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AZ, USA
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Posted: 5/5/2024 3:46:25 PM EDT
[#1]
Quote HistoryOriginally Posted By fdawg: That’s the point, eat well and exercise and you won’t have the MI LOL. Not how it works. I mean, it helps, but healthy people also get sick. |
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Posted: 5/5/2024 3:49:21 PM EDT
[#2]
Quote HistoryOriginally Posted By ACEB36TC: My Doc ( Internal Medicine) is outstanding. He IS the gatekeeper and in the system he works for he has a LOT of stroke. I can get almost any procedure/x-ray/CT scan and more in a heartbeat. It's almost as if they are WAITING for customers. We're VERY rural and I may have to drive a bit to get to the specialist I'm referred too but that's fine with me. I've had nothing but good results since I moved to this Dr. My old Doc (internal medicine) retired and told me "find an internal medicine guy" and he was correct. My system uses "MyChart" as the information system. In most cases my results etc. are ALREADY in my inbox by the time I get home from any visit with any Doc in the system. I can't believe how good Medicare is. I certainly don't understand how we , as a country, can afford it. Good for those who get it, perhaps? Certainly not for the taxpayers. Like most things in our country we actually can't afford it. |
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Posted: 5/5/2024 3:52:42 PM EDT
[#3]
Quote HistoryOriginally Posted By Emeoba69: Every age was the most medically advanced at the time. There is certainly a dearth of cutting edge technology that is only growing better. The actual administration of medicine is a convoluted mess on many many levels. OP has a point that there are some glaring shortcomings. The actual administration of the business of medicine probably hampers more efficient results. If you got sick or injured today, I’d ask the OP when and where he would rather live. |
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WA, USA
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Posted: 5/5/2024 3:58:53 PM EDT
[#4]
Quote HistoryOriginally Posted By HIMARS13A: LOL. Not how it works. I mean, it helps, but healthy people also get sick. I don’t think we are talking about epidemics of “healthy people” have coronary artery disease and stroke and heart attack. PCP will rarely see acute cardiac stuff anyway, that’s reserved for the high school educated EMS folks that literally keep you alive and the MD in the cath lab is the difference maker. |
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Posted: 5/5/2024 3:59:44 PM EDT
[#5]
Healthcare is in a state of collapse. It will get worse.
And the QALY is coming. |
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Posted: 5/5/2024 4:05:38 PM EDT
[#6]
MyChart and other medical records companies are very secure and have plenty of firewalls......so said every one of them before they got hacked and personal information got hijacked.
Around 1.5 years ago there was a national crash/hack of many hospitals and health care systems. I was in the hospital at 6am for scheduled surgery, and around 8am the nurse came in and told me that I needed to get dressed and that the surgery wasn't happening because there was a problem accessing my health care records, and all the records of the hospital, and the health care system in general. It took them months to sort it all out. My guess is that they got hacked and blackmailed and they finally came to an "accommodation" that got their systems back on line. |
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AZ, USA
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Posted: 5/5/2024 4:05:48 PM EDT
[#7]
Quote HistoryOriginally Posted By fdawg: I don’t think we are talking about epidemics of “healthy people” have coronary artery disease and stroke and heart attack. PCP will rarely see acute cardiac stuff anyway, that’s reserved for the high school educated EMS folks that literally keep you alive and the MD in the cath lab is the difference maker. Your PCP screens and treats. It works pretty well. The generic drugs used to help keep people with chronic diseases alive are often $2/mo. If you'd rather take your chances with the cardio or neurosurgeon that's fine too, but often doesn't end well. |
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Posted: 5/5/2024 4:09:17 PM EDT
[#8]
Quote HistoryOriginally Posted By Stutzmech: Op is correct |
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Posted: 5/5/2024 4:11:18 PM EDT
[Last Edit: AlabamaFan64]
[#9]
Hussein promised all these problems would be fixed with obamacare. Prices weren’t going up and you could also use the doctor of your choice. Sometimes we’re too ungrateful for what that man did for us.
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Posted: 5/5/2024 4:14:55 PM EDT
[#10]
Originally Posted By MikefromTX: Then there are the Physician Assistants (PAs) that more and more doctors are using nowadays to allow their office to churn more patients through and make more profits. Profits?! 
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AZ, USA
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Posted: 5/5/2024 4:16:02 PM EDT
[#11]
It’s getting worse.
