patrick.net

Yet still another Democrat proposal that does nothing to control the costs.

zzyzzx says

Yet still another Democrat proposal that does nothing to control the costs.

When will you be presenting your comprehensive plan to control the costs that would be voted through congress? The republican's in congress had 7 years and came up with zero.

I'm not a democrat and it would be far cheaper to do what I propose than the ACA has been.

Oh I forgot, you never present anything but pictures and cartoons. Like the kids when they were 4.

Ironman says

So, are you saying that's exclusive to the US, and none of the aging population in Spain, Sweden, UK and Germany experience the same medical issues, and that's why they spend so much less?

The article from which the graphic derives says that the elderly in these countries don't live as long as in the USA, perhaps due to the increased spending on medical care in the USA. Are you suggesting we let the elderly die, when their lives can be extended by existing technology?

"Looking only at deaths caused by disease, Dr. Fischbeck's analysis shows that American men have a survival advantage over men in Western Europe that increases steadily after age 65. American women gain a similar advantage starting later, at about age 80.

Putting it another way, if Americans died from diseases at the same rate as people in the Netherlands, for instance, there would be 60,000 more male deaths and 14,000 more female deaths in the United States -- all coming after age 70 -- his tables show"

bob2356 says

There is far too many wealthy investors and highly paid executives making far too much money with far too much influence on the political system for that to ever happen.

I think it will happen eventually. What might drive it is the realization on the part of the corporate world that it will benefit their bottom line, transferring some of the cost away from them. It would probably be cost effective for them in terms of addressing cost increases, to shift the payment for health care over to people's medicare contribution and just pay them more instead. Salaries and health care are both pre tax expenses, but it shifts the concern about increasing health care costs to the government.

Blurtman says

The article from which the graphic derives says that the elderly in these countries don't live as long as in the USA, perhaps due to the increased spending on medical care in the USA. Are you suggesting we let the elderly die, when their lives can be extended by existing technology?

The article is totally lacking any explanation of methodology. When I see weasel words like "looking only at deaths caused by disease" it's a big flag that things are being manipulated. How do you reconcile shorter life spans in the US with people surviving longer?

Ironman says

So why is treatment costs 4X in the US for similar treatments and conditions that old people get treated for?

Why assume that the elderly in the other countries are receiving the same treatment?

Most old people develop the same medical conditions as they age.

-------------

False

bob2356 says

How do you reconcile shorter life spans in the US with people surviving longer?

Don't know. Opioid addiction might account for some of that. Also perhaps deaths from heart attacks due to obesity and related conditions. You have to make it the hospital alive to rack up expensive treatment costs. It is conceivable that less folks in the USA die before they become elderly.

Ironman says

bob2356 says

The 2 leading causes of death 50-59 are heart disease and cancer.

Why do you go off on such straw men??

YOU made the claim medical spending is LOWER in other countries because they put people into hospice and they don't try to keep them alive longer with expensive treatments. If that was true, wouldn't the live expectancy be SHORTER for those countries?? Except, their life expectancy is LONGER than the US...

FAIL!!

So, instead you go off on a straw man to tell us about people dying from cancer and heart disease.... Really???

Folks, you can't make this shit up....

How can it be my straw man? YOU made the claim that people didn't start dying of heart disease or cancer until after 65 not me. Dementia is really sad.

You are really confused on this average life span concept. The math thing again. The majority of the big expenses at end of life are the last 6 months of life. That time span doesn't affect average life span at all. It's useless to explain this to someone who can't grasp addition and subtraction so I don't know why I bother.

Keep shucking and jiving.

Ironman says

They probably aren't, that's my point, the elderly get MORE treatment here, because they "can"..

Conceivable. So are you advocating letting the elderly in the USA die then? Are you on board with the dreaded "Obama Death Panels?"

Ironman says

Please tell us what the claims denial rate is for Medicare? I'll be waiting....

You claimed the denial rate was zero. You prove it.

Blurtman says

Ironman says

They probably aren't, that's my point, the elderly get MORE treatment here, because they "can"..

Conceivable. So are you advocating letting the elderly in the USA die then? Are you on board with the dreaded "Obama Death Panels?"

What is more important:

Quality of life

Or

Quantity of life

Blurtman says

Conceivable. So are you advocating letting the elderly in the USA die then? Are you on board with the dreaded "Obama Death Panels?"

Oh yea, keeping someone alive "because they can" in an icu for an extra month for $100,000 certainly avoids the dreaded "Obama Death Panels". Just look at ironbrains chart to see how it works out financially.

bob2356 says

Oh yea, keeping someone alive "because they can" in an icu for an extra month for $100,000 certainly avoids the dreaded "Obama Death Panels".

Why do you think it is all ICU care?

Tim Aurora says

While this is one of the aspect, there are others

* Our Doctor's are more expensive because

- they have to study longer than doctor's than most countries

- malpractice insurance in this country is higher

Unless you are an OB or neurosurgeon malpractice is less than 10k a year, more like 4-5k for a gp. There are some big outliiers, florida is just off the charts, but most states are very reasonable.

