Watchhttp://fitness.mercola.com/sites/fitness/archive/2012/08/03/obesity-surpasses-smoking.aspx
obesity surpasses smoking in terms of ill health effects
A staggering two-thirds of Americans are overweight. This does indeed place a heavy burden on the health care system. It's important to realize that a large number of diseases are directly attributable to obesity,
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Obesity is a huge problem (heh, heh). But what about end of life care? As medical technology keeps us around for longer and does more miraculous things to keep us alive, we're paying for that final year of life. Lots of razzle dazzle, let's put off the inevitable, but not a lot of quality of life.
I looked around and found a figure of $147 billion for obesity-related issues. And I also found the final year of life costs account for around 30 percent of health care costs. With all the boomers coming up on their last year, that percentage is only going to increase - by a lot...
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Right. Doctors have one imperative - get the patient into a death spiral scenario as quickly as possible to charge them for all manner of crap and seize every last liquid or liquidatible asset before they call the morgue for a pick-up.
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APOCALYPSEFUCK is Shostakovich says
You clearly do not know... When you see a physician there is often a profession fee and a hospital fee. Physicians collect the profession fee, which is a fraction of most bills. I find it funny that you think physicians are the ones making the money. If you look at physician earnings, they have actually gone down in the last decade. Most physicians work longers hours and yet take home less money than they did 10 years ago. Physician make up about 6-7% of the entire healthcare costs. They are simply the work horses in medicine, but not the money makers. Look else where with your conspiracy theories.
Increases in healthcare is attributed to many issues such as mal-practice insurance and un-ending number of frivolous lawsuites, aging population, rampant obesity and diabetes, caring for the uninsured/illegal immigrants, high administrative costs of some insurance companies, labor laws and unions which drive up costs of nursing and support staff, pharmas which charge more in USA than other countries, etc etc. I can go on and on... its not as simple as doctors want to make you sick so they can collect...
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Exactly, doctors are victims and therefore entitled to come up with any set of billings they can throw at the fat, lazy litigious old unionized fucks before hey die. Given the strangle-hold the insurance companies have, no one can blame them.
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Umm, doctors are my least favorite. They constantly mis diagnose and know virtually nothing, or rather practice nothing in regards to health nutrition. I took my daughter to clinic, she hurt her arm roller skating. They took X-ray, said it was broken, put on semi cast and referred me to a specialist. $255. Went To the specialist the next day and he said it WAS NOT BROKEN, cut off the $255 cast and sent us away. $189. I always pay cash and claim no insurance. I have insurance but have found this is the cheaper way.
So I spent about $450 for nothing and 340 a month for insurance coverage in fear that if we ever really need serious medical attention I won't be sued and liens placed on my property.
We eat both healthy and junky depending on the situation. My children won't regular dentists either due to good practices brushing and flossing. Baking soda. No need for braces as if you guide their teeth as they are growing in, you can help them to grow straight. Duh. No one really knows this. That's how my grandmother taught me. It hurts less than braces, doesn't really hurt at all to tug them straight when they grow in.
Most problems with health are due to lack of knowledge and education, poor diet, poor hygienic care.
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APOCALYPSEFUCK is Shostakovich says
Never said doctors are the victims, please do not put words into my mouth. I was simply correcting your inaccurate accusations. You simply blamed physicians for the cost of health care yet you had NO evidence nor facts... and you will find very little because like i mentioned physicians are only 6-7% of healthcare costs.
Oh btw, physicians cannot bill anything they want as you incorrectly suggest again. Medicare has a strict billing code in which they will ONLY pay as it is designated per procedure or visit. All insurances will set their payments based on medicare standards, although it can be little lower or higher.
You can speak about insurance companies as they are a complete separate identity from physicians. As I have mentioned in my previous posts, some insurance companies are a part of the problem. But you incorrectly associate physicians which insurance companies.
