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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
5.5K 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
399 Takip Edilen352 Takipçiler
@DrDiGiorgio Quick question: what does the pressure to pursue RVU targets look like in practice? Is it monthly quotas with fixed amount of revenue they would generate? Does it mean doctors end up recommending tests and procedures to unsuspecting patients that they do not really need? How horrifying is this?
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Is there a conflict of interest when hospitals:
1) design policies to prevent pt “leakage”
2) incentivize intensity of care with RVU targets
3) use 340b arbitrage
There’s an honest convo to be had re: pros & cons of competition from MD-owned hospitals.
The below is propaganda.
Federation of American Hospitals@FAHhospitals
There is no issue with physician-led hospitals- the issue is about the conflict of interest when physicians self-refer patients to their own hospitals. The data is clear: POHs tend to treat more commercially insured and healthier patients than full-service hospitals. In rural communities, this can leave rural hospitals with a greater financial burden, further threatening their ability to keep their doors open and keep 24/7 care available in their communities. Read more: fah.org/wp-content/upl…
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@MSerdikoff @jaredrhoads What is your point? Perhaps you can clarify.
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@SBlake2000 @jaredrhoads Are you in healthcare? It appears not.
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The quiet scandal of U.S. healthcare: the more "insured" we've become, the less like customers we've been allowed to act.
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@AaronMLong @jaredrhoads Those "profits" are manipulated because of fake prices. Not sure how this is not obvious.
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@SBlake2000 @jaredrhoads The overall net profit margin in the health care industry is between 2 to 3%, making it among the least profitable industries in the United States. Cherry picking individual procedures or drugs will always yield a distorted picture of the entire business.
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Technology is not allowed to reveal its efficiency in health-care -- as it does in every other industry -- because we allow third-parties to pay for "everything." An MRI at a cash-only independent imaging center is $500. At a HOPD, the chargemaster states a price of $8000, where insurance "pays" $1500, and "patient owes" $500. That is a total of $2000 for something that technology and efficiency has really brought to us at a price of $500. In other words, we are spending about four times as much on health-care as the real cost merits because of INSURANCE.
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@SBlake2000 @jaredrhoads No, it is really, really not. Listen, I am no fan of single payer. Check my post history if you don't believe me. The problem is that the technology investments we have put into health care go into improving the *QUALITY*, not the efficiency. As it should be.
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It is still rare. And that is what third-party payment is for. For most of the population -- and most of the time -- routine services need not be paid for by third parties. They are "too cheap to insure." Do you think that auto-insurance ought to pay for oil changes and new tires? Why should third-parties meddle in primary care office visits? Ah, yes, because large systems buy primary care -- and collude with insurance -- to control the referral stream. That is anti-competitive, leads to lack of choice and higher costs for all of us, and ought to be BANNED. No reason why people cannot afford a $75 or $100 office visit.
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@SBlake2000 @jaredrhoads The most expensive care is rarely not emergent or time sensitive
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@AaronMLong @jaredrhoads Good health-care, in a free market, is CHEAP. This is gaslighting in order to justify single-payer. Further, most health-care is demand elastic. Food is more essential than healthcare. Oh and Baumol was a rube.
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@SBlake2000 @jaredrhoads False.
en.wikipedia.org/wiki/Baumol_ef…
Nobody actually wants cheap health care, they want *GOOD* health care, and the market can never be free because there are no substitute goods for "being alive".
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@AaronMLong @jaredrhoads A real free-market (at the lower end) would ration it more cheaply and more accessibly (i.e without the insurance bloat which causes bottenecks and hassle).
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That is false. For most care, which is non-emergent, people will shop based on price. And the "prices" that you see are not real market prices. Do you think market-based PCP office visit for $75 cash is unreasonable? Why are insurance middlemen involved in such a routine, low-cost and predictable service?
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@jaredrhoads That is part of the problem. But, the price of services and the speed at which they are required eliminates shopping around. We need some king of universal system that EVERYBODY else has
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@DrTessaT @HouseCommerce @DrDiGiorgio @RepJohnJoyce Exactly. This is one of the most horrifying things about insurance contracts. It is likely that the doctor's contract would Kaiser stipulated that he could not accept cash from you even if Kaiser refused to pay.
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@SBlake2000 @HouseCommerce @DrDiGiorgio @RepJohnJoyce 💯!!! I have never understood why I was told that a surgeon could not see me as a self-pay bc I had Kaiser Permanente. If I had that consult, I wouldn’t be permanently disabled now.
I sought this consult bc Kaiser Permanente denied me emergency medical care.
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@DrTessaT @HouseCommerce @DrDiGiorgio @RepJohnJoyce This is exactly why office visits and consults MUST be removed from third-party payment.
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@HouseCommerce @DrDiGiorgio @RepJohnJoyce Kaiser Permanente somehow managed to prevent me from getting a self-pay surgical consult after I had a self-pay MRI that indicated I needed emergency surgery. That delay caused me to be permanently disabled. This needs to be stopped!
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@SacksDisa That’s because it is simple.
What has prevented doctors from building a website, setting up a bank account, coming up with a thesis, and deploying lobbyists?
