Preventive Healthcare

[xotoxi]

What is your take?

 

[PoliticalChic]

What is your take?

I suspect that the two reasons that you instituted this thread are:

1) you have a daily quota of threads, and

2) you are aware to the studies on this subject.

Sitting on my desk is an artilce in the June 25th Intelligencer Journal, Lancaster, Pa.. which includes:
"Prevention is a good deal, some experts say, if you can buy one year of perfect health for less than $50,000. The most recommended efforts- like flu shots for adults, Pap smears for women and colon cancer screening for people over 50- meet the cutoff. But they certainly don't save money."
Carla K. Johnson, AP Medical Writer

And:
"Prevention instead of treatment? Nancy-Ann De Parle, director of the White House Office of Health Reform, said on March 23 that "we have to get to a system of keeping people well, rather than treating the sickness." That would make sense if all disease were behavior-related, but many cancers and other diseases are linked to genetics or unknown causes. De Parle's pronouncement echoes how Sir Michael Rawlins, a British health official, explains his nation's low cancer survival rates. The British National Health Service, he said, has to be fair to all patients, "not just the patients with macular degeneration or breast cancer or renal cancer. If we spend a lot of money on a few patients, we have less money to spend on everyone else. We are not trying to be unkind or cruel. We are trying to look after everybody."
This approach is deadly for those with serious illness. In the U.S., about 5 percent of the populace needs 50 percent of treatment dollars. The drumbeat for shifting resources from treatments to prevention should worry any family dealing with M.S., Alzheimer's, Parkinson's, or cerebral palsy, or with a history of cancer. "

Defend Your Health Care

 

[johnrocks]

I think they should be encouraged and you should get one, I am greatly overdue for one now,they aren't very expensive and noone should really have to be encouraged and damn should not be forced in the "land of the free",imho.

 

[Missourian]

I have had one every year for the last 15 years to keep my DOT certification.

Never once have they saved me a single dollar.

 

[auditor0007]

I wish I had went for yearly checkups when I was younger. I was never sick, so I never saw a doctor for twenty-five years. Then when I did go because my skin was turning yellow, I found out all could have been avoided had my condition been diagnosed when I was younger, all from a simple blood test.

The funny thing is though, had I gone for regular physicals and had the normal regimen of bloodwork done every few years, they never would have done the blood test I needed to spot my condition because it is not something they normally test for. All I needed was an iron test to check my blood iron, but this test is not routinely performed unless someone is considered to be anemic. My issue was that I had too much iron instead of not having enough. So in the end, even if I had gone, I probably never would have found out about my condition.

 

[xotoxi]

Sitting on my desk is an artilce in the June 25th Intelligencer Journal, Lancaster, Pa.. which includes:
"Prevention is a good deal, some experts say, if you can buy one year of perfect health for less than $50,000. The most recommended efforts- like flu shots for adults, Pap smears for women and colon cancer screening for people over 50- meet the cutoff. But they certainly don't save money."
Carla K. Johnson, AP Medical Writer

Are you agreeing with Carla Johnson's assessment, that screening for certain cancers do not save money?

If so, please show the evidence that the cost of performing screening Pap smears is more expensive then the cost of treating cervical cancer if no screening existed.

Go ahead...

 

[PoliticalChic]

Sitting on my desk is an artilce in the June 25th Intelligencer Journal, Lancaster, Pa.. which includes:
"Prevention is a good deal, some experts say, if you can buy one year of perfect health for less than $50,000. The most recommended efforts- like flu shots for adults, Pap smears for women and colon cancer screening for people over 50- meet the cutoff. But they certainly don't save money."
Carla K. Johnson, AP Medical Writer

Are you agreeing with Carla Johnson's assessment, that screening for certain cancers do not save money?

If so, please show the evidence that the cost of performing screening Pap smears is more expensive then the cost of treating cervical cancer if no screening existed.

Go ahead...

Ouch!

You take me by surprise when your posts are serious.

Ms. Johnson's article was much longer, and she certainly was not making the point that "cost of performing screening Pap smears is more expensive then the cost of treating cervical cancer if no screening existed...'

She was making the same overriding point that Ms. McCaughey made in the other item in the post made, that one cannot claim great saving along the order necessary for the funding of the healthcare bill under discussion by stressing 'prevention.'

The point is that there will be great funding requirements, far more than claimed by the administration, for Obamacare.