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Right. Insurance companies just MAKE UP those billings and throw KILLERJANE says
Oh, a diagnosis? Is that what you want? That will take at least 400 tests and 17 office visits. I know. I know. It does look like your arm has been torn away from your torso. But, hey, mustn't be hasty, lest you be misdiagnosed and you set 1000 savage lawyers after me. We have to protect the physician from criminality and unfair compensation! Oh, you'll die of blood loss by then? Well, before you go do check out the fish tacos in the hospital cafeteria - my company has the MRI and cafeteria franchises at the hospital.
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elliemae's website
End-of-life care is HUGE business! Hospices get paid $175/day to care for patients - and their marketing practices are thru the roof.
There's a lot of pressure for docs to refer to hospices - from hospitals, insurance companies and the hospices themselves.
Yes, people are sicker at the end of their lives, and cost more. But people are being pressured to sign up for hospice like you wouldn't believe.
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Meccos says
Malpractice insurance is high because of insurance companies wanting fatter and fatter profits, not because of frivolous lawsuits. These companies know that doctors feel commited to their professions and will pay higher rates to continue practicing. Malpractice insurance providers collude with health insurance companies (often a different division of the same company) to drive up those costs. When an injury at birth will cost a family over 30 million dollars in medical and special education costs over a lifetime, how can you cap that accurately? No, tort reform opponants want to give a family like that $250,000 and wash their hands of liablity. Limit malpractice claims and all that will happen is a windfall for insurers. Doctors will still see their malpractice insurance continue to rise.
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I wish everyone all together would just stop paying for insurance and let the free market rule. And remove the legislation that allows for liens to be placed due to med costs.
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futuresmc says
Sorry you couldnt be more wrong. YOu have no idea the number of frivolous malpractice lawsuits that are filed every year. The problem is that it is often cheaper to settle than to actually fight and win the cases even though the overwhelming majority of cases are found to be without any cause. This unfortunately causes the cost of insurance to rise. On average each and every doctor has one lawsuit every seven years. Many lawyers do not charge a fee unless their client recieves money, thus making clients easy to find since they do not lose out of anything.
Like I said, I dont disagree with insurance company greed, but to make a statement that frivolous lawsuits do not contribute is totally off base.
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APOCALYPSEFUCK is Shostakovich says
I dunno what billings you are talking about, but it is a fact that there are certain payment schedules for visits and procedures. That is a fact.
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KILLERJANE says
I totally agree...
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From another site, I think, mish
Healthcare Key Points
* "Health care" (HC) spending is now 17% of GDP and an equivalent of 50% of private wages and of total government spending, growing at twice the rate of GDP since '00.
* 50% of HC spending is on the sickest 5%.
* 20% is spend on end-of-life services for elders.
* Private HC and total government spending is an equivalent of 100% of public and private wages.
* HC and war spending make up and equivalent of 25% of GDP.
* Out-of-pocket HC costs are now the primary cause of personal bankruptcy.
* HC in the US is unaffordable for most people were they to have to pay for it themselves.
* "The market" is "rationing" care for at least 50 million uninsured people and would for most elders were they to have to bear more of the true costs of their late-life care.
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Meccos says
Have to laugh at this one. No, Dr's are not the work horses of Medicine, Nurses are. You had better figure this one out and in the future your very life may depend on it.
The Doctor's bill is actually a small part of where your healthcare dollars actually go. What is amazing is that the Insurance Administrative costs suck up about 25% of every healthcare dollar spent. In countries that have socialized medicine, and with the US VA, those amounts are cut nearly in half. This also does not account for the fact that a huge chunk of the Doctor's bill is there to cover his own administrative costs sucked up by his staff shuffling papers all day that the insurance companies demand of them in order to get paid.
Once again, the rather obvious hulking 900 lb gorilla in the living room is ignored and the half starved kitten in the corner is blamed for all the poop on the carpet.
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A doctor would just as soon stubb out a cigarette on your face as look at you.
But a nurse would actually have to dress the burn wound.
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Several reasons make healthcare more expensive in the U.S.
