|
Reik posted:Net Profit Margin from: The main carrier business units are operating on even less than the profit margin for the whole business. Huge parts of payer/carrier profit margin is now being driven by their spin off businesses. The primary profit driver these days are their spin offs that provide risk and IT services to Providers, Pharma and Device makers. Why invest in a business with a 2% profit margin when you can sell providers poo poo on a 200% margin? Providers are so crazy flush with cash that it boggles the mind. When I was still in the industry we were able to pre-sell products and services that were little more than pipe dreams at the time of the sale. The providers just kept coming to us looking to buy more and more. It was the most mind boggling thing I ever saw. call to action posted:It's sort of weird seeing people defend PPACA as a jobs program when they'd never do the same for the F-35 program. A small amount of inefficiency in a system designed to save lives is much less bothersome than an entire system being a massive clusterfuck of self-reinforcing inefficiencies.
|
#
?
Mar 10, 2017 23:18
|
|
|
|
| # ? May 14, 2024 00:19 |
|
|
hobbesmaster posted:You misunderstand. If you go to an ER at a teaching hospital, you will be asked the same questions by: Not to mention every student of every other discipline (paramedic student, nursing student, RT students) as well as other technicians. The resident compounds the attending physicians work because they can't trust their findings. I saw an adage somewhere ("House of God," maybe) that said, paraphrasing, "Show me a resident that only triples my work and I'll kiss his feet."
|
|
#
?
Mar 10, 2017 23:19
|
|
|
call to action posted:It's sort of weird seeing people defend PPACA as a jobs program when they'd never do the same for the F-35 program. If the F35 saved lives that would be an argument, but it's a flying deathtrap (when it manages to fly).
|
|
#
?
Mar 10, 2017 23:42
|
|
|
There are people who are seriously arguing that Ryan/Republicans don't really want to pass AHCA. When have Republicans never been serious about cutting taxes for the rich?
|
|
#
?
Mar 11, 2017 00:12
|
|
|
What is the AMA saying this year? That there are too many doctors or not enough doctors?
|
|
#
?
Mar 11, 2017 00:24
|
|
|
Bueno Papi posted:There are people who are seriously arguing that Ryan/Republicans don't really want to pass AHCA. When have Republicans never been serious about cutting taxes for the rich? I don't buy the argument, but there's easier ways to cut taxes.
|
|
#
?
Mar 11, 2017 00:26
|
|
|
Nissin Cup Nudist posted:What is the AMA saying this year? That there are too many doctors or not enough doctors? Both are true, entertainingly. Too many of the wrong kind of doctors, too few of the right kind. Turns out they'd been churning out as many high-tier specialists as they could for decades and then discovered whoopsie, without competent primary care docs to feed them cases they sit around very expensively doing nothing. For the last twenty years, primary care was where you shoved the bottom forty percent of your graduating med school class, who couldn't get a specialized position. This turns out to have been a problem. It's also why the muslim ban+derivatives is a particularly nuanced bit of bad news for health care: awful lot of kids from southeast asia went through med school, and for the usual the-people-making-hiring-decisions-at-the-desirable-positions-are-almost-invariably-old-white-guys reasons they're overrepresented in the list of people who couldn't get specialized positions. Long story short, whole lotta rural primary care docs with family in islamic-majority countries, and seriously weighing if sticking around in the States is a good idea at the moment.
|
|
#
?
Mar 11, 2017 00:35
|
|
|
Bueno Papi posted:There are people who are seriously arguing that Ryan/Republicans don't really want to pass AHCA. When have Republicans never been serious about cutting taxes for the rich? I think it's plausible but I don't know if I completely buy that theory, which is that there's no repeal bill that could actually pass the house AND get 50 votes in the Senate. They can't do a full-on 100% repeal because that would require 60 Senate votes, so it has to be a version that can be passed through budget reconciliation. What is true is that Republicans are split between "anything short of full repeal is treasonous" types and the squishier non-hardliners who are nervous about voting to take away people's insurance and it's a very fine needle to thread to attempt to satisfy both groups at the same time. I'm sure the Republican leadership would be happy if it _did_ pass considering all the giveaways to the rich, but (so the theory goes), they half-assedly threw this bill together at the last minute to get at least an attempt at repeal out of the way first-- and basically expect it to fail-- before moving on to the more comprehensive tax cuts. I really really hope it's the case that they're not actually trying to pass it but I'm not optimistic.
|
|
#
?
Mar 11, 2017 00:45
|
|
|
When does the CBO score come out? I read on NPR or somewhere that if it adds 1 or more billions to the deficit then it can't be passed through reconciliation correct?
|
|
#
?