Blurtman says

bob2356 says

Oh yea, keeping someone alive "because they can" in an icu for an extra month for $100,000 certainly avoids the dreaded "Obama Death Panels".

Why do you think it is all ICU care?

That was what is called an example. There are many expensive procedures done at end of life.

Ironman says

I did, please repost my quote where I said that.... I'll be waiting.

Ironman says

The reason is Medicare, patients don't give a crap what the costs are and doctors can bill for what ever procedure, treatment, test, surgery, etc. they want because it never gets turned down or rejected by Medicare. What ever the doctor "orders" is what's done. No price checks, no questions, no nothing.

it never gets turned down or rejected by Medicare

So are you going to pull a trump and say it never gets turned down actually means it sometimes gets turned down?

bob2356 says

That was what is called an example. There are many expensive procedures done at end of life.

Yes there are. Who decides if granny gets an extra three or four months?

Ironman says

bob2356 says

it never gets turned down or rejected by Medicare

So are you going to pull a trump and say it never gets turned down actually means it sometimes gets turned down?

So stop posting all your bullshit and prove me wrong and post the claims denial rate.. or STFU...

Perfect, you can't make this shit up. Back up your bullshit claim.

Ironman says

Oh bobby, you haven't explained why the cost graph takes a big up turn around 60 when the life expectancy here is late 70's

Yes I have, but you just don't have the capability of grasping it.

Healthcare in Denmark is largely financed through local (regional and municipal) taxation with integrated funding and provision of health care at the regional level.

In 2014, the Danish healthcare expenditure amounted to 10.6 per cent of GDP, which is more than the OECD average of 9.0 per cent. Approximately 84 per cent of healthcare expenditure is publicly financed (2015). Life expectancy in Denmark has increased from 77.9 years in 2005 to 80.6 years in 2015. Danish women have a higher life expectancy (82.5 years in 2015) than Danish men (78.6 years in 2015).

There is 1 doctor for every 294 persons in Denmark.[1]

https://en.wikipedia.org/wiki/Healthcare_in_Denmark

Aggregate U.S. hospital costs were $387.3 billion in 2011—a 63% increase since 1997 (inflation adjusted). Costs per stay increased 47% since 1997, averaging $10,000 in 2011.[23]

According to the World Health Organization (WHO), total health care spending in the U.S. was 17.9% of its GDP in 2011, the highest in the world.[26] The Health and Human Services Department expects that the health share of GDP will continue its historical upward trend, reaching 19.5% of GDP by 2017.[61][62] Of each dollar spent on health care in the United States, 31% goes to hospital care, 21% goes to physician/clinical services, 10% to pharmaceuticals, 4% to dental, 6% to nursing homes and 3% to home health care, 3% for other retail products, 3% for government public health activities, 7% to administrative costs, 7% to investment, and 6% to other professional services (physical therapists, optometrists, etc.).[63]

https://en.wikipedia.org/wiki/Health_care_in_the_United_States

Blurtman says

bob2356 says

That was what is called an example. There are many expensive procedures done at end of life.

Yes there are. Who decides if granny gets an extra three or four months?

That is a cultural issue, not a health system issue. I said that before. The US culture is death is a failure and must be fought to the last possible second.

Ironman says

So, why didn't Obama fix that when he passed Obamacare... Would have been the perfect time.

What should he have done?

bob2356 says

That is a cultural issue, not a health system issue. I said that before. The US culture is death is a failure and must be fought to the last possible second.

You are a Death Panel Kultist.

Ironman says

See bobby, this is how it works, if you disagree with someone's assertion, YOU have to provide the facts and data to prove them wrong.

Since you CAN'T do that in this case, just STFU...

Only in your pink sky world. But since you are incapable of backing up your bullshit I'll give it to you. The denial rate is 10%. I knew that all along. https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-29.html

Still want to claim NO medicare claims are denied? This is the point where normal people say I fucked up. But you will go off on another strawman shuck and jive instead.

Blurtman says

bob2356 says

That is a cultural issue, not a health system issue. I said that before. The US culture is death is a failure and must be fought to the last possible second.

You are a Death Panel Kultist.

I have my end of life directive in place. I'm not hanging around for months living a miserable existence on a machine. You can choose to spend your last days any way you want. Enjoy it.

You can choose to spend your last days any way you want. Enjoy it.

-----------

On whose dime?

Blurtman says

Ironman says

So, why didn't Obama fix that when he passed Obamacare... Would have been the perfect time.

What should he have done?

Ironbrain never has solutions, just grumpy old man criticisms for everything.

bob2356 says

I have my end of life directive in place.

Your choice, your right. Do you think you have the right to decide for others?

errc says

On whose dime?

We all pay now for the sick.

Blurtman says

bob2356 says

I have my end of life directive in place.

Your choice, you right. Do you think you have the right to decide for others?

