Countering medical cost myths

[jacksonm2]

What has been your history?

I've been off sugar since 1985 (but tons of fruit) yet I go for three cleanings per year so as to make the whole experience much less painful. I'm known as the model patient for the way I take care of my teeth (flossing and brushing). I seem to be prone to plaque buildup thus my attention to self-care and going to get the teeth cleaned every four months. Which I pay every cent of the costs of doing so.

Vinny

I have gum disease so I was getting cleanings 4 times per year. Decided to forego it for a while after I retired about 3 years ago to see what would happen if I just took good care of my teeth. Well, guess what? The "numbers" hadn't changed a bit which makes me question the whole idea of frequent cleanings now.

As for the sugar, I don't know how much of a factor that really was but I'm sure it didn't hurt cutting it out of my diet. I eat some fruit but stick to those low in fructose - mostly avocado smoothies with some berries thrown in. Some times I'll throw in one small piece of banana.

Way back thirty plus years ago the periodontist told me I needed the expensive operation because my gums had receded so much. Or, something like that. I'm forgetting precisely what it was given the so much passage of time.

But he said, let's first try a deep cleaning. Which was then paying $75 just to do one quarter of your mouth at a time. So, four appointments. I think he said after he'd finished, let's give it some time to see what happens. By the time I went back to see "what HAD happened" I was psychologically prepared for this expensive work on my gums. And, was I shocked (and pleased) when he said you are now doing fine. No need for it.

And, I've not heard a word from my dentist of their even being a re-occurrence of what led him to sending me to the periodontist in the first place.

My frequent cleanings evolved from...initially going just once a year...and that turned out too be way too painful because of all the scraping that had to be done. So, I proposed twice. I'm now forgetting the exact reasons how it has now evolved into three times a year. I consider a relative small price to pay to hold on to one's teeth for hopefully ones entire life.

I once went to a dentist who said I had periodontal disease and needed all kinds of treatment. Turns out he told nearly every patient that and fortunately he got busted for it before my treatment started.

[vnatale]

I once went to a dentist who said I had periodontal disease and needed all kinds of treatment. Turns out he told nearly every patient that and fortunately he got busted for it before my treatment started.

Needing 'deep cleaning' is for sure the most over-diagnosed condition in dentistry, however, an unusually high number of adults do suffer from some form of gum disease.

I never once doubted it was the correct diagnosis for me since the process had started after my highly regarded (by me) dentist first detected the problem and referred me to the periodontist who had me convinced It did need the gum operation (my words. But I'm sure you can better tell me what he was going to do.). And, then the periodontist told me I no longer needed this $3,000 procedure (30+ years ago) because, instead, the $300 four deep cleanings took care of the problem. That was the first and only time I'd had that done.

Vinny

[Xan]

Here's a horrifying tale of a dentist who sold his practice, and his successor discovered that he'd been doing all manner of nightmarish and unnecessary procedures on all his patients.

https://www.theatlantic.com/magazine/ar ... ry/586039/

[ochotona]

Exactly, and likewise. These Millennials have no idea what having it rough is. Way too coddled.

No Americans who were born Stateside after 1945 and who have never been in combat have any idea about hardship. I heard it second-hand from my immigrant parents.

[jacksonm2]

Exactly, and likewise. These Millennials have no idea what having it rough is. Way too coddled.

No Americans who were born Stateside after 1945 and who have never been in combat have any idea about hardship. I heard it second-hand from my immigrant parents.

My 3 kids were born 1974-1977 and I can assure you they have seen plenty of hardship in their lives.

So much so that my 23-year old adopted granddaughter just told me she has no intention of ever having kids. Had to tell her I didn't blame her at all, notwithstanding the fact that if I had felt the same way at her age she wouldn't be here.

[WiseOne]

I've been off sugar since 1985 (but tons of fruit) yet I go for three cleanings per year

You forgot to mention the grains/cereals.

You're not off sugar, you're just consuming it in a different form. In bucketfuls probably, if you're still vegan.

Nice story Jacsksonn! I doubt there has been much research into the association between plaque and dietary starch (not just sugar), but I would not be surprised if a link were found.

BTW be careful about what you read in books. Any hack can say whatever they want in a book. I not only prefer to go directly to the medical literature but I also read the studies (especially the methods section) to find out what they REALLY showed (instead of what they were advertised to show). The authors I do like to read use that same method to write their books & blogs.

[vnatale]

I've been off sugar since 1985 (but tons of fruit) yet I go for three cleanings per year

You forgot to mention the grains/cereals.