Mar 11, 2017 01:50
|
|
|
Peven Stan posted:When does the CBO score come out? I read on NPR or somewhere that if it adds 1 or more billions to the deficit then it can't be passed through reconciliation correct? No. Has to do with the Byrd Rule and the sunset provision. Basically, if the budget adds to the deficit after the budget period, typically done for ten years, it violates the Byrd Rule and thusly must have a sunset provision. A good example is the Bush tax cuts. Enacted in 2001, obviously added to the deficit*, they ended in 2011. Republicans tried to argue that tax cuts pay for themselves. Bueno Papi fucked around with this message at 02:31 on Mar 11, 2017 |
|
#
?
Mar 11, 2017 02:25
|
|
|
Ze Pollack posted:Both are true, entertainingly. Too many of the wrong kind of doctors, too few of the right kind. Turns out they'd been churning out as many high-tier specialists as they could for decades and then discovered whoopsie, without competent primary care docs to feed them cases they sit around very expensively doing nothing. As a bonus, a lot of the top medical students end up going into fields like dermatology and cosmetic surgery, simply because they can get paid in cash and don't have to bother with insurance claims, meaning they make more money with less effort.
|
|
#
?
Mar 11, 2017 02:26
|
|
|
https://twitter.com/Nate_Cohn/status/840213598748192769
|
|
#
?
Mar 11, 2017 04:28
|
|
|
I will agree to a compromise where all subsidies are taken away from trump voters and given to the rich.
|
|
#
?
Mar 11, 2017 04:48
|
|
|
Remember when I said that the repeal would affect HIV transmissions..... http://time.com/money/4693379/healthcare-hiv-prep/ quote:Emtricitabine/tenofovir was approved for medical use in the United States in 2004.[1] It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system.[7] The wholesale cost in the developing world is about 6.06 to 7.44 USD per month.[5] In the United States, as of 2016, the wholesale cost is about 1415.00 USD per month.[8] Hollismason fucked around with this message at 04:54 on Mar 11, 2017 |
|
#
?
Mar 11, 2017 04:49
|
|
|
Hollismason posted:Remember when I said that the repeal would affect HIV transmissions..... Big cities have started to see a decline in new infections because of early treatment and PREP and now that is in danger because of shitheads who can't even bother to listen to their constituents.
|
|
#
?
Mar 11, 2017 05:20
|
|
|
http://nymag.com/daily/intelligencer/2017/03/trump-already-wavering-on-trumpcare.htmlquote:The last thing the imperiled GOP effort to repeal and replace Obamacare needs right now is confusion at the very top. But that’s what they have, thanks to the mixed signals coming out of the White House about the president’s willingness to deal away major provisions of Trumpcare involving the speed with which the Affordable Care Act’s Medicaid expansion is canceled.
|
|
#
?
Mar 11, 2017 07:29
|
|
|
Bueno Papi posted:There are people who are seriously arguing that Ryan/Republicans don't really want to pass AHCA. When have Republicans never been serious about cutting taxes for the rich? I think it's probably more a case of the Republicans are playing the health care gambit to supplement the abortion gambit they already like to play. Essentially, public opinion is pretty decisively opposed to Republican policy, but Republican base enthusiasm is much higher on the issue than the enthusiasm of the public at large. So if the Republicans control the legislature but not the executive, they'll pass some bullshit that is certain to get vetoed and tell their base they tried, but those darn Democrats, vote in November. Or if they control both the legislative and the executive, they'll include some odious provision that s certain to get the law struck by the courts in which case they tell their constituents that they tried, but those damned liberal activist judges. Vote for us in November. The problem for the Republicans is if they actually do anything real and tangible about these types of issues, they'll satisfy their base and rile up the public at large, close the enthusiasm gap and create real problems for their election campaigns. As long as nothing gets done, or they can just whittle away at the edges and blame Democrats they are fine. The AHCA is a real problem for them because there really isn't anything stopping them from doing whatever. The Democrats can't really block it, and their really isn't anything way for the courts to block it regardless of how poo poo it is. Passing a really unpopular piece of legislature in the current political climate is not something anyone other than the lunatics and the incredibly safe members of congress really want to do right now.
|
|
#
?
Mar 11, 2017 09:50
|
|
|
silence_kit posted:This doesn't make that much sense to me--why are residents a net drain on hospitals? It seems to me that there could be a lot of useful work that they could be doing at hospitals and so they'd be a net benefit to them and not a hindrance. You have to pay the resident as well as the supervising doctor. Also doctor salaries have not been growing at the same rate as total medical costs. The piece of the pie that goes to labor costs is shrinking compared to devices, drugs, and hospital costs.
|
|
#
?