I have digestive diseases, among other things. I require yearly endoscopic dilation procedures in order to be able to swallow anything including water or saliva. The one doctor told me 8 month to schedule a visit and 2 months for the procedure. Mind you if you’re unable to consume enough calories to survive you will eventually die. I suffered for 10 months barely getting in 800 calories a day some days it turned into 500 and others it was less. They kept telling me it wasn’t serious enough for them schedule me any sooner. I begged for help and one day it was bad enough I couldn’t get saliva down. So off to the ER, I was transferred to the digestive diseases center where they only treat people who have what I do. I had an Endoscopy scheduled July 3, 2023, I remember because I spent my Bday in the hospital again. It’s only my 17th procedure since 2005. I need another one done this year. I’m getting tired of this bullshit, I dislike my pcp, but they are better than others I have had to deal with who just gaslight me into the ER for choking on food. I need to see a neurologist, the one I wanted to go see has a 2 year wait list yet their waiting room is empty when I go to see them. 😳 I know how to work the system now, and I don’t simply take my pcp direction and do as they say. If I want to go see a certain specialist in my network I will pick them myself. That said FJB and open border policy. |
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Posted: 5/5/2024 5:15:15 PM EDT
[#12]
Quote HistoryOriginally Posted By victorgonzales: There is no simple fix. We'd have to unwind a hundred years of regulations in healthcare and insurance and pretty much collapse the current system to fix it. We'd have to let the elderly and poor die for the most part because the cost is too immense to give everyone everything for free. Just like social security the current healthcare system is a house of cards they just keep building taller. The best thing you can do is exercise eat healthy. Stop eating sugar and processed foods. Get your own blood tests and research what your body is lacking and fix it through diet if possible. People lean too heavily on drugs and do nothing to make their bodies healthy in this country and that's a large part of the cost problem as well. Quote HistoryOriginally Posted By victorgonzales: Originally Posted By 1245xx: Not one person has yet given their well defined, silver bullet solution yet. In past threads I've read posts saying, if we the healthcare industry just did this ONE simple thing, our problems would be solved! There is no simple fix. We'd have to unwind a hundred years of regulations in healthcare and insurance and pretty much collapse the current system to fix it. We'd have to let the elderly and poor die for the most part because the cost is too immense to give everyone everything for free. Just like social security the current healthcare system is a house of cards they just keep building taller. The best thing you can do is exercise eat healthy. Stop eating sugar and processed foods. Get your own blood tests and research what your body is lacking and fix it through diet if possible. People lean too heavily on drugs and do nothing to make their bodies healthy in this country and that's a large part of the cost problem as well. Exactly. 100 years is about right. More: https://meridianhealthclinic.com/how-rockefeller-created-the-business-of-western-medicine/ |
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Posted: 5/5/2024 5:20:48 PM EDT
[#13]
Quote HistoryOriginally Posted By ceetee: Don't blame the doctors. Most of them probably wish they could spend more time with their patients, and take care of ALL their patients' problems. Blame government and insurance companies who have (as the guy from Caunkistan that just joined three weeks ago said) turned patients from people into product. I've told this story before: I needed an MRI. The imaging center worked through my insurance company, so I wasn't out of network or anything like that. My cost for the MRI was going to be more than my annual out-of-pocket, which was $2,500. So I was going to be stuck with a bill for $2.5k. My surgeon's office called a different MRI center, one that worked on a cash-only basis. My cost from them was $365. Tell me why a procedure that cost $365 when paid with cash, cost $2.5k when "covered" by my insurance company? that’s awesome, glad you were able to get that squared away. i don’t disagree, all the prices are moronic. i HATE seeing and hearing about this, when regular folks just want to get and feel better. |
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TX, USA
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Posted: 5/5/2024 5:30:41 PM EDT
[#14]
Quote HistoryOriginally Posted By ACEB36TC: I can't believe how good Medicare is. I certainly don't understand how we , as a country, can afford it. Pardon me, but you do realize we’re 34 Trillion dollars in debt, don’t you? We, as a country, aren’t affording Jack Shit. |
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Posted: 5/5/2024 5:32:57 PM EDT
[#15]
Quote HistoryOriginally Posted By HIMARS13A: The problem we have is that people feel that insurance is a kind of prepaid health care card, when it's simply not. And that is a huge part of the true underlying problem. And don't forget that it is government interference that got that ball rolling to begin with. |
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Posted: 5/5/2024 5:36:40 PM EDT
[#16]
Had a relative w/ asthma get seen for Influenza B. The joke of a doctor with a Spanish last name told him to take his rescue inhaler every 2-4 hours until symptoms improve. That fucking moron could've killed him had another physician not intervened, and told him to disregard those instructions, and use the nebulizer w/ prescription solution instead.
