm with ACA. Next they can use it for regulation.

YOU SAID a mouthful.. "use it for regulation"!

Did you ever think that there may be too much regulation???
-- The International Classification of Diseases version 10 (ICD-10) contains 141,060 code sets used to report medical diagnoses and inpatient procedures.
That’s a 712 percent increase over the 19,817 code sets in the currently used ICD-9 version.
--- As we have noted before, physicians are already spending 22 percent of their time interacting with insurers on formularies, claims, billing, credentialing,
pre-authorizations, and quality measure data. The workload can only increase with the new codes.
Healthcare Is Turning Into An Industry Focused On Compliance, Regulation Rather Than Patient Care

How the U.S. Health-Care System Wastes $750 Billion Annually
How the U.S. Health-Care System Wastes $750 Billion Annually
More than 18 months in the making, the report identified six major areas of waste:
unnecessary services ($210 billion annually);
inefficient delivery of care ($130 billion);
excess administrative costs ($190 billion);
inflated prices ($105 billion);
prevention failures ($55 billion), and
fraud ($75 billion).
Adjusting for some overlap among the categories, the panel settled on an estimate of $750 billion.

Your post seems to be a general rant about healthcare.
FYI, ICD codes have nothing to do with government regulations. ICD (International Classification of Disease) listing assigns a code to essentially every know disease and all medically recognized treatments. Without ICD codes, computerized claim processing and billing would be virtually impossible. The ICD as we know it has been around for over a 150 years.

Most of what we call waste in the healthcare industry is unavoidable in American healthcare because there is no way of determine the full cost of diagnosis and treatment or whether it will be successful until after the services have been rendered. Furthermore, it's the people that are selling the service who actually determine the need for service. Pre-authorization is usually just a formality that delays the rendering of the service. The problem is fee for service which encourages waste and over-utilization.

So you have NO problem with what doctors have told us are over $850 billion a year in duplicate testing, referrals, all out of fear of lawsuits? You think they made that up?

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

90% of physicians surveyed say they order $850 billion a year in wasted duplicate tests, referrals all out of FEAR of being SUED!
--- Emergency medicine, primary care, and OB/GYN physicians are most likely to practice defensive medicine.
--- 79 to 83% of surgeons and OB/GYNs have been named in lawsuits.
"Physicians contracted by the federal government practice significantly less defensive medicine as they are protected against lawsuits by the
1946 Federal Tort Claims Act. "
-- BUT........Only 48% practice defensive medicine compared to 92% of non-government physicians.
Consider that fact that of the physicians interviewed 52% DID NOT practice defensive medicine!
Who were they? Doctors contracted by federal government!
WHY did these doctors NOT practice "defensive medicine"??? 1946 Tort reform!

I have a problem with the study. In a 2014 study led by the Cleveland Clinic and published in JAMA Internal Medicine, fives years after the Jackson Healthcare study researchers asked a few dozen physicians in three hospital medicine services to estimate the defensiveness of their own orders.
Fully 28% of 4,200-plus orders were reported by physicians as being at least partially defensive, but only 2.9% were seen as completely defensive in nature. The Cleveland Clinic study cited a national cost estimate of $46 billion related to defensive medicine, not $850 billion dollars. Also when doctors were asked would tort reform result in a significant decrease in healthcare cost, 80% said no.

Rarely is defensive medicine the sole reason why a doctor orders more than required number of tests. When doctors where asked, they cited requests by the patient, age of the previous test, not trusting the test, unable to locate the test, and fear legal action. When doctors were asked would they still practice defensive medicine after tort reform, 72% of the doctors said yes. The reason being doctors do not want to go to court regardless of the amount of the lawsuit.

The defensive medicine balancing act
Cost of Defensive Medicine

YOU didn't read the study did you? You wrote: "asked a few dozen physicians in three hospital medicine services"
FEW DOZEN???
See right there I have a lot of doubt in your understanding!
Page 19 and 20 shows you are really really WRONG!

More than 3,000 physicians spanning all states and medical specialties completed the survey, a 2.21 percent response rate. The survey error range is at the 95 percent confidence level: +/-1.15 percent.

JUST a little more then a few dozens!!!

