Countering medical cost myths

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WiseOne
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Countering medical cost myths

Post by WiseOne » 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.
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Re: Countering medical cost myths

Post by jacksonm2 » Sun Oct 20, 2019 4:35 pm

I figured this out a long time ago.

Nowadays I only go the Urgent Care clinic when I am truly in need, like almost exactly two years ago when I had shingles. And they have very good doctors at the urgent care clinic I visit. Unlike other doctors they don't even schedule a follow up visit just so they can ask you if you are feeling better and bill your insurance company for letting them know.
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.
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Re: Countering medical cost myths

Post by shekels » Mon Oct 21, 2019 9:58 am

Article From the Ticket Forum:
Pretty Smart guy, Just don't know if it will happen.
I just know I am tired of getting screwed by Medical Insurance.

https://market-ticker.org/akcs-www?post=231949


Also he has a new podcast up that goes over Medical Costs. (Warning there is some rough Language).
Where 2024 is the date that Medicare comes to a head.
https://market-ticker.org/akcs-www?post=237140
¯\_(ツ)_/¯
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Re: Countering medical cost myths

Post by InsuranceGuy » Mon Oct 21, 2019 10:21 am

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Last edited by InsuranceGuy on Mon Mar 08, 2021 6:00 pm, edited 1 time in total.
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Re: Countering medical cost myths

Post by Kriegsspiel » Tue Nov 05, 2019 6:58 pm

https://marginalrevolution.com/marginal ... lator.html

Image

Can it be true that rising medical costs is as simple as people using more cheaper medicine? The "escalator paradox" is similar to Jeavon's Paradox.
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Re: Countering medical cost myths

Post by Xan » 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??
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Re: Countering medical cost myths

Post by vnatale » 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
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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Re: Countering medical cost myths

Post by Kriegsspiel » 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.
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Re: Countering medical cost myths

Post by vnatale » Tue Nov 05, 2019 8:37 pm

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.
When I was in school my generation was not even aware of attention deficit disorder and, of course, no drugs were being proscribed for it. Now you are reminding me that sometime in the 90s that doing so became not so rare?

Vinny
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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Re: Countering medical cost myths

Post by ochotona » Tue Nov 05, 2019 9:25 pm

58 and take 3. Mediocre genes.
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Re: Countering medical cost myths

Post by ochotona » Wed Nov 06, 2019 6:56 am

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. O0
After I retire and get exposed to less stress and get more sleep / exercise it's entirely possible I could wean off of two of them. Third one very unlikely. Looking forward to a trial.
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Re: Countering medical cost myths

Post by WiseOne » 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.
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Re: Countering medical cost myths

Post by Maddy » 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.
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Re: Countering medical cost myths

Post by jacksonm2 » Wed Nov 06, 2019 8:28 am

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.
I'm 70 and so far I take nothing but beer and pot for my ailments. Can't be any worse than 26 drugs, can it?
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Re: Countering medical cost myths

Post by jacksonm2 » Wed Nov 06, 2019 8:29 am

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.
I thought cancer was being dubbed as type 3 diabetes.
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Re: Countering medical cost myths

Post by Xan » 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?
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Re: Countering medical cost myths

Post by vnatale » Wed Nov 06, 2019 9:57 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.
Had no idea of this! I will immediately start polling some of my 65 and over friends / others to see how their lists match with the above!

Vinny
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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Re: Countering medical cost myths

Post by vnatale » 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
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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Re: Countering medical cost myths

Post by Mountaineer » Wed Nov 06, 2019 11:23 am

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. :D
Surely your decimal point was one place to the left of where you intended. ;D ;D ;D ;D

On another note, I've heard the person who may be typing this would say: no asprin or Plavix, one statin, two bp meds, no diabetes meds, no pain meds, no antidepressants, one GERD suppresant, one supplement - calcium, no fosamax or equivalent, no as needed meds for sleep or anxiety. But that scotch sounds tasty and promising. :)
DNA has its own language (code), and language requires intelligence. There is no known mechanism by which matter can give birth to information, let alone language. It is unreasonable to believe the world could have happened by chance.
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Re: Countering medical cost myths

Post by ochotona » 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!
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Re: Countering medical cost myths

Post by vnatale » Wed Nov 06, 2019 4:21 pm

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!
!!!!!!!!!!!!!

Same thing with all those smokers putting less of a strain on Social Security and Medicare since they are dead long before us?

Vinny
Above provided by: Vinny, who always says: "I only regret that I have but one lap to give to my cats." AND "I'm a more-is-more person."
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Re: Countering medical cost myths

Post by Kriegsspiel » Wed Nov 06, 2019 5:50 pm

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
The original paper the chart was in was linked in the post on MR. It goes into a lot more detail.
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Re: Countering medical cost myths

Post by Kriegsspiel » Wed Nov 06, 2019 5:50 pm

ochotona wrote:
Wed Nov 06, 2019 3:33 pm
Then I realized it... by overfeeding employees now, the Corporation was controlling pension expenses!
:D
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Re: Countering medical cost myths

Post by ochotona » Wed Nov 06, 2019 6:37 pm

It's like Dilbert where the product is killing people. The management meeting is headlined by:

"Decline in unsatisfied customers"
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Re: Countering medical cost myths

Post by Kriegsspiel » Thu Nov 07, 2019 7:26 pm

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?
I just happened upon these two recent articles corroborating what I've read previously:

Millennial health is deteriorating faster than older generations — at a steep economic cost

Millennials are less healthy than Gen X and it may be due to mental illness, Blue Cross report finds
You there, Ephialtes. May you live forever.
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