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AZ, USA
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Posted: 5/5/2024 5:37:58 PM EDT
[#17]
Quote HistoryOriginally Posted By Walkure: And that is a huge part of the true underlying problem. And don't forget that it is government interference that got that ball rolling to begin with. The feds are spending $200B a year on ACA subsidies and forgoing $350B in taxes on employer health insurance. It's a huge racket. |
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Posted: 5/5/2024 5:50:20 PM EDT
[#18]
Medicine in the USA has never been better. In fifty years, we will be able to say the same thing. More money and manpower (women power) are devoted to this industry than virtually anything else.
We don't have enough doctors IMO, and unless you are actively perusing your PhD, you're not helping the cause. If you don't live in a large city, try finding an Endocrinologist. If your community is lucky enough to have one, they usually don't hang around very long. Eight to ten years of school, followed by what could basically be described as an apprenticeship in an emergency room, will finally qualify a person to hang a shingle over their door. We are blessed to have world class health care in our nation. Our standards for admittance are very high. Make one mistake (real or imagined) and the lawyers show up to ruin your life. |
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Posted: 5/5/2024 5:52:56 PM EDT
[#19]
Originally Posted By 1245xx: Not one person has yet given their well defined, silver bullet solution yet. In past threads I’ve read posts saying, if we the healthcare industry just did this ONE simple thing, our problems would be solved! Originally Posted By Stutzmech: Problem is too complex for a simple solution, involves medical,insurance,legal system, too much money involved Originally Posted By HIMARS13A: Frankly no one has the perspective to know how to fix everything. I know how primary care could be fixed, but I don't know how to mitigate the effect that would have on hospitals. Similarly, I know that PBMs are bad, but I don't know how prices would be set in their absence. I know that subsidiarity should be the principal used to determine site specific reimbursement, that is to say everything should be done at the lowest competent level. You don't need to go to the ED for stitches when primary care can do it, and you don't need outpatient procedures don't in a hospital when an ASC can do it. But tying it all together? No one person can articulate all of it. Get rid of politicians. |
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Posted: 5/5/2024 5:56:27 PM EDT
[#20]
Quote HistoryOriginally Posted By veritas8985: OP nailed it. It's a fucking shit show now and it will only get worse. My PBP, primary billing physician, said about my sciatica that I needed to do 6 weeks of physical therapy to start. Prick failed to say that in certain circumstances delay in the right treatment would have a risk of permanent nerve damage to my legs and that risk can best be determined by an MRI. And that the fucking insurance companies require therapy first based on absolutely no knowledge of the patient as we are all cookie-cutter premium-paying blobs. Now I have some permanent nerve damage to my legs. If that idiot would have mentioned the risk of permanent damage that only could be determined by an MRI I'd have paid for the MRI out of pocket. That is exactly why we built an emergency nest egg separate from our retirement savings. Could have paid for 10 MRIs and had enough left over for BOTH of us to eat at 5 Guys. The ER didn't help when I showed up unable to walk. Shot me up with painkillers and some other shit and said go see my PBP instead of doing some of that diagnostics a competent professional would have done. My fault for trusting the idiot who determines treatment based on insurance company tightwad cunts rather than the patient's best and informed interests. The eventual MRI showed bone growth l4, l5, s1 pressing on the nerves to the extent the only fix was to go in and dremel off the excess bone. Absolutely nothing else would have fixed the problem. One mildly inconvenient laminectomy and problem solved except for the nerve damage. I'm hitting the gym heavily and working on my legs which is helping quite a bit but not going to go back to normal. 6 months ago I could barely shift my bike and after about 30 minutes couldn't shift it at all. Now I can ride all day, day after day, and only start having trouble later each day. The numbness in both legs is grating like nails on a blackboard. Agility sucks but I can walk a mostly straight line if I concentrate. |
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Posted: 5/5/2024 5:57:56 PM EDT
[#21]
Quote HistoryOriginally Posted By LibertyShip: Exactly. 100 years is about right. More: https://meridianhealthclinic.com/how-rockefeller-created-the-business-of-western-medicine/ Morris Fishbein and the AMA. |
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WY, USA
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Posted: 5/5/2024 6:03:49 PM EDT
[#22]
Quote HistoryOriginally Posted By 1245xx: Not one person has yet given their well defined, silver bullet solution yet. In past threads I’ve read posts saying, if we the healthcare industry just did this ONE simple thing, our problems would be solved! A silver bullet (maybe just a 22 but not the 50 you’re looking for) would be if people ate 500 less calories a day and went for a walk. Healthcare is expensive and busy for lots of reasons, but a large one is because people are fat fucks |
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AZ, USA
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Posted: 5/5/2024 6:04:40 PM EDT
[#23]
Quote HistoryOriginally Posted By MATTINFAIRBORN: My PBP, primary billing physician, said about my sciatica that I needed to do 6 weeks of physical therapy to start. Prick failed to say that in certain circumstances delay in the right treatment would have a risk of permanent nerve damage to my legs and that risk can best be determined by an MRI. And that the fucking insurance companies require therapy first based on absolutely no knowledge of the patient as we are all cookie-cutter premium-paying blobs. Now I have some permanent nerve damage to my legs. If that idiot would have mentioned the risk of permanent damage that only could be determined by an MRI I'd have paid for the MRI out of pocket. That is exactly why we built an emergency nest egg separate from our retirement savings. Could have paid for 10 MRIs and had enough left over for BOTH of us to eat at 5 Guys. This is why we don't take insurance. MRI is like $500. |
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Posted: 5/5/2024 6:05:52 PM EDT
[#24]
Concierge medicine FTW!