Also... what the hell difference is "completely or partially defensive"? Idiot! Either one is still a waste!
And they do cite "fear legal action".... AND YES they know the claims are paid by the insurance companies BECAUSE no one wants to waste time in court!
Less then 6% of Medical lawsuits go to court! The rest you idiot are settled out of court OR worse the insurance companies PAY!!!

Finally you cited " The Cleveland Clinic study cited a national cost estimate of $46 billion related to defensive medicine, but noted that such costs have been measured only indirectly. Other studies, along with the American Medical Association, put the cost impact much higher."

Study after study concludes "more then a half dozen physicians" "defensive Medicine " is practiced by almost ALL PHYSICIANS!

Virtually all respondents (93%) reported that they sometimes or often engaged in at least 1 of the 6 forms of defensive medicine outlined in the survey, and 82% of those who reported practicing defensively (626/768) detailed their most recent defensive act. Many of the respondents to the survey also reported that they had restricted the scope of their clinical practice because of liability concerns (42%) and/or were likely to do so further in the next 2 years (49%).
Defensive Medicine Among High-Risk Specialist Physicians in a Volatile Malpractice Environment

Gallup Survey Methodology: Cost of Defensive Medicine

Between December 2009 and January 2010, Gallup conducted telephone interviews with 462 randomly selected practicing physicians from across the U.S.

Jackson Healthcare Survey Methodology: Cost of Defensive Medicine

In December 2009, Jackson Healthcare invited 138,686 physicians to participate in a confidential online survey in an effort to quantify the costs and impact of defensive medicine. More than 3,000 physicians spanning all states and medical specialties completed the survey, a 2.21 percent response rate. The survey error range is at the 95 percent confidence level: +/-1.15 percent.

Jackson Healthcare Survey Methodology: Impacts Beyond Costs

In March 2010, Jackson Healthcare invited 124,572 physicians to participate in a confidential online survey in an effort to quantify the costs and impact of defensive medicine. More than 1,400 physicians spanning all states and medical specialties completed the survey, a 1.13 response rate. The survey error range is at the 95 percent confidence level: +/- 1.7 percent.

Jackson Healthcare Survey Methodology: Obstetrician Views on C-Section Rate

In June 2010, Jackson Healthcare invited 8,669 obstetricians to participate in a confidential online survey in an effort to qualify reasons for the increasing C-section rate in the U.S. More than 700 physicians completed the survey, an 0.8 percent response rate. The survey error range is at the 95 percent confidence level: +/-2.4 percent.

Jackson Healthcare Survey Methodology: Federally Contracted Physicians

Jackson Healthcare conducted a web-based survey of 347 physicians. The survey has an error range of +/- 3.42 percent, at the 95 percent confidence level.

Jackson Healthcare Survey Methodology: International Physicians

Jackson Healthcare retained Survey Pacific to complete telephone surveys of physicians in four countries. Results are based on telephone interviews with 200 randomly selected physicians in each country.

Jackson Healthcare Survey Methodology: Tort Reform Efforts

Jackson Healthcare conducted an online survey from August 31, 2012 to October 31, 2012. Respondents were self-selected with 1,548 respondents completing the survey. The error range for this survey at the 95 percent confidence level is +/- 2.5 percent.

Jackson Healthcare Survey Methodology: Hospital Executives

A total of 106 hospital executives completed the Jackson survey between February 7 and March 25, 2014. To qualify, participants answered that they believe some physicians practice defensive medicine. The error range for the survey was +/-9.5 percent at the 95 percent confidence level.

pg 20

Completely defensive in nature means the only reason for additional tests and procedures were to head off possible lawsuits. There are a number of factors that effect whether additional tests and healthcare procedures are preformed, in additional to fear of legal action; for example, request by the patient, age of the test, time that it takes to get the previous test results, patient history, and the trust the doctor has in the previous test.

However, I think you're missing a few major point. No doctor wants to be dragged into court. It doesn't matter whether the lawsuit is for $100,000, a million or 100 hundred million, defensive medicine will always be a factor in ordering additional tests and procedures. Also, almost half our doctors are in clinic or hospital settings who often pressure them to make full use of their diagnostic facilities and out patient services. And don't think for a minute that doctors don't profit from defensive medicine.