You're not off sugar, you're just consuming it in a different form. In bucketfuls probably, if you're still vegan.

Nice story Jacsksonn! I doubt there has been much research into the association between plaque and dietary starch (not just sugar), but I would not be surprised if a link were found.

BTW be careful about what you read in books. Any hack can say whatever they want in a book. I not only prefer to go directly to the medical literature but I also read the studies (especially the methods section) to find out what they REALLY showed (instead of what they were advertised to show). The authors I do like to read use that same method to write their books & blogs.

1) I eat no cereals and the only grains are some rolled oats and bulgur. And, not each day. But I do eat a fair amount of fruit and definitely get my share of fructose.

2) I'm listening to this author speaking about this book right now: https://www.amazon.com/Gender-Our-Brain ... l_huc_item Gender and Our Brains: How New Neuroscience Explodes the Myths of the Male and Female Minds

She cited an example of an assertion of another author's book regarding male / female humans and her then going back to the footnote and determining that the study was actually based upon birds! And, she also said there is a lot of (her phrase) "neurotrash" out there!

Vinny

[ochotona]

My 3 kids were born 1974-1977 and I can assure you they have seen plenty of hardship in their lives.

So much so that my 23-year old adopted granddaughter just told me she has no intention of ever having kids. Had to tell her I didn't blame her at all, notwithstanding the fact that if I had felt the same way at her age she wouldn't be here.

I guess I didn't say it correctly.

Outside of the Great Depression and being a combatant in a shooting war, Americans have not systematically on a widespread basis (millions of people at a time) experienced huge hardship. Our "average hardship" is another society's wealth.

"Huge hardship" is people from the other political party coming after you with guns in the night unless you catch the last boat / train out, the currency going to zero, stocks going to zero, can't get food or water or medication, the schools are closed and kids lose years of education. That's what I mean by hardship. My Mother went through this. She thinks Millennials are total snowflakes.

[jacksonm2]

My 3 kids were born 1974-1977 and I can assure you they have seen plenty of hardship in their lives.

So much so that my 23-year old adopted granddaughter just told me she has no intention of ever having kids. Had to tell her I didn't blame her at all, notwithstanding the fact that if I had felt the same way at her age she wouldn't be here.

I guess I didn't say it correctly.

Outside of the Great Depression and being a combatant in a shooting war, Americans have not systematically on a widespread basis (millions of people at a time) experienced huge hardship. Our "average hardship" is another society's wealth.

"Huge hardship" is people from the other political party coming after you with guns in the night unless you catch the last boat / train out, the currency going to zero, stocks going to zero, can't get food or water or medication, the schools are closed and kids lose years of education. That's what I mean by hardship. My Mother went through this. She thinks Millennials are total snowflakes.

What country was she from?

[vnatale]

My 3 kids were born 1974-1977 and I can assure you they have seen plenty of hardship in their lives.

So much so that my 23-year old adopted granddaughter just told me she has no intention of ever having kids. Had to tell her I didn't blame her at all, notwithstanding the fact that if I had felt the same way at her age she wouldn't be here.

I guess I didn't say it correctly.

Outside of the Great Depression and being a combatant in a shooting war, Americans have not systematically on a widespread basis (millions of people at a time) experienced huge hardship. Our "average hardship" is another society's wealth.

"Huge hardship" is people from the other political party coming after you with guns in the night unless you catch the last boat / train out, the currency going to zero, stocks going to zero, can't get food or water or medication, the schools are closed and kids lose years of education. That's what I mean by hardship. My Mother went through this. She thinks Millennials are total snowflakes.

How many of you have prior read this quote? And, for those of you who have prior seen, how many times have you already seen it?

They [Young People] have exalted notions, because they have not been humbled by life or learned its necessary limitations; moreover, their hopeful disposition makes them think themselves equal to great things -- and that means having exalted notions. They would always rather do noble deeds than useful ones: Their lives are regulated more by moral feeling than by reasoning -- all their mistakes are in the direction of doing things excessively and vehemently. They overdo everything -- they love too much, hate too much, and the same with everything else.

Vinny

[ochotona]

What country was she from?

China during the Japanese occupation and after the war. She's still around, 90 years old. She thinks Trump is a snowflake too, and the Chinese counterparties in the negotiations have him on puppet strings.

[Maddy]

Here's an interesting development: https://www.zerohedge.com/health/shock- ... ose-secret

In a move that will send shockwaves across the $3.5 trillion US healthcare industry, on Friday [today] the Trump administration unveiled a plan that would - for the first time - force hospitals and insurers to disclose their secret negotiated rates, the WSJ reported.

