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See Elizabeth Warren's 2003 book "The Two-Income Trap" -- a shockingly based analysis of the consequences of married women entering the workforce en masse in the 1970s and 1980s. Concludes everyone is worse off.
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SydneyBlake2000
6.3K posts
SydneyBlake2000
@SBlake2000
Promoter of Classical Masculine and Feminine Virtue | Health and Wellness start with Clean Air | Eliminate Toxic Chemicals and Fragrances from Environment
Katılım Ağustos 2021
452 Takip Edilen356 Takipçiler
@crappiedoc @billychaffin23 @mcuban @DrDiGiorgio The "ten essential health benefits" mandate that ACA compliant insurance companies must "cover" office visits! That is a government intervention that has led to higher overall health-care expenditures.
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No chance it would. When there is regulatory capture, huge conglomerates effectively define the prices and rules. Not government.
They would love to have government out of the way. They are so big, with so many subsidiaries, they could whatever they want.
And it wouldn’t be to the benefit of patients.
Matthew Bednarik@BednarikMatt
@mcuban @GovBillLee Or just let the free market compete and get the government out of Healthcare. A free market would inevitably lead to lower costs for consumers.
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@DaveLemox @Gabe__MD @realdocspeaks How do people not know by now that Tom Frieden is the biggest pharma whore around?
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Why would you renew a medication without seeing the patient, reviewing vitals, and performing an exam?
Otherwise, you could renew a blood pressure medication that is failing, and the patient could have a CVA.
This is part of being a physician, and telehealth doesn't replace physicians.
Dhruv Vasishtha@dvasishtha
It feels extremely bottom of license for PCPs to do quarterly / semi-annual telehealth appointments to represcribe chronic meds that patients have been taking for years on end. It's why I really do hope for the doctronic pilot in Utah to proceed --> make it easy for patients to refill rx and let docs do higher value work.
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Actually, the current state of medication "in general" is that most people are in fact "overmedicated." Blood pressure is a perfect example: many seniors have an elevated blood pressure when they go to the doctors office or when they are in the hospital. They are then prescribed medication and -- when taken at home -- results in pressures that are too low and can lead to really awful consequences.
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@SBlake2000 @approfre @DrSuneelDhand I don’t have a subscription. I also don’t need an article. I’m not advocating for OVERmedicating, that is stupid. He reposted my tweet out of context and in response to a comment on his thread. It was not about overmedicating, it was about medication in general.
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Because the United States medical establishment is expert at medicalizing things that don’t need prescriptions— and wouldn’t be on drugs in most other countries
hillie23🇺🇸🌻❤️🔥@hillie23
@fidgeyhatesleft @DrSuneelDhand Why would people be on meds if they don’t have health issues?
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@hillie23 @approfre @DrSuneelDhand And, what about when patients are taking certain medications unnecessarily, which cause their own harm? The WSJ article here is excellent: wsj.com/health/healthc…
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@SBlake2000 @approfre @DrSuneelDhand I’m talking about real life patients with conditions that require medication to control their disease processes and progression, don’t take them and end up hospitalized over and over and over. That’s what.
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@Medic2_14INF @FrenlyOfficer It all washes out. You will have patients that come in and out in two minutes with one question, and then of course you have the others. The two minute patient should be charged the same as the loquacious one.
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@SBlake2000 @FrenlyOfficer I think I should be reimbursed more to have to listen to patients complain about things I don't care about (URIs and chronic low back pain).
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@DrSuneelDhand This is a banger of an article by the WSJ: wsj.com/health/healthc…
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@hillie23 @approfre @DrSuneelDhand What do you mean by "huge medication adherence issues"? Are you referring to the onerous and totalitarian CMS "Medication Adherence Measure?" If patients only knew that their doctors were not really working for them.
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@approfre @DrSuneelDhand This repost was in response to his post. There was no disclaimer excluding the diseases mentioned (just to name a few). It’s misleading to patients. There are already huge med adherence issues which I’m sure he faces in his daily work.
Selling supplements/teas.
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Right. Regulation of standards is something we should want and we should at the same time demand a free-market for those services that are naturally cheap in order to ensure access, and so that the consumer is the one calling the shots: PCP office visits, labwork, and imaging. It is madness that people are begging insurance to "cover" what would otherwise be a $500 MRI. If the patient determines -- based upon physician advice -- that such an MRI is necessary, then they should not have to request "authorization" from third-parties that are beholden to shareholders.
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@psych_biscuits A free market and regulation of standards are not mutually exclusive.
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I promise you do not want a free market in medicine.
There’s a lot of luxury in regulation and proper oversight/provision.
As bad as you think it is now, it can be ALOT worse
More importantly, this framework will not affect the rich & finically capable.
Which isn’t most
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@houmanhemmati "Too expensive" is very subjective when it comes to medication. People have a skewed and distorted perception of what things cost: they will drop a lot of money on incidental items and then balk at a $100 prescription.
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As a doctor, it’s frustrating to prescribe a patient a drug & have them call asking for an alternative prescription because when they got to the pharmacy, they realized it was way too expensive.
As a patient, it’s more frustrating to waste time having to go to the pharmacy to find out how much you’ll have to pay, and then figure out if you can get it cheaper paying cash.
Under @SecKennedy @DrOzCMS plan, both doctor and patient will immediately know the cash and insurance price before the prescription is sent. Massive savings of time & money, and better opportunities for shared decision making.
Another win-win. Thank you 🙏!