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Posted: 5/5/2024 6:06:22 PM EDT
[#25]
Quote HistoryOriginally Posted By MATTINFAIRBORN: There is a lot of truth to what OP said. My PBP, primary billing physician, said about my sciatica that I needed to do 6 weeks of physical therapy to start. Prick failed to say that in certain circumstances delay in the right treatment would have a risk of permanent nerve damage to my legs and that risk can best be determined by an MRI. And that the fucking insurance companies require therapy first based on absolutely no knowledge of the patient as we are all cookie-cutter premium-paying blobs. Now I have some permanent nerve damage to my legs. If that idiot would have mentioned the risk of permanent damage that only could be determined by an MRI I'd have paid for the MRI out of pocket. That is exactly why we built an emergency nest egg separate from our retirement savings. Could have paid for 10 MRIs and had enough left over for BOTH of us to eat at 5 Guys. The ER didn't help when I showed up unable to walk. Shot me up with painkillers and some other shit and said go see my PBP instead of doing some of that diagnostics a competent professional would have done. My fault for trusting the idiot who determines treatment based on insurance company tightwad cunts rather than the patient's best and informed interests. The eventual MRI showed bone growth l4, l5, s1 pressing on the nerves to the extent the only fix was to go in and dremel off the excess bone. Absolutely nothing else would have fixed the problem. One mildly inconvenient laminectomy and problem solved except for the nerve damage. I'm hitting the gym heavily and working on my legs which is helping quite a bit but not going to go back to normal. 6 months ago I could barely shift my bike and after about 30 minutes couldn't shift it at all. Now I can ride all day, day after day, and only start having trouble later each day. The numbness in both legs is grating like nails on a blackboard. Agility sucks but I can walk a mostly straight line if I concentrate. Not following your doctor's advice does not make him the idiot. |
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AZ, USA
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Posted: 5/5/2024 6:09:28 PM EDT
[#26]
Quote HistoryOriginally Posted By borderpatrol: Not following your doctor's advice does not make him the idiot. I get his complaint. He let the insurance coverage determine the treatment plan and not the patient. |
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Posted: 5/5/2024 6:11:59 PM EDT
[#27]
Originally Posted By MikefromTX: Back in the Old Days we had doctors, and when something was wrong with you that doctor either treated it, or if it was beyond his skill level he would help you find a specialist and work with that specialist. Nowadays, we have Primary Care Physicians (PCPs), who are mainly gatekeepers and do little more than send you to specialists. If you're unfortunate enough to have more than one condition, you end up with multiple specialists. Those specialists almost never coordinate with each other (or your PCP), so it's up to you (with no medical training) to somehow bridge that gap and manage your own medical care. YOU have to figure out which specialist should deal with specific issues that come up, and go see that specialist (after waiting 3 weeks or more for an app't). Often that specialist will not be able to deal with your issue and will send you somewhere else. The frustration begins to run deep. Then there are the Physician Assistants (PAs) that more and more doctors are using nowadays to allow their office to churn more patients through and make more profits. Most don't know shit from a good grade of apple butter, and end up aggravating the situation. Finally, your problem gets so bad you go to the ER. There you start all over and often get admitted and spend a week (and lots of $$) in a room with tubes and wires hooked up to you. And your odds of getting well ... ? Are we Canada now? England? India? There's GOT to be a better way.  @MikefromTX You are mostly correct. Hospital corporations lobbied Congress ~ 20 years ago to get an additional 30% “facility fee” when any of their employees (doctors, APRN/nurse practitioner, PA/Physician assistant, etc) sees a patient. This gave hospital corporations the financial leverage to buy out/shut down most private, physician-run practices. We are now at ~ 75% of doctors working for hospital corporations. Doctors have lost most of control of the medical system as a result. Yes, some private practices do still exist, but the writing is on the wall. Most doctors are simply trying to hang in there. Many, if they have a spouse that works and has health insurance are retiring early, 59/60/61, to get out from under the control of hospital corporations. Without the additional “facility fee”, and the financial buffer, it’s very difficult to go out on your own. My sister is a dermatologist and somehow manages to do it but she spends a lot of time after hours managing her practice. An additional problem is medical reimbursements are higher the more invasive the medical interaction. So primary care, psychiatry, pediatrics, etc don’t get reimbursed as much as surgeons. This leads to fewer people going into primary care. The hospital corporations like to hire APRNs and PAs because they are less expensive and then pressure them, on a fixed salary, to see as many patients as possible. You’re seeing this now even in the ER! I don’t have time to do a deep dive on this, but I have witnessed the changes since starting my practice in 2001. You are absolutely correct that our medical system is in a death spiral. What comes out on the other end is unknown, but it’s not going to be good. |
