Gyroscopic Investing

Let’s begin with emergency rooms, which many people believed would get less use after passage of the Affordable Care Act. The opposite occurred. It’s not just the A.C.A. The Oregon Medicaid Health Insurance experiment, which randomly chose some uninsured people to get Medicaid before the A.C.A. went into effect, also found that insurance led to increased use of emergency medicine. Massachusetts saw the same effect after it introduced a program to increase the number of insured residents.

There’s little reason to believe that even more preventive care in general is going to save a fortune. A study published in Health Affairs in 2010 looked at 20 proven preventive services, all of them recommended by the United States Preventive Services Task Force. These included immunizations, counseling, and screening for disease. Researchers modeled what would happen if up to 90 percent of these services were used, which is much higher than we currently see.

They found that this probably would have saved about $3.7 billion in 2006. That might sound like a lot, until you realize that this was about 0.2 percent of personal health care spending that year. ... The task force doesn’t model costs in its calculations; it models effectiveness and a preponderance of benefits and harms.

WiseOne wrote: ↑Fri Oct 18, 2019 8:02 am This is a most interesting article in (of all places) the New York Times.

https://www.nytimes.com/2018/01/29/upsh ... costs.html

It counters two prevailing myths, that universal coverage and perfect compliance with all preventive care recommendations both independently reduce the cost of medical care. Not true, as many of us had already guessed.

Let’s begin with emergency rooms, which many people believed would get less use after passage of the Affordable Care Act. The opposite occurred. It’s not just the A.C.A. The Oregon Medicaid Health Insurance experiment, which randomly chose some uninsured people to get Medicaid before the A.C.A. went into effect, also found that insurance led to increased use of emergency medicine. Massachusetts saw the same effect after it introduced a program to increase the number of insured residents.

There’s little reason to believe that even more preventive care in general is going to save a fortune. A study published in Health Affairs in 2010 looked at 20 proven preventive services, all of them recommended by the United States Preventive Services Task Force. These included immunizations, counseling, and screening for disease. Researchers modeled what would happen if up to 90 percent of these services were used, which is much higher than we currently see.

They found that this probably would have saved about $3.7 billion in 2006. That might sound like a lot, until you realize that this was about 0.2 percent of personal health care spending that year. ... The task force doesn’t model costs in its calculations; it models effectiveness and a preponderance of benefits and harms.

Note that because the task force ignored costs of preventive care, it is likely a massive money loser. Given the nearly non-existent actual benefits of most preventive care recommendations, it's pretty clear that THIS (along with the USDA's disastrous dietary guidelines) is what needs to be reconsidered if we're ever going to rein in health care costs. There are one-shot efficiency improvements that can help temporarily, like reversing the layers of regulations put in place by the Obama administration and minimizing administrative overhead, but these will only slow the advancing tide.

Xan wrote: ↑Tue Nov 05, 2019 8:18 pm The average 30-year-old is on SEVEN (7) prescription medications??

And 70 is pretty old, I guess, but TWENTY-SIX drugs is the average??

vnatale wrote: ↑Tue Nov 05, 2019 8:23 pm

Xan wrote: ↑Tue Nov 05, 2019 8:18 pm The average 30-year-old is on SEVEN (7) prescription medications??

And 70 is pretty old, I guess, but TWENTY-SIX drugs is the average??

I read that 90% of those over 65 are taking either blood pressure or cholesterol medications. But I'm as astounded as you are by each of the stats you cited. I've made it so far to 68 without ever having any routine medications.

Vinny

Kriegsspiel wrote: ↑Tue Nov 05, 2019 8:34 pm

vnatale wrote: ↑Tue Nov 05, 2019 8:23 pm

Xan wrote: ↑Tue Nov 05, 2019 8:18 pm The average 30-year-old is on SEVEN (7) prescription medications??

And 70 is pretty old, I guess, but TWENTY-SIX drugs is the average??

I read that 90% of those over 65 are taking either blood pressure or cholesterol medications. But I'm as astounded as you are by each of the stats you cited. I've made it so far to 68 without ever having any routine medications.

Vinny

Back when I started finding out about how many drugs young people were on, "give us free healthcare" came a bit more into focus. I was really staggered by the number of people on head meds.

MangoMan wrote: ↑Wed Nov 06, 2019 6:31 am

ochotona wrote: ↑Tue Nov 05, 2019 9:25 pm 58 and take 3. Mediocre genes.

No excuse. I have crappy genes, too.

ochotona wrote: ↑Tue Nov 05, 2019 9:25 pm 58 and take 3. Mediocre genes.

WiseOne wrote: ↑Wed Nov 06, 2019 8:14 am

ochotona wrote: ↑Tue Nov 05, 2019 9:25 pm 58 and take 3. Mediocre genes.

. . . Alzheimer's (which has been rightly dubbed as type 3 diabetes).

