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clean ayers act posted:Michigan is no where close to solidly blue enough to ever pass single payer evilweasel posted:i mean three of those "blue" states voted for trump and have republican governors and legislatures so idk in what world they're blue states these days Then they go into the Super Screwed category. There is no way that they can get around the ability to stop states from developing a single payer system. If they block grant and say the state can't develop an additional non-Medicaid single payer system, they could set the threshold for Medicaid at all incomes then add to the pool of money. If the bill limits the threshold for income, that would be disaster and it will break the system even faster. If they can't add or take away from the pool of money, that means that it's not a block grant.
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Sep 19, 2017 23:46
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evilweasel posted:you mean...republicans might be lying? It's just a strategy that I don't think they've thought about the implications. Mandating block grants for everyone removes any incentive for states who expanded Medicaid to keep the current system AND it also forces them to build a mini single payer system for their poor. It also dynamites the current model of payment and irrepairably damages it. If they're forced into building a single payer system for the lowest and most costly 20-30% of their population already, why not make it for everyone? That said, states that actually care about their poor will have huge incentive to pass a single payer or universal healthcare system. States that just want to pillage Medicaid will get tax cuts and poo poo healthcare.
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Sep 20, 2017 00:47
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Chortles posted:This story from June about what turned out to be the BCRA has been making the rounds on liberal Twitter recently in regards to Cassidy-Graham. If the link doesn't work: The "Dallas piggy bank" is most likely Andy Beal.
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Sep 24, 2017 22:47
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This will be the true test of accelerationism if it passes. It's going to wreck the California and New York markets. Negative 58 billion in California alone. The only way the state governments can prevent themselves from going bankrupt would be a single payer / universal system.
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Sep 25, 2017 06:44
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Dead Reckoning posted:I think about this a lot, because I'm considering investing in further education to advance a healthcare career. Bureau of Labor Statistics says that nursing is going to continue to grow, but I'm concerned that most of that will be wiping the asses of the elderly in SNFs for the lowest wages owners can get away with paying. I think that point of patient care work is still going to be around for a while, I don't expect that the future where glorified janitors wheel in the machine that starts IVs, does tests, skin checks, changes dressings, etc. as needed is happening soon, mostly because patients won't accept it, but the large number of people going into nursing and contracting need for paperwork will have downward pressure on wages. I think the real losers will be MDs, as a few MDs working with an expert system to supervise the work of NPs and PAs will be the new norm. You're only talking about primary care doctors. NPs are not going to take the place of specialists before primary care doctors. Given the primary care shortage in the US, there's a long way to go before MDs will get replaced. There simply aren't the training spots in he pipeline.
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Sep 30, 2017 23:52
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Software already does automatic checks for medication interactions that are much more complex than this mistake. It would be trivial to implement a "Are you sure you want to give 38 times the normal dose?" Screen after a large medication order. If this was IV Septra / Bactrim, this would have cleaned out the hospital stockpile. There should have also been a nurse asking a question of "Did the doctor really mean to give 38.5 pills of Septra? A medication I normally give 2 pills?" The system should be designed where it's impossible to make a mistake. The famous case for implementing duty hours for residents in the USA was because of Libby Zion dying because she got phenelzine plus pethidine which has a severe interaction. Today, with EMR and electronic prescribing, most systems will have 1 or 2 screens that pop up that say "Are you sure you want to do this? There is a risk of XYZ due to a severe medication interaction." You will get a call from the pharmacist. Etc. etc. There are many less ergregious errors made all the time in dosing. 1.4 becomes 14 or off by a factor of 10. With an EMR, it should be trivial to install a check on doing this. Any excuse of "well, our patients are different," is bullshit because you should be having a discussion with the pharmacist instead of saying 'patient population' and calling it a day. Lote fucked around with this message at 14:55 on Oct 4, 2017 |
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Oct 4, 2017 14:46
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esquilax posted:You should read the full 4 part article, all of these points are directly addressed and either happened or explained in detail why that line of thinking is disastrous. I understand the article. This is a case where the medication in question is a combo drug that comes written as double strength 1 pill instead of other medications. Pediatrics is also obsessed with weight based dosing even for medications that don't need to be dosed based off weight. This is primarily a systems design issue where there's a flaw in the system. The system should take into account mistakes possibly happening at every interaction, including during the additional steps to correct those mistakes. BarbarianElephant posted:A lot of software includes a bunch of bullshit confirmations, so you get used to clicking yes, yes, YES without reading it. That's as dangerous as a pilot skipping steps in a check list and can be considered fraud. There are prompts where you have to enter reasons for why you're ordering what you're ordering for example.
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Oct 4, 2017 15:52
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The nurse has access to the chart. She could've looked up the note from the doctor. Also the "research hospital therefore we don't always go by the book" is just them trying to cover their rear end. This medicine is rarely given in doses more than 2 pills, even in adults. These pills are large tablets that can only be taken one or two at a time. The nurse absolutely should be empowered to speak up, especially when something doesn't make sense.