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Posted: 5/5/2024 6:14:25 PM EDT
[#28]
Quote HistoryOriginally Posted By ACEB36TC: My Doc ( Internal Medicine) is outstanding. He IS the gatekeeper and in the system he works for he has a LOT of stroke. I can get almost any procedure/x-ray/CT scan and more in a heartbeat. It's almost as if they are WAITING for customers. We're VERY rural and I may have to drive a bit to get to the specialist I'm referred too but that's fine with me. I've had nothing but good results since I moved to this Dr. My old Doc (internal medicine) retired and told me "find an internal medicine guy" and he was correct. My system uses "MyChart" as the information system. In most cases my results etc. are ALREADY in my inbox by the time I get home from any visit with any Doc in the system. I can't believe how good Medicare is. I certainly don't understand how we , as a country, can afford it. About that . . . |
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Posted: 5/5/2024 6:16:49 PM EDT
[#29]
Quote HistoryOriginally Posted By NotIssued: As a former PCP, you're only half wrong. There's plenty I can handle. But there's plenty who demand a specialist, or who need to go once or twice a year and need a referral from me due to insurance. Patients are half the problem too. Don't do anything to help themselves (lose weight, exercise, stop smoking, etc) and expect a pill to fix things...which of course doesn't happen. Then gripe about the treatment, and often aren't that compliant anyway. Or they come in for literally everything. Runny nose for a day. Rash after playing in poison ivy. Sunburns. Back pain after shoveling the driveway on the first day of snow. "I'm going on vacation and want to make sure I won't get sick." So, yeah, we send some packing to someone else- because when we have 15 minute appointments, and you have 4 medical conditions that each deserve 15 minutes, it just doesn't work. To top if off, billing you an level 3 might get us $50 compensation, despite you taking 30 minutes of our time. Kind of hard to run a business on $100/hr, ya know? We have to make that up with quick visits, like an ear infection, or a UTI- but they usually go to the urgent care, cuz the office is clogged with the chronically unwell. Believe me, there's 2 sides to every story. If you don't like the game, don't play. Darwin will take care of things. @NotIssued We need 3 times the number of PCP’s. They are the backbone of medicine. |
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Posted: 5/5/2024 6:18:04 PM EDT
[Last Edit: MikeJGA]
[#30]
In OPS good old days the one size fits all GP killed a lot of their patients. I'd much prefer to be alive due to my GP sending me to a:
Brain Surgeon 2010 Cardic Surgeon 2021 Back Surgeon 2022 The USA has the finest health care in the world. |
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Posted: 5/5/2024 6:18:40 PM EDT
[#31]
Quote HistoryOriginally Posted By victorgonzales: The good news is pretty soon AI will be able to diagnose and come of with more personal treatment plans. You'll only need to get MRI, X-ray, blood work ect. AI will likely eventually be better at diagnosing and treating people than most doctors as well. Lol, I'm pretty sure it'll be treating my ingrown toenail for every possible diagnosis that pops up when I search by symptoms on the web. "Herpes?"  |
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Posted: 5/5/2024 6:18:50 PM EDT
[#32]
Quote HistoryOriginally Posted By 1245xx: Not one person has yet given their well defined, silver bullet solution yet. In past threads I’ve read posts saying, if we the healthcare industry just did this ONE simple thing, our problems would be solved! @1245xx Some argue that it took us since 1965 to get where we are. There is no silver bullet for that. |
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Posted: 5/5/2024 6:19:38 PM EDT
[#33]
Quote HistoryOriginally Posted By HIMARS13A: There's nothing stopping you from hiring an old school doctor, it will cost you $100/mo or less. Concierge is becoming a thing around here..... |
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Posted: 5/5/2024 6:29:29 PM EDT
[#34]
Quote HistoryOriginally Posted By HIMARS13A: Which is why we don't take insurance of any kind, or do coding of any kind. The problem we have is that people feel that insurance is a kind of prepaid health care card, when it's simply not. Absolutely. You don't use car insurance to pay your gas and oil changes, why use it for office visits? |
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AZ, USA