Insurance companies add costs at every stage, and when it's mandatory you can't say no so they can charge even more. They take a % of premiums for overhead and profit, trying to collect as much as possible while paying as little as possible. This applies equally to health insurance and malpractice insurance. Doctors are trapped between two divisions of the same insurance company: the health side wants to avoid paying them so they have to hire a full time billing coordinator; meanwhile the malpractice division charges the same premium regardless of claims history, so the careful doctor who never gets sued pays the same as the butchers and poisoners down the street. The fee-for-service model drives out careful doctors who spend time listening to patients, while subsidizing quacks who over-operate and over-prescribe.
Hospital corporations have undertaken a huge PR and advertising campaign to get everyone to go to the hospital for everything from cradle to grave, even though smaller independent providers to a better job at lower cost. In Holland, babies are born at home, with a midwife followed by a visiting nurse. Costs and infant mortality are both lower than here. In America, hospitals injure 20% of patients, including spreading infections like MRSA, and when people demand change all they can say is "tort reform." Only 1% of actual malpractice results in a lawsuit, and those cost only 2% of medical spending, but the enormous cost of hospital-inflicted injury and infections actually increases hospital revenue, i.e. it's part of their business model.(http://www.theatlantic.com/magazine/archive/2009/09/how-american-health-care-killed-my-father/7617/)
The AMA cartel (including medical schools and CME that are basically drug company infomercials instead of teaching actual health like diet and exercise) raises costs by restricting the number of doctors, blocking foreign competition, and skewing Medicare to overpay specialists regardless of actual benefit while underpaying the primary care providers that people actually need.
The drug companies, though only 10% of total spending, are at the apex of the pyramid. Like Bernie Madoff, they take the smallest piece for themselves, but they run the whole show. DTC ads on TV control the evening news, and exhort everyone to "ask your doctor" about the latest toxic pill. Meanwhile, the doctors must pay for CME (drug company infomercials), but the drug companies will pay if the doc prescribes profitably, so pretty soon the docs learn to get with the program and prescribe as told. The mandatory prescription law ensures that everyone overpays for everything and maximizes PhRMA opportunity to push new toxic pills via doctors when old pills would do a better job at lower cost; at best you might get a generic equivalent, but you're not allowed to buy something else cheaper. Then a pharmacist with 10 years post-secondary education counts out your 30 pills, a job that elementary schoolkids could do most of but you're not allowed to bypass that because then how would the pharmacy schools make $$$?
The whole system is created by the provider lobbies for the provider lobbies. The obese certainly do weigh heavily on the system, adding all sorts of costs (hypertension, diabetes, GIRD, etc.), but they would be only their own problem if not for insurance. Of course all that subsidized ADM corn has to go somewhere, so the obese are subsidized through Obamneycare, so the lobbyists all get their cut.
America is becoming a feedlot with constituencies corralled into various pens, fattened for slaughter in the most lucrative way possible. Compare to Mexico and Costa Rica: no prescription requirement, minimal national health service, total spending 10% of USA, life expectancy nearly as long, maybe longer if you adjust for education. And education remains the best predictor of longevity; health insurance and money pale in comparison, which should tell you something about what value (if any) we're getting for 20% of GDP. As Bill Gates said, you get maximum value around 2% of GDP, after that the returns flatten out; I'd say they become negative because Americans spend twice what the British do, and die sooner.
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jhall says
Making people die more slowly and profitably isn't a miracle, it's a business model. Most people fear a slow painful death more than anything, but it's what they get.
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I support universal healthcare, and I am someone who wants to privatize sidewalks.
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curious2 says
That's not true, home birth in netherlands is about 30% and that's after very careful screening for potential problems. It's not a valid comparison. It's a very small country and even if something goes badly wrong a hospital is very close at hand. Costs are lower than the us for all the oecd countries for all medical care. Infant mortality is also lower for all the other oecd countries. Netherlands is mid pack, so home delivery isn't really a factor.
Home birth can be a good option for carefully screened women, but until there are major reforms in malpractice insurance, home births in the US are going to struggle to get to the 1% mark.
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curious2 says
I don't want to be kept alive at all costs -- literally. And I agree, the medical system is designed to do everything possible to keep us alive, even when it's time to go. It's up to my (only) kid to pull the plug, and I'm confident that she'll make the right decision when the time comes. My end of life wishes are in writing...