Indicative of the need for greater cost-cutting is this:
"Also slipped into the emergency stimulus legislation was substantial funding for a Federal Council on Comparative Effectiveness Research, comparative effectiveness research is generally code for limiting care based on the patient's age. "
Defend Your Health Care

and
"..Dr. David Blumenthal, a Harvard professor and key health advisor to President Obama, conceded that "government controls on health care spending are associated with longer waits for elective procedures and reduced availability of new and expensive treatments and devices."

and
Another key administration figure committed to cost cutting is Dr. Ezekiel Emanuel, a health policy advisor in the Office of Management and Budget and brother of Rahm Emanuel, the president's chief of staff. By far, the most dangerous misconception in Washington is that the way to rein in health spending is by slowing the development and use of new technology. Imagine any industry or nation thriving on such a philosophy. Dr. Emanuel criticizes Americans for being "enamored with technology."

And let's not forget the record of government officials' ability to estimate the cost of healthcare programs:
"In fact, every federal social program has cost far more than originally predicted. For instance, in 1967 the House Ways and Means Committee predicted that Medicare would cost $12 billion in 1990, a staggering $95 billion underestimate. Medicare first exceeded $12 billion in 1975. In 1965 federal actuaries figured the Medicare hospital program would end up running $9 billion in 1990. The cost was more than $66 billion.
In 1987 Congress estimated that the Medicaid Special Hospitals Subsidy would hit $100 million in 1992. The actual bill came to $11 billion. The initial costs of Medicare's kidney-dialysis program, passed in 1972, were more than twice projected levels.
The Congressional Budget Office doubled the estimated cost of Medicare's catastrophic insurance benefit — subsequently repealed — from $5.7 billion to $11.8 billion annually within the first year of its passage. The agency increased the projected cost of the skilled nursing benefit an astonishing sevenfold over roughly the same time frame, from $2.1 billion to $13.5 billion. And in 1935 a naive Congress predicted $3.5 billion in Social Security outlays in 1980, one-thirtieth the actual level of $105 billion.
Doug Bandow on Medicare on National Review Online


No, I am not claiming what you state, re: cervical cancer, nor is Ms. Johnson. Her sub-heading is "The truth, shockingly few prevention efforts actually save the healthcare system money overall..."

Not screening, but prevention.

Not to put too fine a point on it, the nationalized healthcare program of this administration will be a budget-buster, and it is disingenuous to suggest that 'prevention' will be a major money saver.

 

[PLYMCO_PILGRIM]

What is your take?

I choose the 3rd option.

 

[Annie]

Rather than dealing with the new health care 'reform' nonsense, seems a better use of the bully pulpit would be to address both insurance and gov't programs. Both should give really basic care-covered, without deductibles for CBC, pap smears, prostate exams, mammograms, and whatever tests tend to pick up impending disasters medically.

I'll be the first one here to say I've always had 'very good' insurance. If I go into hospital tomorrow, I'll owe very little. At the same time, my deductible is $800. I don't have that. Sooo, I've not had a mammogram or pap smear in over 10 years. Went through 'change' on my own, probably a good thing. Can't afford a bone density test.

Now if I get 'really sick' and hospitalized, all those will be done or shortly thereafter.

Shouldn't be like that.

 

[xotoxi]

Ms. Johnson's article was much longer, and she certainly was not making the point that "cost of performing screening Pap smears is more expensive then the cost of treating cervical cancer if no screening existed...'

She was making the same overriding point that Ms. McCaughey made in the other item in the post made, that one cannot claim great saving along the order necessary for the funding of the healthcare bill under discussion by stressing 'prevention.'

The point is that there will be great funding requirements, far more than claimed by the administration, for Obamacare.

Actually, my initial comment(s) were regarding preventive medicine in general, and not how it relates to nationalized healthcare. In particular, I thought of the post because I saw a patient who is new to Medicare and I told her essentially that she can say goodbye to her annual preventive visits because Medicare will have nothing to do with them.

And let's not forget the record of government officials' ability to estimate the cost of healthcare programs:
"In fact, every federal social program has cost far more than originally predicted. For instance, in 1967 the House Ways and Means Committee predicted that Medicare would cost $12 billion in 1990, a staggering $95 billion underestimate. Medicare first exceeded $12 billion in 1975. In 1965 federal actuaries figured the Medicare hospital program would end up running $9 billion in 1990. The cost was more than $66 billion.
In 1987 Congress estimated that the Medicaid Special Hospitals Subsidy would hit $100 million in 1992. The actual bill came to $11 billion. The initial costs of Medicare's kidney-dialysis program, passed in 1972, were more than twice projected levels.
The Congressional Budget Office doubled the estimated cost of Medicare's catastrophic insurance benefit — subsequently repealed — from $5.7 billion to $11.8 billion annually within the first year of its passage. The agency increased the projected cost of the skilled nursing benefit an astonishing sevenfold over roughly the same time frame, from $2.1 billion to $13.5 billion. And in 1935 a naive Congress predicted $3.5 billion in Social Security outlays in 1980, one-thirtieth the actual level of $105 billion.