Secretary Kennedy@SecKennedy
Patients deserve to know what their medications cost before they leave the doctor’s office. @DrOzCMS, National Coordinator for Health IT @ONC_HealthIT Tom Keane, and I are calling on electronic health record vendors to accelerate the integration of drug price transparency into clinical care — well before the 2028 regulatory deadline. We are also asking them to include cash-pay and direct-to-consumer drug prices on their platforms, which can be lower than the prices patients would pay through insurance. Our priority is simple: give patients the drug price transparency they need to find the most effective medications at the lowest cost.
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That's because property taxes are not really "taxes" -- they are essentially "assessed fees" based, incidentally, on the value of the property at any given moment. Since the are used to pay for schools and public services, we can assume that when the "cost" of those things increases, so will your property taxes. Does that help?
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I don’t believe in taxing people on unrealized gains. But, what about property taxes? They keep going up based on the unrealized value of my house. I didn't sell it, cash out or make a profit. If I don’t pay taxes on paper gains every year, the thugs in power will take my house. Interesting, isn’t it?
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@StatisticUrban @atlanticesque The "costs" in healthcare have nothing to do with the actual provision of healthcare. Baumol, incidentally, was not the sharpest tool in the shed.
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@atlanticesque True, I don't doubt that. I've spilled relatively a lot of ink (via poasting) on how we might make some targeted interventions in that sphere. But we seem to lack the coordination.
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Baumol's cost disease is so devastating. It drives up the price of major, necessary services (education, childcare, eldercare, healthcare), there's no solution, and it makes people SO mad and discontent.
They just require too much human labor atm. No productivity gains in sight.
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@MSerdikoff @cluleyd @realdocspeaks Explain how seniors would go broke from paying $100 a few times a year for primary care appointments and the occasional specialist visit. Seniors are already getting jacked for at least $202/month for Part B premiums.
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@SBlake2000 @cluleyd @realdocspeaks Doctors fees are 8% of health care.
Eliminate part b and seniors would go broke
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It is also worth noting that when JFK was promoting Medicare in the early 1960s, he insisted that it would only cover "hospitalization" and that patients would continue their own private relationships with their doctors and that would be outside the scope of what Medicare covered. In other words, Medicare was originally supposed to just be what Part A is today. If we just chucked Part B, that would solve a lot! Most seniors can pay for their own damn doctors visits. And, yes, I am aware that Part B covers more than that. But the real kicker is hospitalization.
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@aman_shettty Why would he not automatically be on Medicare Parts A and B and a supplemental?
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A family came to me wanting to move their father to a retail health insurance policy.
He's 65. Has diabetes. Was on corporate cover through his son's employer for years.
First thing I had to tell them: the window they were hoping for has mostly closed.
At 65, with diabetes as a declared pre existing condition, underwriting is significantly stricter. Most insurers will either load the premium heavily, add specific exclusions, or both.
The 3 year waiting period for diabetes related claims starts fresh on any new policy.
If they'd done this at 58, even 60, the options would have been meaningfully better.
Cleaner underwriting. Lower premiums. Waiting period already behind them by now.
The harder conversation: this isn't a case where I can find a workaround. It's a case where the cost of waiting became permanent.
The most common mistake families make with parents' health insurance is treating it as something to sort out "when they retire" or "when something happens."
By then, something usually already has.
If your parents are in their 50s and don't have a retail policy, this post is your reminder to get one.
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@RenoHemonc @anish_koka Does anyone know anything about Belmont University's new medical school in Nashville "partnering" with HCA? I had heard that med school graduates would automatically be funneled into residency spots at HCA hospitals.
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@anish_koka HCA itself opened around 7k substandard residency slots in their hospitals !!
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@sterlingkoonce The only players doing any of the work are: (1) manufacturer, wholesaler, and pharmacy. There is literally no reason for other parties to be involved for most drugs, which are too cheap to insure in the first place.
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We do the work. We pay for inventory. We have the liability. We are victims of corrupt recoupment. We are often paid less than $1 to dispense. Ridiculous. And not sustainable.
KP, Pharm.D.@kpharmd12
Such a novel idea. The dispensing pharmacy is allowed to make a profit. I mean we are the ones doing the majority of the work ordering/stocking meds, counseling, etc. The money is already allocated. It’s just being confiscated before it gets to us.
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@realbenbriggs @JoshuaLisec Agree that is the better goal. But this is something that could be implemented in the current cultural paradigm.
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I would be kinda cool if we didn’t let humans go extinct.
Unpaid lead is fine, but encouraging women to have babies first and do a career later if they want would be better.
Would have to be paired with additional cultural and legal obligations for men, but maternity leave is a side question.
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@realbenbriggs @JoshuaLisec Yes, the business not being there is a risk. And yes, that is why I emphasized that this could only apply to medium-large firms. Hospitals are a prime example.
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@SBlake2000 @JoshuaLisec I mean sure, but who knows if the business will even exist in 3 years?
But if unpaid leave makes people happy I’d be fine with it.
We would still have to excluded the smallest businesses. I’d you have 12 employees holding a slot open for 3 years would just be weird.
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The answer is 3 years of UNPAID leave. This gives her a job to go back to (instead of having to "stay in the workforce") if things go south: divorce, husband becomes incapacitated, etc. Medium-large firms can easily accommodate this at little to no cost to themselves. And certain job-types are ideal for this: cashier, staff accountant, hospital nurse, and hospital doctor: anything that is "rotational" in nature. And, it does not impose any further tax burdens on other workers.
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@JoshuaLisec I guess if you hire a woman you should pay her to not work for 9 years if she has 3 kids spaced out 2-3 years each.
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