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bob2356 says
Thanks for the statistic. It's still true to say that babies are born at home, but you're right that the % of babies for whom that's true has fallen: it used to be 2/3, it's now 1/3.
I am curious what reforms to malpractice insurance you would suggest. Some practice groups have proposed creating their own captive insurer, since actual liability is small relative to premiums. From what I have read, the major barrier to home births remain legislative restrictions driven by hospitals and AMA. This was litigated in Missouri, for example, with midwives having to go to the state's Supreme Court.
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jhall says
I have an AHCD as well, naming a friend to pull the plug. In case of any hesitation on his part, I've also given him contact information for someone who really hates me and would show up with a bat to finish me off ASAP.
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Buster says
Do you work in the hospital? I do. Trust me nurses are not the work horses. You are lead to believe that by the nurses and nursing unions, who you probably see on TV protesting about patient care, yet at the bargaining table only seem to care about their pay raises and benefit improvements. You would be surprised to see some of the crap that goes on in the hospitals. Im not saying they dont have their role however. Doctors may seem like they dont care but usually because they only have 15 mins to spend with you until they move onto one of the next 30 patients they need to see. Nurses have all day to spend with the 2-4 patients they take care of. So as a patient, the friendly faces you often see are the nurses, but the trust me they are not the work horses. They have nurses aids who clean the poop and blood and change bed sheets and get crap for them (basically the nurses slaves), they have environmental workers who clean the rooms and toilets, they have transporters who wheel patients to and from tests, etc, etc. You think they do all the work, but TRUST me they dont. This is not to take away from their role, but please do not exaggerate what you dont know. I live it every day at work.
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APOCALYPSEFUCK is Shostakovich says
You should just go to a nurse the next time you are sick... Ill stick with my doctors.
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Buster says
Totally agree with you here. I think i stated the same facts earlier.
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jhall says
Its not the medical system, but the laws passed by our legislators.
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curious2 says
Honestly, you guys are crazy if you think that people do this to make a profit. In fact, end of life care make up the majority of health care costs and if this could be eliminated, would curb health care costs greatly.
Even if this practice did take place, the solution would be very simple. STOP going to the hospital and die at home. Physicians CAN NOT touch you without consent. Also you can always check yourself out of the hospital even against medical advice.
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Freedom!
Remember, in America you are free to be bankrupted by nihilistic opportunists or suck on a hunting rifle!
How can you hate Freedom?
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Saint George, UT
elliemae's website
Meccos says
Doctors will be paid $50 to $100 for each patient they see. They work 3 days in a row. Yes, they are responsible for their patients, but they are paid handsomely for their work. They rely on the nurses, cnas & med techs to follow the orders that they write.
Meccos says
ICU patients have this amount. Medical Floor nurses have more, and run their asses off. Please don't diminish what nurses do. They spend all day with patients, follow MD orders, deal with families, and have to deal with endless bullshit from the hospital administration.
But also be aware that nurses aids do the actual patient care, and are the lowest paid. One complaint and they're fired.
I think it's fair to say that most hospital staff members work hard and are underpaid. Not the docs - they do work hard, but have time off if they wish to take it, and make a shitload of money.
Meccos says
Correct - and if the patient is truly dying, they can choose hospice or comfort care if their doc will cooperate.
Problem is, they can also choose hospice if they're not. Hospice is big business and there are patients who are a full code, don't accept the hospice philosophy and yet still qualify for hospice. hospices pay their marketers HUGE commissions, so their incentive is to sign on every patient regardless of their physical condition. you don't have to have any type of license to be a hospice marketer - and yet you are giving patients advice about their physical condition. lots of abuse, there.
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KILLERJANE says
Never happen. Too many twisted oligarchs get off on the idea that their companies can drive people to homelessmess, despair and suicide. It gives their lives meaning.
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I retrieved my sweetheart from the trauma center in Walnut Creek after she was hit head on by a junkie who crossed a double yellow line while staring at his GPS. The bill for the ambulance ride and a two hour stay with diagnostics in the ER was $30,000. We're raising our car insurance liability to one million. Yet another way to go bankrupt.