There have been studies in Florida, Missouri, and other states that have enacted tort reform. Have they seen billions dollars in reductions in tests and procedures? Nope. Not only that but the huge predicted drop in malpractice insurance due to tort reform never happened, nor the plunge in healthcare costs as predicted.

Tort reform and selling insurance across state lines has been the heart or republican healthcare reform because it is mostly a state initiative and they know quite well the states aren't likely to do anything.

A blow against “tort reform” in Florida | The Incidental Economist
Malpractice Reform in Texas: a Review | The Incidental Economist

 

[Slade3200]

Well one thing is for sure... In general the GOP did nothing to help make the bill a good one. From the start the pouted, dragged their heels, and did what they could to shut down the efforts. It's no surprise it came out full of holes. Think if all that energy was put towards doing their job and giving ideas, input, and strategy to make the bill as good as possible. It's embarrassing how things are running on the hill. I can only hope some miracle changes things for our future.

Was that because Obama told them to ride in the back of the bus? He and the Dems gloated and held the 2008 victory over the GOP and told them that it was there turn. Why would you work with bad leadership?

You work with them because thats your job. You don't pout like a baby and make the situation worse

It's not your job, your job is to represent the people that elected them. The Republicans were told by the Democrats they didn't need any votes.

I saw no scenario that would improve the health care system with more government involvement. Still don't.

I started a thread a few days ago about that... Jist is, people are uninformed idiots! Our elected officials are there to present the concerns and opinions of the people they represent but ultimately their job is to gather information, work together, and make SMART decisions that progresses our country towards a positive direction.

Voice of the idiots... I mean "people"

Calling people idiots, great way to reach out across the aisle. I am not a Cruz fan but you have failed to show how reaching across the aisle would have changed health care when many GOP ideas were not accepted from the start.

People are idiots because they are spoon fed bits and pieces of information by our media. Our elected officials are responsible for gathering real information and finding productive solutions. Not taking uncompromising stances and posturing for future elections. We are all after the same thing, a prosperous future. We have different philosophies and ides on how to get there so we should work together to explore, analyze, and implement the best options. Just as businesses do... We need to respect and work WITH our elected leader and president like he was a CEO

 

[healthmyths]

YOU SAID a mouthful.. "use it for regulation"!

Did you ever think that there may be too much regulation???
-- The International Classification of Diseases version 10 (ICD-10) contains 141,060 code sets used to report medical diagnoses and inpatient procedures.
That’s a 712 percent increase over the 19,817 code sets in the currently used ICD-9 version.
--- As we have noted before, physicians are already spending 22 percent of their time interacting with insurers on formularies, claims, billing, credentialing,
pre-authorizations, and quality measure data. The workload can only increase with the new codes.
Healthcare Is Turning Into An Industry Focused On Compliance, Regulation Rather Than Patient Care

How the U.S. Health-Care System Wastes $750 Billion Annually
How the U.S. Health-Care System Wastes $750 Billion Annually
More than 18 months in the making, the report identified six major areas of waste:
unnecessary services ($210 billion annually);
inefficient delivery of care ($130 billion);
excess administrative costs ($190 billion);
inflated prices ($105 billion);
prevention failures ($55 billion), and
fraud ($75 billion).
Adjusting for some overlap among the categories, the panel settled on an estimate of $750 billion.

Your post seems to be a general rant about healthcare.
FYI, ICD codes have nothing to do with government regulations. ICD (International Classification of Disease) listing assigns a code to essentially every know disease and all medically recognized treatments. Without ICD codes, computerized claim processing and billing would be virtually impossible. The ICD as we know it has been around for over a 150 years.

Most of what we call waste in the healthcare industry is unavoidable in American healthcare because there is no way of determine the full cost of diagnosis and treatment or whether it will be successful until after the services have been rendered. Furthermore, it's the people that are selling the service who actually determine the need for service. Pre-authorization is usually just a formality that delays the rendering of the service. The problem is fee for service which encourages waste and over-utilization.

So you have NO problem with what doctors have told us are over $850 billion a year in duplicate testing, referrals, all out of fear of lawsuits? You think they made that up?

