Sorry for the delay but I have been celebrating both my birthday and the defeat of Mitt.
America is plagued with IDIOTS!
- Thread starter ROKRIG
- Start date
Sorry for the delay but I have been celebrating both my birthday and the defeat of Mitt.
Wrong. EFFECTIVE PREVENTATIVE CARE SAVES MONEY. $10 now so you don't get something or $100000 for care when it is something out of control. Imagine a medical world without diabetic crisis, smoking, etc. We spend 1/3 of our health care money in the last 2 years of life. One major difficulty with healthcare today is that the patient population is not willing to take care of themselves between visits and likes to visit the all-expensive ED instead of getting a massively cheaper and more effective clinic visit for a basic complaint. This is just a couple of the short aspects of what makes our costs ridiculous. That and cost of electronic medical record systems, development, parts, facilities, administration and yet not a dollar has been spent on a patient...I could go on...
I don't believe healthcare is a right. Mostly because I believe that if we don't basics in the way of provide food, clothing, and shelter there is no reason we should be giving away money in health care. The other things are much more important to health and well being. Trust me, having spent a lot of time a big county hospital I know what the poor could use and it is the above three things. Basics first. Good policy for all things in politics, life, etc.
-T
What is the incentive for doctors to provide preventative care?
Agreed, but that is a tricky issue. People like to start talking about death committees when they hear about this, but it is a very serious issue.
What is the incentive for them to?
I thought these systems were supposed to reduce costs? Reducing the amount of space, the amount of personnel, as well as allowing for better analysis of patients.
S
snowmobiler
Well-known member
yep a freind just lost her career to a electronic medical machine.
i seen the commerical where he is getting everyone back to work and bringing manufacturing back to the US. He said it so i must be true.
I cant wait.
I cant wait.
your not insinuating barry is lieing are you? every other politician will lie to get what they want but not old barry.
such it is with technology.. You ever read "Brave New World" by Aldus Huxley?
I don't want to hijack this thread too much, but there are individuals who spend their entire careers working on these questions. Dollars rule all these days sadly.
1. There are several places in which incentives have been implemented. Often salary incentives are available to docs who, for instance, can get a certain percent of their diabetic patients to meet certain measures for health. Medicaid/care is no longer reimbursing for hospital REadmissions if they think that the reason for readmission is something that should have been preventable on stay #1. Any surgeon I meet has no interest in repeating or dealing with a failed surgery. One and done as they get harder/more dangerous to repeat, and many surgeons are reimbursed partially based on a sliding scale (trauma surgeons have a lower expectation for overall survival percentage than outpt surgery) of how successful they are as a surgeon (ie how many deaths, complications). There are more out there, but I assure you they exist. Above all though, having to see someone back in your hospital or office over and over and over is massively annoying if it is something they could manage alone.
2. We somewhat already have these committees when it comes to things like transplants. There are so few available organs that if you don't meet criteria you don't get a new organ. Simple. And yes, it is a difficult topic. Every institution I've been to spends millions to keep very sick patients alive with aggressive measures such that they was able to live for a few more days/weeks/months. Is that worth it for the patient or the provider? For me it is about patient care to the best of my ability and it would be difficult not to do a procedure with a chance to improve someone's status or comfort. But doing something isn't always the right thing to do. We have a lot of individuals suffering through life kept alive only by modern medicine and not their body's internal clock. Thus a committee that doesn't know a patient personally, but has the statistics to back decisions on how much care is appropriate is a not a horrible idea when resources are fixed and limited (as they are now).
3. Motivating anyone to do anything (really manipulating if we're honest) is difficult at best. Sad to say that we need incentives beyond a slow, miserable and early death. A study recently showed that ~50% of medications given are either not taken or taken incorrectly. Really, if your health isn't a serious issue to you it won't be a priority like anything else in life. Not being able to take care of yourself is easily handled by having someone help you. I just don't understand not wanting to take care of yourself when able. If we made it harder to be unhealthy it would be less likely we would be. For instance, parking lots further from buildings, making unhealthy food choices harder to access (ie higher taxes like with cigarettes), etc. Environmental change works to motivate, but is difficult as it steps on the "big brother" button.
4. EMR systems cost large institutions tens of millions of dollars. And they are contracts so they will likely cost millions later. These costs are due partly to shareholders of the EMR companies needing dividends, the people who make $50/hr traveling to train medical professionals how to use the often non-intuitive programming designed by someone without a clue about real-world medicine, computer upkeep, 24/7 helplines (likely in India), etc, etc. They have not improved efficiency or reduced the time spent charting as promised, and most of the systems do not "talk" to one another. So while it eliminates some jobs, it is costing in other ways. There are nice features to having "all" of a patient's chart in front of you, but we are a long way from it being as super as it was dreamed up to be.
None of these are really straight forward. If there was a BEST way to do medicine, we'd all be doing it.
-T
C
CatRpillar
Well-known member
Only true if everyone takes the money saved and doesn't spend it on businesses that offshore fabrication, invest elsewhere, or something similar. And since the US basically runs a constant trade deficit, that is exactly what is happening.
On the other hand, if tax money is used significantly to fund external efforts (wars, aid, fuel, armed force bases in foreign countries, etc) a similar effect occurs.
Like the saying goes, everything in moderation, or, you can't have everything.
Do like any good business - list your priorities, decide your budget, then stick to it. None of that is happening, and it won't until it's too late.
The only thing Obama got elected to was as captain of the Titanic. Keep rearranging those deck chairs.
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