Where did I ever say that I had the right to decide anything for others? I said it's very expensive, not anything about rights. People choose according to their culture. Hospice and dieing as comfortably as possible is a much bigger priority than living an extra month or two in many places. I'm voting with my feet, I won't be ending my life in the US system. When my obligation here is done I'm gone for good.

bob2356 says

I have my end of life directive in place. I'm not hanging around for months living a miserable existence on a machine.

Just hope you don't get stuck in a Catholic hospital, especially if Neil Gorsuch gets promoted to the Supreme Court. "Church doctrine prevents competent patients from refusing artificial nutrition and hydration... All comatose and vegetative patients will be required to accept nutrition and hydration indefinitely, even if they leave behind air-tight living wills objecting to such "heroic" and invasive measures." They say it's their religion, which Gorsuch elevates above secular law, but of course in reality it's the infinite Medicare&Obamneycare subsidies ("No more lifetime caps!"). Catholic "charities" get 90% of their revenue from government. Other religious hospital corporations have the same religious right to discover magically that their doctrines command equally infinite subsidies. In California, we've seen litigation between hospital chains fighting over patients like ranchers poaching cattle. In most states, they can even "balance bill" you or your estate for whatever charges insurance might not cover. You are a potentially infinite revenue stream to them, and they won't let you go without a fight.

Blurtman says

errc says

On whose dime?

We all pay now for the sick.

I thought you were talking about end of life care, specifically pertaining to the elderly.

Not everyone dies from curable sickness.

Many expire due to old age.

It's kinda an important distinction

errc says

Not everyone dies from curable sickness.

Well, they wouldn't if the sickness would be cured. As with other technologies, biotechnology advances are logarithmic.

Ironman says

Until you admit there's a problem, you can't find a solution.

Folks will prioritize their idea of the problem differently. For some, it is insuring those without insurance, including those with pre-existing conditions. For others, it will be providing health care to all as a basic human right. For you, the cost and unsustainability is the problem.

The solution:

Ironman says

TOTAL FAIL!!! Bobby you're DONE, put a fork in it...

The 10% denial rate was due to incorrect BILLING, not denial of medical TREATMENT:

-



-

The denials are because the insurance billers can't fill out the claims forms correctly... Duh...

bob2356 says

You are really becoming a joke today. Where does it say denials are all billing errors, point it out. It doesn't. It says 2.19% were rejected for billing errors. Which jibs with the medicare breakdown below of 2.78%, depending on the year. You said NO claims were denied ever. Want me to post your words AGAIN?

Here's the breakdown of denials for medicare. I can't link, its a pdf.
27.8%
Claim/service lacks information which is needed for adjudication. At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).
20.9%
These are non-covered services because this is not deemed a ‘medical necessity’ by the payer.
13.8%
Claim not covered by this payer/contractor. You must send the claim to the correct payer/contractor.
8.5%
Non-covered charge(s). At least one Remark Code must be provided (may be comprised of either the Remittance Advice Remark Code or NCPDP Reject Reason Code).
5.8%
Claim denied as patient cannot be identified as our insured.
3.9%
These are non-covered services because this is a routine exam or screening procedure done in conjunction with a routine exam.
3.1%
Expenses incurred prior to coverage.
3.0%
Services not covered because the patient is enrolled in a Hospice.

These are non-covered services because this is not deemed a ‘medical necessity’ by the payer.
These are non-covered services because this is a routine exam or screening procedure done in conjunction with a routine exam.
Non-covered charge(s)

These are denials of a medical claim. Period. Do you really want to continue looking this foolish? Remember never gets turned down or rejected? No price checks, no questions, no nothing? I guess it depends on the meaning of the word no.

Ironman says

The reason is Medicare, patients don't give a crap what the costs are and doctors can bill for what ever procedure, treatment, test, surgery, etc. they want because it never gets turned down or rejected by Medicare. What ever the doctor "orders" is what's done. No price checks, no questions, no nothing.

Ironman says

bob2356 says

I can't link,

What a surprise....

Just keep baffling everyone with your bullshit!!

You haven't proved me wrong. Not that you ever do. It's true because I believe it should be true.

Ironman says

Most old people develop the same medical conditions as they age. So why is treatment costs 4X in the US for similar treatments and conditions that old people get treated for?

Clearly not becasue of medicare.

I'm pretty sure that you must understand that all your chart shows is that health care costs more in the US. With no clear causal connection to medicare. Yes, it's only like $1000 more per year in the younger years, where as the difference explodes in later years.

You should be able to understand that there's no evidence this has more to do with medicare than it does to the simple fact that those years are the years when a significant percentage of the population is having serious health issues, that is including in many cases end of life issues. In younger years only 1 in 150 or even less are having those problems in a given year.

Ironman says

bob2356 says

You haven't proved me wrong.

I prove you wrong every fucking day of the week here, and it's really getting tiresome.

Oh my another imaginary smackdown. After dinner I'll faint.

I realize in the strange alternative universe that you, tbp, and indigenous inhabit the act of continually chanting I don't believe you is proving something. But normal rational human beings not living in some dark recess of a diseased mind actually offer up real proof beyond it's true because I believe it's true.

Carry on "winning".