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

90% of physicians surveyed say they order $850 billion a year in wasted duplicate tests, referrals all out of FEAR of being SUED!
--- Emergency medicine, primary care, and OB/GYN physicians are most likely to practice defensive medicine.
--- 79 to 83% of surgeons and OB/GYNs have been named in lawsuits.
"Physicians contracted by the federal government practice significantly less defensive medicine as they are protected against lawsuits by the
1946 Federal Tort Claims Act. "
-- BUT........Only 48% practice defensive medicine compared to 92% of non-government physicians.
Consider that fact that of the physicians interviewed 52% DID NOT practice defensive medicine!
Who were they? Doctors contracted by federal government!
WHY did these doctors NOT practice "defensive medicine"??? 1946 Tort reform!

I have a problem with the study. In a 2014 study led by the Cleveland Clinic and published in JAMA Internal Medicine, fives years after the Jackson Healthcare study researchers asked a few dozen physicians in three hospital medicine services to estimate the defensiveness of their own orders.
Fully 28% of 4,200-plus orders were reported by physicians as being at least partially defensive, but only 2.9% were seen as completely defensive in nature. The Cleveland Clinic study cited a national cost estimate of $46 billion related to defensive medicine, not $850 billion dollars. Also when doctors were asked would tort reform result in a significant decrease in healthcare cost, 80% said no.

Rarely is defensive medicine the sole reason why a doctor orders more than required number of tests. When doctors where asked, they cited requests by the patient, age of the previous test, not trusting the test, unable to locate the test, and fear legal action. When doctors were asked would they still practice defensive medicine after tort reform, 72% of the doctors said yes. The reason being doctors do not want to go to court regardless of the amount of the lawsuit.

The defensive medicine balancing act
Cost of Defensive Medicine

YOU didn't read the study did you? You wrote: "asked a few dozen physicians in three hospital medicine services"
FEW DOZEN???
See right there I have a lot of doubt in your understanding!
Page 19 and 20 shows you are really really WRONG!

More than 3,000 physicians spanning all states and medical specialties completed the survey, a 2.21 percent response rate. The survey error range is at the 95 percent confidence level: +/-1.15 percent.

JUST a little more then a few dozens!!!

Also... what the hell difference is "completely or partially defensive"? Idiot! Either one is still a waste!
And they do cite "fear legal action".... AND YES they know the claims are paid by the insurance companies BECAUSE no one wants to waste time in court!
Less then 6% of Medical lawsuits go to court! The rest you idiot are settled out of court OR worse the insurance companies PAY!!!

Finally you cited " The Cleveland Clinic study cited a national cost estimate of $46 billion related to defensive medicine, but noted that such costs have been measured only indirectly. Other studies, along with the American Medical Association, put the cost impact much higher."

Study after study concludes "more then a half dozen physicians" "defensive Medicine " is practiced by almost ALL PHYSICIANS!

Virtually all respondents (93%) reported that they sometimes or often engaged in at least 1 of the 6 forms of defensive medicine outlined in the survey, and 82% of those who reported practicing defensively (626/768) detailed their most recent defensive act. Many of the respondents to the survey also reported that they had restricted the scope of their clinical practice because of liability concerns (42%) and/or were likely to do so further in the next 2 years (49%).
Defensive Medicine Among High-Risk Specialist Physicians in a Volatile Malpractice Environment

Gallup Survey Methodology: Cost of Defensive Medicine

Between December 2009 and January 2010, Gallup conducted telephone interviews with 462 randomly selected practicing physicians from across the U.S.

Jackson Healthcare Survey Methodology: Cost of Defensive Medicine

In December 2009, Jackson Healthcare invited 138,686 physicians to participate in a confidential online survey in an effort to quantify the costs and impact of defensive medicine. More than 3,000 physicians spanning all states and medical specialties completed the survey, a 2.21 percent response rate. The survey error range is at the 95 percent confidence level: +/-1.15 percent.

Jackson Healthcare Survey Methodology: Impacts Beyond Costs

In March 2010, Jackson Healthcare invited 124,572 physicians to participate in a confidential online survey in an effort to quantify the costs and impact of defensive medicine. More than 1,400 physicians spanning all states and medical specialties completed the survey, a 1.13 response rate. The survey error range is at the 95 percent confidence level: +/- 1.7 percent.