In hopes of bringing some transparency and openness to a pathologically opaque industry, one which many have blamed for being behind the explosion in US underfunded liabilities to more than $100 trillion, administration officials said the final rule will compel hospitals in 2021 to publicize the rates they negotiate with individual insurers for all services, including drugs, supplies, facility fees and care by doctors who work for the facility. The White House would also propose extending the disclosure requirement to the $670 billion health-insurance industry. Insurance companies and group health plans that cover employees would have to disclose negotiated rates, as well as previously paid rates for out-of-network treatment, in computer-searchable file formats.

[WiseOne]

It's about time someone called the health care industry to account for the pricing games. However, I don't know really how this would enable patients to "comparison shop" when they're limited by their insurance plan to a small network of hospitals & doctors. Not to mention the layer of insurance between patients and the bills they pay.

If the next step is to outlaw "insurance networks" and rely on free market competition instead of contract negotiations to set prices, that would be even better. It would have the very nice side effect of getting rid of the out of network "surprise" billing that is responsible for a big chunk of medical bankruptcies.

[Maddy]

. . .I don't know really how this would enable patients to "comparison shop" when they're limited by their insurance plan to a small network of hospitals & doctors. Not to mention the layer of insurance between patients and the bills they pay.

I'm going to stay optimistic. First, the astronomical deductibles attached to many insurance plans (many in the area of $6,000 per year) make a large segment of the "insured" population essentially uninsured when it comes to all but the most catastrophic stuff. When these people realize that they are, in a very direct way, subsidizing those of their neighbors who have employer-paid insurance (or those who rely upon Medicare or Medicaid), they'll undoubtedly be clamoring for the same discounted price offered to their peers. And what is your doctor going to say to that? "I'm sorry, charging you full price is the only way we can afford to offer discounts to our preferred patients?"

Second, it's my understanding that the fiction of "full price" is a tax avoidance strategy that allows providers to artificially inflate their "customary" prices and then offer (illusory) discounts to those patients who pay out of pocket--discounts that become bogus charity write-offs at tax time. (This, of course, works only so long as you can convince everybody (wink, wink) that somebody is actually paying the undiscounted price.) All that's likely to be coming to an abrupt halt.

Third, the transparency itself is likely to cause a change of behavior on the part of the entire health care cabal, who will, I assume, be averse to having their dirty laundry hung out in the sunshine for all to see. Isolated anecdotes about $20 aspirin tablets are quickly forgotten, but an industry-wide conspiracy to extract as much as possible from people who have no realistic choice but to submit to their extortive terms starts looking to your Average Joe like the flat-out racketeering it is.

Finally, this is likely to be just the beginning. I see the next logical step on the part of the administration being the adoption of regulations that preclude disparate pricing and that require reasonable up-front disclosure.

[WiseOne]

Let's hope you're right Maddy! If the regulation works as the Trump administration hopes it could be a big step forward. If it is effective though, just wait for hospital groups and the AMA to start in on the lawsuit train. They've got a nice little racket going and I'm sure they won't give it up without a fight.

In related healthcare cost news....supposedly this year premiums are reported as being stable. Does that mean health costs aren't going up? Ha, more fool you for believing that. I just discovered that the cost of my prescription meds are going up 121%. I pay full price for prescriptions as part of my deductible, but I do get the insurer's negotiated prices.

I'm experimenting to see if I can't substitute over the counter products (easily available through Amazon). It's not like I can't afford the meds even at the increased prices, but it's so enraging to be fleeced like this. It'll be nice to be able to handle my HRT privately and independently of the health care system.

[Maddy]

https://www.wnd.com/2019/11/doctor-wins ... cal-costs/

Here's a timely case to watch. A North Carolina doctor seeking to provide low-cost MRI services to the community is challenging the state's requirement that he first obtain a certificate of need--an administrative process designed to protect the existing medical monopoly by creating artificial scarcity.

The case alleges North Carolina's CON law is unconstitutional because it bans medical providers from offering services patients need "solely to protect existing providers from competition."

"In order to receive a CON, providers must persuade state officials that new services are 'needed' through a cumbersome process that resembles full-blown litigation and allows existing businesses, like established hospitals, to oppose their applications," IJ said.
* * *
"Can the state ban Dr. Singh from providing low-cost MRI services for patients who can least afford them just to protect established providers from competition?" asked IJ Attorney Josh Windham, who represents Singh. "We’re ready to explain to the court why, under the North Carolina Constitution, the answer is no."