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Posted: 5/5/2024 6:31:06 PM EDT
[#35]
Quote HistoryOriginally Posted By justsayin: Concierge is becoming a thing around here..... Technically concierge is a higher service model that uses insurance. Direct Primary Care is much cheaper and never bills insurance. I don't understand why someone would pay for concierge. DPC on the other hand, I don't understand why they wouldn't. |
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AZ, USA
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Posted: 5/5/2024 6:32:18 PM EDT
[#36]
Quote HistoryOriginally Posted By NotIssued: Absolutely. You don't use car insurance to pay your gas and oil changes, why use it for office visits? If we simply excluded primary care and generic drugs from insurance prices would fall by about 30%. It's not very expensive, but the costs rack up to the middleman. 25% of generic prescriptions cost less than the co-pay, and that's after you buy the insurance. |
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TX, USA
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Posted: 5/5/2024 7:10:47 PM EDT
[#37]
Quote HistoryOriginally Posted By HIMARS13A: If we simply excluded primary care and generic drugs from insurance prices would fall by about 30%. It's not very expensive, but the costs rack up to the middleman. 25% of generic prescriptions cost less than the co-pay, and that's after you buy the insurance. On the surface, that looks good. But that’s assuming a very lucrative business model (insurance) would lower costs passed on to customers (which would otherwise become profits). The fact that “25% of generic prescriptions cost less than the co-pay, and that's after you buy the insurance” hasn’t resulted in refunds or reductions in co-pay and/or premium prices to the client tells us how that would likely work out. A business acquaintance once quipped “there’s a reason so many sports stadiums and major sporting events are sponsored/named after insurance companies…and it ain’t ‘cause they’re losing money!”. |
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Posted: 5/5/2024 7:33:32 PM EDT
[#38]
Quote HistoryOriginally Posted By HIMARS13A: The feds are spending $200B a year on ACA subsidies and forgoing $350B in taxes on employer health insurance. It's a huge racket. Quote HistoryOriginally Posted By HIMARS13A: Originally Posted By Walkure: And that is a huge part of the true underlying problem. And don't forget that it is government interference that got that ball rolling to begin with. The feds are spending $200B a year on ACA subsidies and forgoing $350B in taxes on employer health insurance. It's a huge racket. Money printer go brrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr. |
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Posted: 5/5/2024 7:34:59 PM EDT
[#39]
Quote HistoryOriginally Posted By C-4: About that . . . Quote HistoryOriginally Posted By C-4: Originally Posted By ACEB36TC: My Doc ( Internal Medicine) is outstanding. He IS the gatekeeper and in the system he works for he has a LOT of stroke. I can get almost any procedure/x-ray/CT scan and more in a heartbeat. It's almost as if they are WAITING for customers. We're VERY rural and I may have to drive a bit to get to the specialist I'm referred too but that's fine with me. I've had nothing but good results since I moved to this Dr. My old Doc (internal medicine) retired and told me "find an internal medicine guy" and he was correct. My system uses "MyChart" as the information system. In most cases my results etc. are ALREADY in my inbox by the time I get home from any visit with any Doc in the system. I can't believe how good Medicare is. I certainly don't understand how we , as a country, can afford it. About that . . . Guess what I have been dealing with this weekend . . . |
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AZ, USA
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Posted: 5/5/2024 7:41:21 PM EDT
[#40]
Quote HistoryOriginally Posted By RedAngus: On the surface, that looks good. But that’s assuming a very lucrative business model (insurance) would lower costs passed on to customers (which would otherwise become profits). The fact that “25% of generic prescriptions cost less than the co-pay, and that's after you buy the insurance” hasn’t resulted in refunds or reductions in co-pay and/or premium prices to the client tells us how that would likely work out. A business acquaintance once quipped “there’s a reason so many sports stadiums and major sporting events are sponsored/named after insurance companies…and it ain’t ‘cause they’re losing money!”. They're limited to 20% for overhead and profit. Now, that is itself a problem because it removes incentives to keep costs down. But there are people out there crafting ERISA plans that are up to 55% cheaper than fully insured plans. It takes a leap of faith for people to decide to cut the insurance companies out. |
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Posted: 5/5/2024 7:46:55 PM EDT
[#41]
OP it should be something we talk about more, and the fact it's not is tells us how messed up the medical world currently is.