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Oct 5, 2017 01:07
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cis autodrag posted:i used to work at epic. i would not want epic to make any decisions a doctor couldn't override. from my experience, it's a statistical anomaly that epics choices haven't killed more patients than they have. when their transgender care upgrades start to roll out i fully expect a bunch of transgender people to die or be killed after being outed to inappropriate care providers. It's terrible right now regardless. The system doesn't recognize any trans patients so you get escalating warnings (with two !!s) if you try to order medications that may cause birth defects without a documented pregnancy test.
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Oct 5, 2017 15:01
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cis autodrag posted:I'm well aware. The solution they're going with (entirely at the fiat of Janet Campbell because she took gender studies on college for a humanities credit, seriously) is to mark every patient as "Transgender male/female to male" or "transgender female/male to female" and display that information to every single user of the system. And she doesn't think it's important to account for intersex people on this paradigm at all. It's a dumb problem because you could just build in an option that allows for people designated as "females" in the system to not be able to get pregnant. Or "males" in the system to be able to be pregnant, and therefore actually need that negative pregnancy test. You run into the same problem with people that have had hysterectomies. That's really the only thing that needs to be done. You can put in their trans status in as an ICD10 code.
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Oct 6, 2017 16:19
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Reik posted:I think I've posted this in this thread before, but since the big dumb orange baby actually did it, I'll say it again. So people making like 60-120k per year needing silver or gold plans like... 50-64 year olds? That's Trump's biggest demographic
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Oct 13, 2017 15:34
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Timby posted:This is actually legal now on employer-provided plans. My company just changed its insurance offerings this year and explicitly says that any claims filed for injuries or illnesses "resulting from drug or alcohol abuse, or other lifestyle choices" will not be covered. This violates both the mental health equity act of 2008 as well as the ACA. Can’t deny substance abuse treatment. Denying medical coverage for the complications of drug abuse will result in fewer people getting treatment.
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Dec 2, 2017 17:22
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hobbesmaster posted:How do you think this would go in court post hobby lobby? The Mental Health and Addiction Parity Act quote:If a group health plan or health insurance coverage includes medical/surgical benefits and MH/SUD benefits, the financial requirements (e.g., deductibles and co-payments) and treatment limitations (e.g., number of visits or days of coverage) that apply to MH/SUD benefits must be no more restrictive than the predominant financial requirements or treatment limitations that apply to substantially all medical/surgical benefits (this is referred to as the “substantially all/predominant test”).This test is discussed in greater detail in the MHPAEA regulation (linked below) and the summary of the MHPAEA regulation found below. I would imagine that it would be struck down because Hobby Lobby relied on a 1st Ammendment and religious expression argument. I don't think an argument of "I have a religious objection to drug use, therefore I will not pay for addiction treatment" because that would worsen addiction. It could also open up the employer to liability if let's say a truck driver were alcoholic and tries to seek addiction treatment and is denied and then subsequently gets into an accident. If you deny coverage of drug related diseases, you're denying coverage of HIV, Hepatitis C, heart infections, kidney infections, strokes / brain injury / paralysis, etc. If a substance abuse treatment center says they can't take care of a person because they have an opportunistic infection of AIDS, what is that person supposed to do? I can see an argument and have seen the insurance company compell someone to substance abuse treatment in order to cover paying for treatment of the sequelae. Realistically, if this stuff happens on a wide level with blanket denials of coverage for treatment for Hepatits C, diabetes, HIV, etc., doctors are just going to stop ordering urine toxicologies and BACs. You can't prove 100% where you got Hepatits C or HIV or a heart infection or liver failure.
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Dec 2, 2017 23:10
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viral spiral posted:New thread title please: Will building new homes and home ownership destroy the rental market?
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Apr 17, 2018 17:35
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Imagine the fear that a non-profit generic pharma company would generate if they started to make biologics.
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Apr 28, 2018 12:41
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CAPS LOCK BROKEN posted:I don't see why new doctors need a residency. You're falling for the assumption that the status quo is as good as it'll ever get and all that is needed are tweaks. I would never, ever go to a brain surgeon that didn’t do a residency or it’s foreign equivalent. It’s 7 years before a neurosurgeon can practice solo AFTER medical school. I mean holy poo poo this is a terrible opinion.
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Nov 2, 2018 00:29
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tetrapyloctomy posted:What exactly do you think happens in residency training that should be skipped? I mean shouldn’t we have specific tracks for specific surgeons? Like if someone wants to be a heart surgeon they should just train to be a heart surgeon. Same with a brain surgeon or bone surgeon. Just limit it to that specific part of the body. That would make a lot of sense. And we could call the people that go through original track Drs. and just call these surgeons Mr.
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Nov 11, 2018 02:48
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CAPS LOCK BROKEN posted:I wish liberals would stop repeating the myth that the public option would have solved anything: Doesnt explain why the insurance companies hate it though. More expensive AND takes away the sickest people? That’s win - win for them.
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Nov 15, 2018 20:16
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