However, the estimated cost of preventive care would be extremely easy to calculate. It would be cost of one physical exam, cholesterol panel, sugar, kidney, liver, anemia, thyroid, prostate or pap smear/mammogram, for each person once a year, plus colonoscopy every 10 years. I could come up with a total calculation for you, likely within a $billion. And that number would only increase if the population increased.

The savings would come when women who had never had mammograms were diagnosed with very early breast cancer requiring only a lumpectomy and nothing else, instead of being diagnosed very late requiring $millions of dollars of chemo, radiation, surgery, hospitalizations, nursing home, hospice care, and loss of work.

 

[Annie]

Ms. Johnson's article was much longer, and she certainly was not making the point that "cost of performing screening Pap smears is more expensive then the cost of treating cervical cancer if no screening existed...'

She was making the same overriding point that Ms. McCaughey made in the other item in the post made, that one cannot claim great saving along the order necessary for the funding of the healthcare bill under discussion by stressing 'prevention.'

The point is that there will be great funding requirements, far more than claimed by the administration, for Obamacare.

Actually, my initial comment(s) were regarding preventive medicine in general, and not how it relates to nationalized healthcare. In particular, I thought of the post because I saw a patient who is new to Medicare and I told her essentially that she can say goodbye to her annual preventive visits because Medicare will have nothing to do with them.

And let's not forget the record of government officials' ability to estimate the cost of healthcare programs:
"In fact, every federal social program has cost far more than originally predicted. For instance, in 1967 the House Ways and Means Committee predicted that Medicare would cost $12 billion in 1990, a staggering $95 billion underestimate. Medicare first exceeded $12 billion in 1975. In 1965 federal actuaries figured the Medicare hospital program would end up running $9 billion in 1990. The cost was more than $66 billion.
In 1987 Congress estimated that the Medicaid Special Hospitals Subsidy would hit $100 million in 1992. The actual bill came to $11 billion. The initial costs of Medicare's kidney-dialysis program, passed in 1972, were more than twice projected levels.
The Congressional Budget Office doubled the estimated cost of Medicare's catastrophic insurance benefit — subsequently repealed — from $5.7 billion to $11.8 billion annually within the first year of its passage. The agency increased the projected cost of the skilled nursing benefit an astonishing sevenfold over roughly the same time frame, from $2.1 billion to $13.5 billion. And in 1935 a naive Congress predicted $3.5 billion in Social Security outlays in 1980, one-thirtieth the actual level of $105 billion.

However, the estimated cost of preventive care would be extremely easy to calculate. It would be cost of one physical exam, cholesterol panel, sugar, kidney, liver, anemia, thyroid, prostate or pap smear/mammogram, for each person once a year, plus colonoscopy every 10 years. I could come up with a total calculation for you, likely within a $billion. And that number would only increase if the population increased.

The savings would come when women who had never had mammograms were diagnosed with very early breast cancer requiring only a lumpectomy and nothing else, instead of being diagnosed very late requiring $millions of dollars of chemo, radiation, surgery, hospitalizations, nursing home, hospice care, and loss of work.

I have high blood pressure. I brought it down in a 6 month period through diet and exercise. It's up now, 6 months later. Since I cannot afford the deductible, I'll ignore. I haven't really a choice. If my home sells, I'll be dealing with Drs. of medicine and dental for the years of neglect. Can't be helped.

At the same time, do I think the Obama plan would make things better? No. It's obvious to any thinking person that we need to reduce costs. How to do that? Stop unnecessary testing. Tort reform. Stop the insurance bureaucracy between primary doctors and patients.

 

[PoliticalChic]

Ms. Johnson's article was much longer, and she certainly was not making the point that "cost of performing screening Pap smears is more expensive then the cost of treating cervical cancer if no screening existed...'

She was making the same overriding point that Ms. McCaughey made in the other item in the post made, that one cannot claim great saving along the order necessary for the funding of the healthcare bill under discussion by stressing 'prevention.'

The point is that there will be great funding requirements, far more than claimed by the administration, for Obamacare.

Actually, my initial comment(s) were regarding preventive medicine in general, and not how it relates to nationalized healthcare. In particular, I thought of the post because I saw a patient who is new to Medicare and I told her essentially that she can say goodbye to her annual preventive visits because Medicare will have nothing to do with them.