Crazy thing once you get to the specialist you are sitting in a room packed to the gills with miserable faces, and staff that are so overwhelmed there's no way they are providing the level of care they should. ER's are constantly overwhelmed, and getting bought out by what I am pretty sure should be described as a monopoly. |
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Posted: 5/5/2024 7:47:14 PM EDT
[#42]
Quote HistoryOriginally Posted By Genin: MyChart and other medical records companies are very secure and have plenty of firewalls......so said every one of them before they got hacked and personal information got hijacked. Around 1.5 years ago there was a national crash/hack of many hospitals and health care systems. I was in the hospital at 6am for scheduled surgery, and around 8am the nurse came in and told me that I needed to get dressed and that the surgery wasn't happening because there was a problem accessing my health care records, and all the records of the hospital, and the health care system in general. It took them months to sort it all out. My guess is that they got hacked and blackmailed and they finally came to an "accommodation" that got their systems back on line. Interesting. Every facility I have worked at maintained old-school paper forms for just such instances. In fact, we had to use them a few months ago. |
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Posted: 5/5/2024 7:49:02 PM EDT
[#43]
Quote HistoryOriginally Posted By borderpatrol: Not following your doctor's advice does not make him the idiot. Quote HistoryOriginally Posted By borderpatrol: Originally Posted By MATTINFAIRBORN: There is a lot of truth to what OP said. My PBP, primary billing physician, said about my sciatica that I needed to do 6 weeks of physical therapy to start. Prick failed to say that in certain circumstances delay in the right treatment would have a risk of permanent nerve damage to my legs and that risk can best be determined by an MRI. And that the fucking insurance companies require therapy first based on absolutely no knowledge of the patient as we are all cookie-cutter premium-paying blobs. Now I have some permanent nerve damage to my legs. If that idiot would have mentioned the risk of permanent damage that only could be determined by an MRI I'd have paid for the MRI out of pocket. That is exactly why we built an emergency nest egg separate from our retirement savings. Could have paid for 10 MRIs and had enough left over for BOTH of us to eat at 5 Guys. The ER didn't help when I showed up unable to walk. Shot me up with painkillers and some other shit and said go see my PBP instead of doing some of that diagnostics a competent professional would have done. My fault for trusting the idiot who determines treatment based on insurance company tightwad cunts rather than the patient's best and informed interests. The eventual MRI showed bone growth l4, l5, s1 pressing on the nerves to the extent the only fix was to go in and dremel off the excess bone. Absolutely nothing else would have fixed the problem. One mildly inconvenient laminectomy and problem solved except for the nerve damage. I'm hitting the gym heavily and working on my legs which is helping quite a bit but not going to go back to normal. 6 months ago I could barely shift my bike and after about 30 minutes couldn't shift it at all. Now I can ride all day, day after day, and only start having trouble later each day. The numbness in both legs is grating like nails on a blackboard. Agility sucks but I can walk a mostly straight line if I concentrate. Not following your doctor's advice does not make him the idiot. |
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Posted: 5/5/2024 7:52:23 PM EDT
[Last Edit: 1245xx]
[#44]
Quote HistoryOriginally Posted By JoinDatePostCount: A silver bullet (maybe just a 22 but not the 50 you’re looking for) would be if people ate 500 less calories a day and went for a walk. Healthcare is expensive and busy for lots of reasons, but a large one is because people are fat fucks Agree wholeheartedly. I felt a lot better when I lost all that weight. I went from a 36 to a 34 inch waist, and some 33 pants. And I’m not talking that stretch stuff in the waist band. I wanted to add that eating better resulted in my weight loss. No more fat fuck for me. And it was very easy to do. |
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Posted: 5/5/2024 7:56:40 PM EDT
[#45]
Quote HistoryOriginally Posted By C-4: @1245xx Some argue that it took us since 1965 to get where we are. There is no silver bullet for that. I know this: the government can’t fix anything. Like you said, they’ve been helping since 1965. |
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NC, USA
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Posted: 5/5/2024 8:03:11 PM EDT