Jackson Healthcare Survey Methodology: Obstetrician Views on C-Section Rate

In June 2010, Jackson Healthcare invited 8,669 obstetricians to participate in a confidential online survey in an effort to qualify reasons for the increasing C-section rate in the U.S. More than 700 physicians completed the survey, an 0.8 percent response rate. The survey error range is at the 95 percent confidence level: +/-2.4 percent.

Jackson Healthcare Survey Methodology: Federally Contracted Physicians

Jackson Healthcare conducted a web-based survey of 347 physicians. The survey has an error range of +/- 3.42 percent, at the 95 percent confidence level.

Jackson Healthcare Survey Methodology: International Physicians

Jackson Healthcare retained Survey Pacific to complete telephone surveys of physicians in four countries. Results are based on telephone interviews with 200 randomly selected physicians in each country.

Jackson Healthcare Survey Methodology: Tort Reform Efforts

Jackson Healthcare conducted an online survey from August 31, 2012 to October 31, 2012. Respondents were self-selected with 1,548 respondents completing the survey. The error range for this survey at the 95 percent confidence level is +/- 2.5 percent.

Jackson Healthcare Survey Methodology: Hospital Executives

A total of 106 hospital executives completed the Jackson survey between February 7 and March 25, 2014. To qualify, participants answered that they believe some physicians practice defensive medicine. The error range for the survey was +/-9.5 percent at the 95 percent confidence level.

pg 20

Completely defensive in nature means the only reason for additional tests and procedures were to head off possible lawsuits. There are a number of factors that effect whether additional tests and healthcare procedures are preformed, in additional to fear of legal action; for example, request by the patient, age of the test, time that it takes to get the previous test results, patient history, and the trust the doctor has in the previous test.

However, I think you're missing a few major point. No doctor wants to be dragged into court. It doesn't matter whether the lawsuit is for $100,000, a million or 100 hundred million, defensive medicine will always be a factor in ordering additional tests and procedures. Also, almost half our doctors are in clinic or hospital settings who often pressure them to make full use of their diagnostic facilities and out patient services. And don't think for a minute that doctors don't profit from defensive medicine.

There have been studies in Florida, Missouri, and other states that have enacted tort reform. Have they seen billions dollars in reductions in tests and procedures? Nope. Not only that but the huge predicted drop in malpractice insurance due to tort reform never happened, nor the plunge in healthcare costs as predicted.

Tort reform and selling insurance across state lines has been the heart or republican healthcare reform because it is mostly a state initiative and they know quite well the states aren't likely to do anything.

A blow against “tort reform” in Florida | The Incidental Economist
Malpractice Reform in Texas: a Review | The Incidental Economist

Explain why 52% of doctors surveyed that are contracted with Federal government hence protected under the 1946 Tort Reform Act according to the statistics state they don't practice "defensive medicine"?
"Physicians contracted by the federal government practice significantly less defensive medicine as they are protected against lawsuits by the
1946 Federal Tort Claims Act. "- BUT........Only 48% practice defensive medicine compared to 92% of non-government physicians.

Obviously the entire $850 billion would not go away! I never stated it would! If though there was a 25% reduction i.e. over $200 billion a year in CLAIMS
NOT filed with insurance companies then by STATE LAWS approved premiums would be reduced.

This reduction in claim expenses would reduce health insurance premiums.
By the way malpractice insurance costs is so minimally it isn't discussed. Just to be clear "defensive medicine" is defined as requesting additional services
paid by insurance companies to reduce chances of doctors being sued. Of which 94% of lawsuits are settled out of court because of the hassle.
Consequently the cheaper (yet more expensive way to the public) is to practice defensive medicine.

What really baffles me though is how protective people are of lawyers!
The legal services industry in the United States generated 256.66 billion U.S. dollars in revenuein 2013. By 2018, this revenue is expected to increase to approximately 288 billion. Topic: Legal services industry in the U.S.
So why are people like you so protective?
It is clearly stated by doctors ... they practice defensive medicine so they won't get sued!
Geez you obviously have NO problem with tanning salons forced to pay an additional 10% tax under ACA .... so why weren't lawyers taxed 10% i.e. for their
contribution to the cost of defensive medicine?