Mar 11, 2017 11:34
|
|
|
silence_kit posted:This doesn't make that much sense to me--why are residents a net drain on hospitals? It seems to me that there could be a lot of useful work that they could be doing at hospitals and so they'd be a net benefit to them and not a hindrance. You know how you occasionally have a new guy at work who doesn't know how to do anything so you have to spend a week or two having them follow you around like a helpless puppy just trying to absorb information, and then maybe another couple weeks of them being "trained" but they're so bad at their job it actually results in net work for everyone else fixing their messups and explaining things? Stretch that out over a couple years and you have a medical residency. Also if they gently caress up and you don't catch it people can die.
|
|
#
?
Mar 11, 2017 19:56
|
|
|
Not sure if this was posted here, but interesting article in Vox on this bill The Republican plan to slash Medicaid, explained http://www.vox.com/policy-and-politics/2017/3/10/14847218/medicaid-ahca-republican-obamacare-replacement quote:The cumulative effect, according to an analysis by the Center on Budget and Policy Priorities, is a $370 billion cut to federal funding to Medicaid over 10 years. Some of that money could be made up for by states, but most of it won't be. quote:More to the point, the up to 11.2 million people that ending expansion could kick off the rolls is a massive human toll to pay quote:"Under the House plan’s per capita cap, states would have had to cover the entire cost of rising need on their own,” CBPP’s Park, Aron-Dine, and Broaddus write. “And rather than being able to invest in improving care, many states would have been forced to scale back or ration substance use treatment as the need increased, or to weaken Medicaid coverage for other groups.” And those who stay on Medicaid will get even worse coverage. No pun intended, but the more I learn about this new healthcare bill the more sick I get.
|
|
#
?
Mar 11, 2017 20:00
|
|
|
Nice cut. Did you know Medicaid covers about half of US births?quote:WASHINGTON, DC (September 10, 2013)—Medicaid paid for 45 percent of the 4 million births in the United States in 2010, an amount that has been rising over time 
|
|
#
?
Mar 11, 2017 20:55
|
|
|
Medicaid hasn't expanded in that study's window, it didn't open to single childless able-bodied people until 2013. But as part of the old criteria for Medicaid, along with the disabled, was being a parent who couldn't afford to pay for your family's health costs, and people who are already parents are often likely to have another birth, it's no surprise. If anything it contributes to the right's "poor people are having bunches of kids so they can support themselves on the programs designed for those kids welfare" narrative. As a person on the Medicaid rolls, I don't know how I feel about it. I think there certainly could be reforms, but doing it per-capita is going to screw over a lot of states that have Republican Senators whose support is crucial to passage, including mine. I'd go wave a sign at Dean Heller if he wasn't too afraid to face his own voters right now. Craptacular! fucked around with this message at 21:54 on Mar 11, 2017 |
|
#
?
Mar 11, 2017 21:48
|
|
|
Hey all, figured I'd drop in and post this as an interesting discussion on the ACA and healthcare in America that I got to sit in on last week. I know two of these three panelists personally and they are all heavy-hitters on this topic - it's definitely a worthwhile listen for those of you in here who are interested. https://www.mprnews.org/story/2017/03/10/roundtable-health-care-in-the-future
|
|
#
?
Mar 11, 2017 22:01
|
|
|
Boon posted:Hey all, figured I'd drop in and post this as an interesting discussion on the ACA and healthcare in America that I got to sit in on last week. I know two of these three panelists personally and they are all heavy-hitters on this topic - it's definitely a worthwhile listen for those of you in here who are interested. You're that Parente acolyte from the Trump thread, right? Always nice to hear a well-respected academic, in Republican circles, describe poor people getting health care as "inefficiencies" and the only fix is take away poor people's health care with "market-based solutions".
|
|
#
?
Mar 11, 2017 23:26
|
|
|
Konstantin posted:As a bonus, a lot of the top medical students end up going into fields like dermatology and cosmetic surgery, simply because they can get paid in cash and don't have to bother with insurance claims, meaning they make more money with less effort. Almost sounds like people are going into medicine for the wrong reasons! Shocker.
|
|
#
?
Mar 12, 2017 00:56
|
|
|
reagan posted:Almost sounds like people are going into medicine for the wrong reasons! Shocker. Or they go into medicine to do medicine, not insurance paperwork.
|
|
#
?
Mar 12, 2017 02:05
|
|
|
Craptacular! posted:If anything it contributes to the right's "poor people are having bunches of kids so they can support themselves on the programs designed for those kids welfare" narrative. Or to, "Things are terrible and Medicaid's carrying a lot of weight." Edit: Here's a data table from the Kaiser Family Foundation listing state-by-state percentages for most recent year reported. The latest-year-reported ranges from 2010 to 2016 with values ranging from 27% (NH, '15) to 74% (NM, '15). And the GOP's taking a run at it. Accretionist fucked around with this message at 03:00 on Mar 12, 2017 |
|
#
?