[#46]
Quote HistoryOriginally Posted By 1245xx: Guess im an outlier. I’ve never had a problem with my PCP, getting sent to a back specialist, or having any of my bills paid by insurance. My wife was in the hospital for 7 days from back surgery. About 1.5mm. Just got an EOB and that’s it. Oh, well. I’m sure our turn will come. The only problem I have with my PCP is he is retiring after being my doctor for 30 years. I saw him for the last time last Monday but he said don't worry I hand picked my replacement and have gone over my patients with her and she agreed to continue with the treatment I have started them on. I guess I will find out in 3 months how this fresh out of school female doctor works out. |
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IA, USA
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Posted: 5/5/2024 8:08:57 PM EDT
[#47]
Quote HistoryOriginally Posted By C-4: @MikefromTX You are mostly correct. Hospital corporations lobbied Congress ~ 20 years ago to get an additional 30% “facility fee” when any of their employees (doctors, APRN/nurse practitioner, PA/Physician assistant, etc) sees a patient. This gave hospital corporations the financial leverage to buy out/shut down most private, physician-run practices. We are now at ~ 75% of doctors working for hospital corporations. Doctors have lost most of control of the medical system as a result. Yes, some private practices do still exist, but the writing is on the wall. Most doctors are simply trying to hang in there. Many, if they have a spouse that works and has health insurance are retiring early, 59/60/61, to get out from under the control of hospital corporations. Without the additional “facility fee”, and the financial buffer, it’s very difficult to go out on your own. My sister is a dermatologist and somehow manages to do it but she spends a lot of time after hours managing her practice. An additional problem is medical reimbursements are higher the more invasive the medical interaction. So primary care, psychiatry, pediatrics, etc don’t get reimbursed as much as surgeons. This leads to fewer people going into primary care. The hospital corporations like to hire APRNs and PAs because they are less expensive and then pressure them, on a fixed salary, to see as many patients as possible. You’re seeing this now even in the ER! I don’t have time to do a deep dive on this, but I have witnessed the changes since starting my practice in 2001. You are absolutely correct that our medical system is in a death spiral. What comes out on the other end is unknown, but it’s not going to be good. Private practices really only work for procedural heavy fields with high reimbursement like dermatology. Anesthesia, radiology, and surgical sub-specialties also fall under the same umbrella. Even highly specialized medical sub-specialties like endocrinology or nephrology can seldom cut it in private practice because the reimbursement for non-procedural fields is so poor. |
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Posted: 5/5/2024 9:33:48 PM EDT
[#48]
Quote HistoryOriginally Posted By exponentialpi: Guess what I have been dealing with this weekend . . . Quote HistoryOriginally Posted By exponentialpi: Originally Posted By C-4: Originally Posted By ACEB36TC: My Doc ( Internal Medicine) is outstanding. He IS the gatekeeper and in the system he works for he has a LOT of stroke. I can get almost any procedure/x-ray/CT scan and more in a heartbeat. It's almost as if they are WAITING for customers. We're VERY rural and I may have to drive a bit to get to the specialist I'm referred too but that's fine with me. I've had nothing but good results since I moved to this Dr. My old Doc (internal medicine) retired and told me "find an internal medicine guy" and he was correct. My system uses "MyChart" as the information system. In most cases my results etc. are ALREADY in my inbox by the time I get home from any visit with any Doc in the system. I can't believe how good Medicare is. I certainly don't understand how we , as a country, can afford it. About that . . . Guess what I have been dealing with this weekend . . .
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Posted: 5/5/2024 9:38:50 PM EDT
[#49]
Quote HistoryOriginally Posted By RedAngus: Pardon me, but you do realize we’re 34 Trillion dollars in debt, don’t you? We, as a country, aren’t affording Jack Shit. Point of order: if you include liabilities it is over 100 trillion. |
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Posted: 5/5/2024 9:47:02 PM EDT
[#50]
You got it figured out.
Plus there are not enough nurses. Now. And 20 years from now when I need one, I will be lucky to have one that speaks a single word in English. |
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