In the most recent peer-reviewed study, orthopedic surgeons recorded in real time whether imaging was required for clinical care or ordered for defensive reasons and found that physicians ordered 19.1 percent of imaging tests and 38.5 percent of MRIs for defensive reasons. Tellingly, physicians who had been sued within the past five years were substantially more likely to order defensive imaging. The same was true for physicians who had practiced medicine for more than 15 years.
Reducing the Cost of Defensive Medicine

19.1% of imaging tests ordered for defensive medicine purposes.
When assessing a patient's aches and pains, doctors often turn to medical imaging tests to reach a swift and accurate diagnosis. But a new investigation from Consumer Reports finds x-rays, CT scans and other tests that expose patients to high levels of radiation are being done too frequently.
Currently, some 80 million CT scans are performed each year in the U.S., up from 3 million in 1980. However, as many as a third of these tests are not necessary and needlessly expose patients to high doses of dangerous radiation, according to the Consumer Reports probe
Many medical imaging tests performed in U.S. are unnecessary

A stress imaging test costs between $500 and $2,000. At 19% for defensive purposes that is 15,200,000 tests @ $1,000 per test: $15 Billion alone wasted!

38.5 percent of MRIs for defensive reasons
NerdWallet Health, the average cost of an MRI in the U.S. is $2,611. Why Does an MRI Cost So Darn Much?
Of the 30 million MRI scans performed in the United States each year Getting an MRI Head Scan
So 38.5% of MRI scans are defensive or 11,550,000 tests at cost of $2,611 means $30.157 Billion in wasted defensive medicine.
MRIs/ and CT scans collectively nearly $50 billion a year! Mostly according to the above surveys because physicians practice defensive medicine!

This is just $50 billion a year wasted!

Another study conducted by Harvard Medical School concluded that majority of physicians across various specialties tends to adopt a defensive professional culture.[2] Rodriguez, et al., study in 2007 demonstrated that 50% of the doctors operating in emergency departments in California between 2001 and 2005 were concerned with matter of malpractice litigation.[5] Similar results emerged from a study conducted in Japan in 2006 with a group of 131 gastroenterologists.[6]
Insurance status of patients has also added to the keenness to use resources. It was clearly seen in various researches that hospital patients with private insurance stay in hospitals longer and receive many procedures compared to patients with Medicaid coverage or patients who lack health insurance,
Defensive Medicine: A Bane to Healthcare

So again... why are you defending lawyers when doctors are telling you fear of lawsuits increase health care costs due to defensive medicine practices?

 

[Papageorgio]

Was that because Obama told them to ride in the back of the bus? He and the Dems gloated and held the 2008 victory over the GOP and told them that it was there turn. Why would you work with bad leadership?

You work with them because thats your job. You don't pout like a baby and make the situation worse

It's not your job, your job is to represent the people that elected them. The Republicans were told by the Democrats they didn't need any votes.

I saw no scenario that would improve the health care system with more government involvement. Still don't.

I started a thread a few days ago about that... Jist is, people are uninformed idiots! Our elected officials are there to present the concerns and opinions of the people they represent but ultimately their job is to gather information, work together, and make SMART decisions that progresses our country towards a positive direction.

Voice of the idiots... I mean "people"

Calling people idiots, great way to reach out across the aisle. I am not a Cruz fan but you have failed to show how reaching across the aisle would have changed health care when many GOP ideas were not accepted from the start.

People are idiots because they are spoon fed bits and pieces of information by our media. Our elected officials are responsible for gathering real information and finding productive solutions. Not taking uncompromising stances and posturing for future elections. We are all after the same thing, a prosperous future. We have different philosophies and ides on how to get there so we should work together to explore, analyze, and implement the best options. Just as businesses do... We need to respect and work WITH our elected leader and president like he was a CEO

When the leadership discounts your ideas, and fails to recognize ideas put forth, then why are you participating. If you are not listened to then you shut up. Several ideas came from Republicans, tort reform, allowing more competition by allowing insurance to cross state line and other ideas, yet the Democrats said no. It was obvious all the Democrats wanted was their ideas. So why try to talk to a brick wall, it was unproductive. Again, democrats didn't lead, they told the GOP that they were running the show. The Democrats shut out the GOP, no point moving forward. Just like in business, if your ideas a shot down and leadership isn't listening or acknowledging then you turn it off.

I have worked for companies that wanted ideas and companies that said they wanted ideas. A very different environment and a different result.