There are 120,000+ docs in independent medicine.
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I could spend the rest of my life cataloguing the failures of the American Medical Association.
I may just for fun.
HOWEVER, the AMA is not the problem.
The problem is that physicians never built anything to replace it.
You don't lose a political war because your enemy is strong.
You lost because you weren't organized.
Most physicians will not invest $10 a month in their own profession's survival.
The physician who won't fund a movement will absolutely fund a malpractice attorney.
They'll pay six figures to a hospital system that owns their contract.
They'll absorb a 4% Medicare cut without a single phone call to their congressman.
But $10 or $100 a month to own the conversation?
That's where it falls apart.
The AMA didn't beat physicians.
Physicians beat physicians.
AMA@AmerMedicalAssn
The AMA applauds bipartisan legislation to exempt international medical graduate physicians from the $100,000 H-1B visa fee - a critical step to ensure patients, especially in underserved areas, have access to care. Thank you to @RepMikeLawler, @SanfordBishop, @MaElviraSalazar, and @RepYvetteClarke for introducing the bill, and we call on Congress to act quickly to protect patients’ access to care. spr.ly/6010B6r31q
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@sallypipes Of course price falls when things go OTC! Imagine if Tylenol were prescription only!!! How ridiculously priced it would be.
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One of the most promising elements of the Trump's healthcare proposal is expanding over-the-counter access to certain medicines. Evidence consistently shows that when drugs move from prescription to OTC status, prices fall and access improves.
nysun.com/article/trumps…
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What people think universal healthcare does:
- Provides "free" medical care for all
- Eliminates medical bankruptcies
- Creates efficient single-payer system
- Reduces overall costs through economies of scale
What universal healthcare actually does:
- Forces productive citizens to subsidize others' poor health choices through taxation
- Creates artificial scarcity through price controls and rationing
- Eliminates price signals that coordinate supply and demand
- Generates massive waiting lists and deteriorating quality
You're not getting "free" healthcare. You're getting Soviet-style central planning applied to life-and-death decisions.
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@BrentAWilliams2 No one who supports price transparency suggests it's for emergencies. But most healthcare is not emergent, and that's the part that would benefit patients by posting clear, reliable pricing.
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When you have crushing chest pain, you don't go somewhere and ask for a menu, you call 911 and hope that someone comes and whisks you somewhere and saves your life.
Why anyone would compare medical care to going to a restaurant is beyond my comprehension.
Jared Rhoads@jaredrhoads
Would you eat at a restaurant that gives you a menu without any prices on it, and then when you ask for a menu that does have prices on it, they hand you one with ridiculously inflated price labels next to each item, but reassure you that you won't actually pay those list prices--you'll pay a different, lower price based on what membership card you have. And when you ask what that lower price is, they can't reliably tell you, but promise to send you a bill in the mail a month later telling you what you actually owe. Welcome to the American healthcare system, which is the way it is not because businesses set out to do business this way, but because this is where they've found themselves after reacting to each previous policy and intervention (e.g., tax exclusion for employer-sponsored health insurance, institutionalized third-party payment, gov't reimbursement formulae, cross-subsidization of public programs, etc.)
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@SpineNeuro Cuban wants Medicare for All -- he cannot be trusted.
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Ins companies get all the negative press (deservedly).
Meanwhile , “non profit” hospitals execs are laughing all the way to the bank
Mark Cuban@mcuban
@SpineNeuro Ins companies need to be removed from the mix. They have just become banks with different fees
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@SBlake2000 @USDS Have lived long enough to have seen and experienced enough & learned the hard way that nice little boxes, tools, can miss the unique, the new; currently finding Dr's that are not limited to practicing within whatever codes the insurers will pay is getting harder to find.
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You go to different doctor’s offices and fill out the same forms over and over again when you could scan a QR code and have your information transferred instantly.
We live in the 21st century. Healthcare shouldn’t feel like Groundhog Day.
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Bingo. This is why EMR need to be abolished and for real allergies/conditions that require emergency medics to know about, we can go back to wearing those little medic-alert bracelets. This is the only way to re-empower the patient. Oh, and remove third-party payment from PCP office visits altogether.
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@USDS do those instantly transferred records also include the conclusions, whether misdiagnosis or plain assumptions from a previous doctor's conclusions, thus negating any true 2nd opinion which is often desperately needed? Or simple transfer of test results with no predetermination?
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@KirkSpano @Handre The "skin in the game" is paying for your own fucking PCP office visit. All third-party involvement MUST be removed from that sector if we are to restore sanity and cost-effectiveness into this industry.
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@Handre #MedicareForAll if set up like #Medicare & paid for by billion dollar revenue companies, would be the most efficient healthcare system America ever had. Why? Because Medicare is the most efficient healthcare in 🇺🇸 by far & requires “skin in the game” by consumers.
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@sterlingkoonce @_APCI @NEWS9 The only solution is to remove INSURANCE from the transaction entirely. Most drugs are generic and are cheaper than the cost of insurance to "process" the delivery of them as "claims."
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Oklahoma enforcing #PBM audit laws and returning funds to affected pharmacies. | @NEWS9
ow.ly/inoP50YvNPZ
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