Mar 12, 2017 02:53
|
|
|
evilweasel posted:Or they go into medicine to do medicine, not insurance paperwork. Hahaha. That is why they will slaughter one another for one of those specialties. Sure. I'm also tired of hearing physicians cry over how difficult the paperwork is. Maybe they should quit if it is too much of a hassle.
|
|
#
?
Mar 12, 2017 07:52
|
|
|
Bueno Papi posted:You're that Parente acolyte from the Trump thread, right? Always nice to hear a well-respected academic, in Republican circles, describe poor people getting health care as "inefficiencies" and the only fix is take away poor people's health care with "market-based solutions". So two things: 1. Real nuanced argument there. Truly, good stuff. 2. You clearly did not follow the discussion.
|
|
#
?
Mar 12, 2017 07:54
|
|
|
Subvisual Haze posted:You know how you occasionally have a new guy at work who doesn't know how to do anything so you have to spend a week or two having them follow you around like a helpless puppy just trying to absorb information, and then maybe another couple weeks of them being "trained" but they're so bad at their job it actually results in net work for everyone else fixing their messups and explaining things? Stretch that out over a couple years and you have a medical residency. Also if they gently caress up and you don't catch it people can die. Medical residents are locked in to contracts that change very little across the country, from year to year, specialty, class rank in med school, etc. An upper year resident is absolutely more productive than a lower year resident and can provide a valuable service. You only have to look at hospitals that are willing to hire residents to "moonlight" at market wages to cover understaffing to show that this is true. It's also silly to think that a graduating medical resident making 60k/year is "bad at their job" on June 30th and is suddenly capable of making decisions on July 1st and being paid for it.
|
|
#
?
Mar 12, 2017 14:07
|
|
|
https://twitter.com/braddjaffy/status/840943495816839168
|
|
#
?
Mar 12, 2017 17:28
|
|
|
Christ from the "uhhhh the very concept of insurance is waaaayyyy too collectivist for us" comment from a few days ago to this I don't even know where to begin with Paul Ryan
|
|
#
?
Mar 12, 2017 17:57
|
|
|
Monkey Fracas posted:Christ from the "uhhhh the very concept of insurance is waaaayyyy too collectivist for us" comment from a few days ago to this I don't even know where to begin with Paul Ryan everything he says makes so much more sense when you realize the half of his brain that is politically skilled is holding down the half that wants to shout THEY SHOULD ALL DIE RATHER THAN TAKE ONE CENT FROM THE WEALTHY in response to every question about health care i'm not joking, he's a hardcore randian and just keeps it under wraps
|
|
#
?
Mar 12, 2017 18:12
|
|
|
evilweasel posted:everything he says makes so much more sense when you realize the half of his brain that is politically skilled is holding down the half that wants to shout THEY SHOULD ALL DIE RATHER THAN TAKE ONE CENT FROM THE WEALTHY in response to every question about health care He's doing a poor job of hiding it right now. He's not even attempting to bullshit the general public into thinking this bill helps them in any way. Any time a question about coverage or affordability comes up he just barrels past it and starts talking about taxes. He's really proud of what this bill actually does and it's killing him that he can't boast about it with a huge grin on his face without coming off like an inhuman monster.
|
|
#
?
Mar 12, 2017 20:01
|
|
|
In a better world, Paul Ryan would be dragged into the streets and hung from a lamppost. I'm not joking. He is actively working to take necessary healthcare away from millions of people to protect the wealth of those who already have more than they need, and if that doesn't get the revolutionary blood flowing I don't know what else does.* *This post is not meant to advocate for real-world behaviors. Please do not use murder as a tool for political change.
|
|
#
?
Mar 12, 2017 20:01
|
|
|
Voyager I posted:In a better world, Paul Ryan would be dragged into the streets and hung from a lamppost. He's literally Marie Antoinette
|
|
#
?
Mar 12, 2017 20:08
|
|
|
http://www.reuters.com/article/us-usa-obamacare-idUSKBN16J0XH?il=0quote:In a series of television interviews, White House budget director Mick Mulvaney and top White House economic adviser Gary Cohn said that the CBO is focusing on the wrong metrics with the estimates it will provide on the number of people who are insured. Cohn and Mulvaney said CBO should instead should analyze whether patients can actually afford to go to a doctor. I think they're expecting bad news
|
|
#
?
Mar 12, 2017 20:08
|
|
|
i really like this alternate gop universe where people who can't afford insurance can afford to go to a doctor
|
|
#
?
Mar 12, 2017 20:11
|
|
|
They know it's bad news and they are desperately trying to make it go away, as if what's coming out will be... fake news.
|
|
#
?
Mar 12, 2017 20:12
|
|
|
|
| # ? May 14, 2024 00:19 |
|
|
Concerned Citizen posted:i really like this alternate gop universe where people who can't afford insurance can afford to go to a doctor you just pay your bills in chickens
|
|
#
?
Mar 12, 2017 20:19
|
|