Dems got the results of poor leadership.

 

[Slade3200]

You work with them because thats your job. You don't pout like a baby and make the situation worse

It's not your job, your job is to represent the people that elected them. The Republicans were told by the Democrats they didn't need any votes.

I saw no scenario that would improve the health care system with more government involvement. Still don't.

I started a thread a few days ago about that... Jist is, people are uninformed idiots! Our elected officials are there to present the concerns and opinions of the people they represent but ultimately their job is to gather information, work together, and make SMART decisions that progresses our country towards a positive direction.

Voice of the idiots... I mean "people"

Calling people idiots, great way to reach out across the aisle. I am not a Cruz fan but you have failed to show how reaching across the aisle would have changed health care when many GOP ideas were not accepted from the start.

People are idiots because they are spoon fed bits and pieces of information by our media. Our elected officials are responsible for gathering real information and finding productive solutions. Not taking uncompromising stances and posturing for future elections. We are all after the same thing, a prosperous future. We have different philosophies and ides on how to get there so we should work together to explore, analyze, and implement the best options. Just as businesses do... We need to respect and work WITH our elected leader and president like he was a CEO

When the leadership discounts your ideas, and fails to recognize ideas put forth, then why are you participating. If you are not listened to then you shut up. Several ideas came from Republicans, tort reform, allowing more competition by allowing insurance to cross state line and other ideas, yet the Democrats said no. It was obvious all the Democrats wanted was their ideas. So why try to talk to a brick wall, it was unproductive. Again, democrats didn't lead, they told the GOP that they were running the show. The Democrats shut out the GOP, no point moving forward. Just like in business, if your ideas a shot down and leadership isn't listening or acknowledging then you turn it off.

I have worked for companies that wanted ideas and companies that said they wanted ideas. A very different environment and a different result.

Dems got the results of poor leadership.

I agree with you... The problem is the environment. Both sides feed into this partisan problem and make collaboration so difficult. Don't fool yourself thinking the GOP was working in good faith to better this bill. Every other week they were speaking out about blocking and now repelling the ACA. How do you accept input and have productive meetings with people who are running to the media and bashing the entire idea?? The Dems did close up, I can't say a blame them... However, they also hold responsibility. Its our leaders job to create a productive and inclusive working environment. He should be setting the agenda, which should be respected by congress. I just doesn't work that way right now. I've seen efforts from our president to reach out and then i've seen him do the opposite. I understand why he gets fed up, I think most would do the same, but it is also his job to rise above that.

 

[Flopper]

Explain why 52% of doctors surveyed that are contracted with Federal government hence protected under the 1946 Tort Reform Act according to the statistics state they don't practice "defensive medicine"?

By definition, defensive medicine is recommending medical tests and procedures that serves to protect the physician from potential legal actions from patients. So if we eliminate the possibility of legal action, there can be no defensive medicine. Does that mean we save 850 billion in healthcare cost? Of course not, doctors will continue as they do now to order medical tests and procedures that go beyond guidelines and often more than they consider absolutely necessary. As I have said previous, there's a number of reasons in addition to fear of lawsuits why doctors order more tests and procedures.

Physicians hate paying malpractice insurance and hate even more the possibility of being sued. Of course they are going to claim defensive medicine as the reason for medical unnecessary tests and procedure. Do you think they're going to admit they're doing it for the money?

You seem to be basing your claims on totally barring legal actions by patients. In states that have enacted tort reform, there is no limit on economic damage, that is loss of wages, medical costs, and other damages. These damages typically run from several hundred thousand dollars to several million. Limits on non-economic damage varies by state from $250,000 to $750,000. As long as there is any possibility of lawsuits you will have defensive medicine and as long we have healthcare, you will have doctors recommending tests and procedures that exceed recommended norms.

23 states have passed tort reform laws, so if there were any hundreds of billions of dollars in healthcare savings we should have seen it in these states. The only way we would see any significant savings would be to protect doctors and hospitals from any malpractice suits and that is not going happen with 210,000 to 400,000 people dying each year from medical errors.

Physician Employment Articles and Information on Doctor Jobs – NewPhysician
Could malpractice reform save the U.S. health care system?
Low Costs Of Defensive Medicine, Small Savings From Tort Reform