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errc says
errc says
OMG 2/3rds of us don't look like fashion models, I'm fucking shocked, somebody call Richard Simmons!
Hmm it would seem to me 2/3rds of us are dying from one form of cancer or another. What does the propaganda machine say about that?
Because to honest, I don't know where you Clowns live, but here where I am, 2/3rds of the people are NOT fat. What kind of shake down is this, Michelle Obama's Wholefoods stock doing bad or something?
But What is alarming, cancer seems to have touched at least 2/3rds of every family I know, in the last two years.
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jhall says
Obligatory:
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OK yeah good point, 2 fat kids, one fatter than the other, what are there must have been at least 50 other patrons in that McDonalds, what they weren't fat enough to make a point for the photog? Where's the 6 fat fucks standing next to 3 skinny guys? It's just propaganda folks, when the libs control what you consume, they will control what you consume.
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curious2 says
There are no restrictions at the federal level on home births. At the state level the only restrictions I've ever heard of are certified nurse midwife vs certified professional midwife. CNM have medical as well as midwifery training. CNM's can deliver at home in all 50 states. CPM are direct entry, with no medical training. They are trained only in midwifery. CPM's can deliver at home in 27 states.
What legislative restrictions driven by hospitals and the AMA are you talking about? CPM vs CNM seems to be mostly a bureaucratic cya thing from what I've read although I'm sure protecting turf enters into it.
As someone who has several family members who are ob's some of the tales I've heard are very hair raising. When things go bad in childbirth they can go really bad, really fast. As in dead mother and child. Home birth is a good option for someone who is very low risk, but even then things can still go very bad out of the blue.
Insurance for home births is a bigger problem. Malpractice insurance for ob's doesn't cover home births. Get caught doing one you will lose your insurance and no other carrier will pick you up. For CNM's it depends, but if they are part of a dr's practice home birth is not insured. Most CPM's don't have insurance. I can understand why, ob insurance can run 100k plus a year. A CPM doing home births would be pretty expensive insurance also without nearly the billing of an ob to cover it. But if the CPM drops the ball then the patient is out of luck in terms of getting an insurance settlement to pay for damages. It's not something CPM's advertise.
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Minneapolis, MN
curious2 says
I hadn't thought of that. Great idea!
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Minneapolis, MN
elliemae says
Good information here. I had no idea.
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Old news but reality none the less
http://finance.yahoo.com/news/pf_article_109143.html
And many of them had insurance, we'reallfucked.org
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elliemae says
WTF? where do you get these numbers? First of all, doctors get paid differently depending on specialty. On top of that, they do not get paid per patient, but on what is done per patient and why it is done. Clearly there is some lack of knowledge with this original poster. Secondly, most doctors work minimum 5 days a week, with many often working 6 days or even 7 days a week.
elliemae says
They were paid handsomely. Doctors get paid less now than they did 10 years ago. There are MANY nurses in the hospital that I work at that get paid more than most doctors...
elliemae says
Yes, true.
elliemae says
Yes, nurses do deal with bullshit everyday. Unfortunately everyone in the hospitals deal with bullshit everyday. Sorry I am not trying to diminish nursing work. BUT the fact is the nursing:patient ratio in ICU is 2 to 1, and on the floors its usually 4-5 to 1. Physicians to patient ratio is usually 20-30:1.elliemae says
Yes nurse do actual patient care. BUT i have to disagree that they are the lowest paid. Nurses in general are usually the next highest paid after the doctors. I cant say what happens outside of California, but in California, there are plenty and plenty and plenty of nurses who are easily making 6 figures. Some, as I mentioned, make more than most family medicine docs, internal medicine docs and pediatricians.
elliemae says
This is laughable on all parts. MOst ppl in hospitals are overpaid (ill admit, even some docs), Docs cannot take time off as they wish, and certainly it is not a shitload of money...
If you wanna talk about people who get paid loads of money for what they do, then look into these nurses... yes they are nurses
http://www.anesthesiazone.com/crna-salaries.aspx