MangoMan wrote: ↑Tue Nov 05, 2019 8:42 pm

vnatale wrote: ↑Tue Nov 05, 2019 8:23 pm

Xan wrote: ↑Tue Nov 05, 2019 8:18 pm The average 30-year-old is on SEVEN (7) prescription medications??

And 70 is pretty old, I guess, but TWENTY-SIX drugs is the average??

I read that 90% of those over 65 are taking either blood pressure or cholesterol medications. But I'm as astounded as you are by each of the stats you cited. I've made it so far to 68 without ever having any routine medications.

Vinny

Likewise. I'll be 60 in Feb and I take nothing.

Maddy wrote: ↑Wed Nov 06, 2019 8:20 am

WiseOne wrote: ↑Wed Nov 06, 2019 8:14 am

ochotona wrote: ↑Tue Nov 05, 2019 9:25 pm 58 and take 3. Mediocre genes.

. . . Alzheimer's (which has been rightly dubbed as type 3 diabetes).

Please explain! Sounds interesting.

WiseOne wrote: ↑Wed Nov 06, 2019 8:14 am

ochotona wrote: ↑Tue Nov 05, 2019 9:25 pm 58 and take 3. Mediocre genes.

Or zealous MDs on the preventive med bandwagon.

Most people aren't like this crowd though. Your typical 65 year old is on: aspirin +/- Plavix, a statin, 2-3 blood pressure meds, 2-3 diabetes meds, 2-3 pain medications, an antidepressant or two, a proton-pump inhibitor, supplements such as iron, vitamin D, and calcium, Fosamax or equivalent, and a pile of "as-needed" meds for sleep, anxiety etc. Plus Aricept for those diagnosed with Alzheimer's (which has been rightly dubbed as type 3 diabetes).

To quote Malcolm Kendrick, I suppose it saves on food.

Xan wrote: ↑Wed Nov 06, 2019 9:16 am Certainly seems like most here are relatively non-medicated. WiseOne's nightmare scenario above stretches to get in the 20-25 range. Krieg's chart shows 27 as the average for a 70-year-old. Does that mean for every 70-ish person here on no meds, there's one out there on 50?

And are there really 30-year-olds on 7 prescriptions? On AVERAGE?

That chart's got to be wrong. ...Doesn't it?

MangoMan wrote: ↑Wed Nov 06, 2019 11:12 am

WiseOne wrote: ↑Wed Nov 06, 2019 8:14 am

ochotona wrote: ↑Tue Nov 05, 2019 9:25 pm 58 and take 3. Mediocre genes.

Or zealous MDs on the preventive med bandwagon.

Most people aren't like this crowd though. Your typical 65 year old is on: aspirin +/- Plavix, a statin, 2-3 blood pressure meds, 2-3 diabetes meds, 2-3 pain medications, an antidepressant or two, a proton-pump inhibitor, supplements such as iron, vitamin D, and calcium, Fosamax or equivalent, and a pile of "as-needed" meds for sleep, anxiety etc. Plus Aricept for those diagnosed with Alzheimer's (which has been rightly dubbed as type 3 diabetes).

To quote Malcolm Kendrick, I suppose it saves on food.

I find that 0.5 shot of brandy, scotch or bourbon works really well for both anxiety and sleep inducement.

ochotona wrote: ↑Wed Nov 06, 2019 3:33 pm So what does the research say about preventative medicine and minimzing public (or family) health care costs? Don't do preventative health care? Treat oneself like a mobile phone, use yourself until you breaks, make no effort to prevent failures, happily jump into the dirt box?

Along those lines, at ExxonMobil they always used to have lots of food left over after catered company lunch meetings, this was before the oil price crashed. The post-lunch pickings were excellent; there'd be 1/3 or 1/2 an aluminum catering tray left with penne pasta and chicken breat in Alfredo sauce, or fajitas, etc.

Then I realized it... by overfeeding employees now, the Corporation was controlling pension expenses!

vnatale wrote: ↑Wed Nov 06, 2019 10:00 am

Xan wrote: ↑Wed Nov 06, 2019 9:16 am Certainly seems like most here are relatively non-medicated. WiseOne's nightmare scenario above stretches to get in the 20-25 range. Krieg's chart shows 27 as the average for a 70-year-old. Does that mean for every 70-ish person here on no meds, there's one out there on 50?

And are there really 30-year-olds on 7 prescriptions? On AVERAGE?

That chart's got to be wrong. ...Doesn't it?

Anyone find any similar type charts from different sources? I'm with you in terms of incredulity!

Vinny

ochotona wrote: ↑Wed Nov 06, 2019 3:33 pm Then I realized it... by overfeeding employees now, the Corporation was controlling pension expenses!

Xan wrote: ↑Wed Nov 06, 2019 9:16 am And are there really 30-year-olds on 7 prescriptions? On AVERAGE?

That chart's got to be wrong. ...Doesn't it?