And let's not forget the record of government officials' ability to estimate the cost of healthcare programs:
"In fact, every federal social program has cost far more than originally predicted. For instance, in 1967 the House Ways and Means Committee predicted that Medicare would cost $12 billion in 1990, a staggering $95 billion underestimate. Medicare first exceeded $12 billion in 1975. In 1965 federal actuaries figured the Medicare hospital program would end up running $9 billion in 1990. The cost was more than $66 billion.
In 1987 Congress estimated that the Medicaid Special Hospitals Subsidy would hit $100 million in 1992. The actual bill came to $11 billion. The initial costs of Medicare's kidney-dialysis program, passed in 1972, were more than twice projected levels.
The Congressional Budget Office doubled the estimated cost of Medicare's catastrophic insurance benefit — subsequently repealed — from $5.7 billion to $11.8 billion annually within the first year of its passage. The agency increased the projected cost of the skilled nursing benefit an astonishing sevenfold over roughly the same time frame, from $2.1 billion to $13.5 billion. And in 1935 a naive Congress predicted $3.5 billion in Social Security outlays in 1980, one-thirtieth the actual level of $105 billion.

However, the estimated cost of preventive care would be extremely easy to calculate. It would be cost of one physical exam, cholesterol panel, sugar, kidney, liver, anemia, thyroid, prostate or pap smear/mammogram, for each person once a year, plus colonoscopy every 10 years. I could come up with a total calculation for you, likely within a $billion. And that number would only increase if the population increased.

The savings would come when women who had never had mammograms were diagnosed with very early breast cancer requiring only a lumpectomy and nothing else, instead of being diagnosed very late requiring $millions of dollars of chemo, radiation, surgery, hospitalizations, nursing home, hospice care, and loss of work.

I have high blood pressure. I brought it down in a 6 month period through diet and exercise. It's up now, 6 months later. Since I cannot afford the deductible, I'll ignore. I haven't really a choice. If my home sells, I'll be dealing with Drs. of medicine and dental for the years of neglect. Can't be helped.

At the same time, do I think the Obama plan would make things better? No. It's obvious to any thinking person that we need to reduce costs. How to do that? Stop unnecessary testing. Tort reform. Stop the insurance bureaucracy between primary doctors and patients.

I had to search for the following data, but it certainly backs up your statement re: tort reform:
While malpractice litigation accounts for only about 0.6 percent of U.S. health care costs, the fear of being sued causes U.S. doctors to order more tests than their Canadian counterparts. So-called defensive medicine increases health care costs by up to 9 percent, Medicare's administrator told Congress in 2005. "
Canada keeps malpractice cost in check - St. Petersburg Times

Now, compare those with these:
"Also, it’s worth noting that while these figures sound like a lot of money — and few would dispute the fact that health insurance company CEOs make healthy salaries — these numbers represent a very small fraction of total health care spending in the U.S. In 2007, national health care expenditures totaled $2.2 trillion. Health insurance profits of nearly $13 billion make up 0.6 percent of that. CEO compensation is a mere 0.005 percent of total spending."
FactCheck.org: Pushing for a Public Plan

So the cost of malpractice suits is equal to the profit of the entire industry.

This may be significant of and by itself, but when we look at the costs of defensive medicine, it alone adds to the costs of healthcare by a factor 15!!!

And, for further improvements in the system:
1. Allow insurance companies to write policies covering exactly what the consumer asks for:
Take two very different states: Wisconsin and New York. In Wisconsin, a family can buy a health-insurance plan for as little as $3,000 a year. The price for a basic family plan in the Empire State: $12,000. The stark difference has nothing to do with each state’s health sector as a share of its economy (14.8 percent in Wisconsin as of 2004, the most recent year for which data are available, and 13.9 percent in New York). Rather, the difference has to do with how each state’s insurance pools are regulated. In New York State, politicians have tried to run the health-insurance system from Albany, forcing insurers to deliver complex Cadillac plans to every subscriber for political reasons, driving up costs. Wisconsin’s insurers are far freer to sell plans at prices consumers want.
The gulf in insurance-premium prices among American states is a sign that too much government intervention—not too little—is what’s distorting prices from one market to the next. The key to reducing health-care costs for patients, then, is to promote competition, not to dictate insurance requirements from on high. Unfortunately, a government-run insurance plan is the core of ObamaCare.
Bigger Is Healthier by David Gratzer, City Journal 22 July 2009


2. Doctors currently have no ability to re-price or re-package their services that way every other professional does. Medicare dictates what it pays for and what it won’t pay for, and the final price. Because of this there are no telephone consultations paid for, and the same for e-mails, normal in every other profession.
Most doctors don’t digitize records, thus they cannot use software that allows electronic prescription, and make it easier to detect drug interactions or dosage mistakes. Again, Medicare doesn’t pay for it.

3. Another free market idea aimed at better quality is have warranties for surgery as we do for cars. 17% of Medicare patients who enter a hospital re-enter within 30 days because of a problem connected to the original surgery. The result is that a hospital makes money on its mistakes!

4. Walk-in clinics are growing around the country, where a registered nurse sits at a computer, the patient describes symptoms, the nurse types it in and follows a computerized protocol, the nurse can prescribe electronically, and the patient sees the price in advance

5. To reduce healthcare costs, increase the number of doctors. Obama care would do the opposite. Both tax incentives and support of the tuition of medical school.

6. Identify the 8-10 million who need and are unable to get healthcare, including those with pre-existing conditions,and provide debit cards as is done for food stamps:

"Food debit cards help 27 million people buy food, similar to the number who need help buying health coverage. In all fifty states, debit card technology has transformed the federal food stamp program, which used to be notorious for fraud and abuse. (Only 2 percent of card users are found to be ineligible, according to the General Accounting Office.) Cards are loaded with a specific dollar amount monthly, depending on family size and income, and allow cardholders to shop anywhere. The same strategy could be adapted to provide purchasing power to families who need help buying high-deductible health coverage. It's what all Americans used to buy (see chart 5), and it's all that's needed for families with moderate incomes, who can afford a routine doctor visit. "
Downgrading Health Care

 

[PoliticalChic]

Ms. Johnson's article was much longer, and she certainly was not making the point that "cost of performing screening Pap smears is more expensive then the cost of treating cervical cancer if no screening existed...'

She was making the same overriding point that Ms. McCaughey made in the other item in the post made, that one cannot claim great saving along the order necessary for the funding of the healthcare bill under discussion by stressing 'prevention.'

The point is that there will be great funding requirements, far more than claimed by the administration, for Obamacare.

Actually, my initial comment(s) were regarding preventive medicine in general, and not how it relates to nationalized healthcare. In particular, I thought of the post because I saw a patient who is new to Medicare and I told her essentially that she can say goodbye to her annual preventive visits because Medicare will have nothing to do with them.

And let's not forget the record of government officials' ability to estimate the cost of healthcare programs:
"In fact, every federal social program has cost far more than originally predicted. For instance, in 1967 the House Ways and Means Committee predicted that Medicare would cost $12 billion in 1990, a staggering $95 billion underestimate. Medicare first exceeded $12 billion in 1975. In 1965 federal actuaries figured the Medicare hospital program would end up running $9 billion in 1990. The cost was more than $66 billion.
In 1987 Congress estimated that the Medicaid Special Hospitals Subsidy would hit $100 million in 1992. The actual bill came to $11 billion. The initial costs of Medicare's kidney-dialysis program, passed in 1972, were more than twice projected levels.
The Congressional Budget Office doubled the estimated cost of Medicare's catastrophic insurance benefit — subsequently repealed — from $5.7 billion to $11.8 billion annually within the first year of its passage. The agency increased the projected cost of the skilled nursing benefit an astonishing sevenfold over roughly the same time frame, from $2.1 billion to $13.5 billion. And in 1935 a naive Congress predicted $3.5 billion in Social Security outlays in 1980, one-thirtieth the actual level of $105 billion.

However, the estimated cost of preventive care would be extremely easy to calculate. It would be cost of one physical exam, cholesterol panel, sugar, kidney, liver, anemia, thyroid, prostate or pap smear/mammogram, for each person once a year, plus colonoscopy every 10 years. I could come up with a total calculation for you, likely within a $billion. And that number would only increase if the population increased.

The savings would come when women who had never had mammograms were diagnosed with very early breast cancer requiring only a lumpectomy and nothing else, instead of being diagnosed very late requiring $millions of dollars of chemo, radiation, surgery, hospitalizations, nursing home, hospice care, and loss of work.

Yes, I realized afterward that you were focusing on a very specific point.
I'm sorry, I inferred where you didn't imply.

But I don't think you meant that the figure in " I could come up with a total calculation for you,..." would approach the actual cost of the ObamaCare plan, did you?

I am absolutely in favor of various forms of screening, although I have seen questions about the efficacy of mammograms.
"The researchers' conclusion: yearly mammograms did not necessarily lead to an increase in survival rates once cancers were discovered."
How Effective are Mammograms and Breast Self-Exams?: The Mammogram Controversy

 

[Emma]

Ms. Johnson's article was much longer, and she certainly was not making the point that "cost of performing screening Pap smears is more expensive then the cost of treating cervical cancer if no screening existed...'

She was making the same overriding point that Ms. McCaughey made in the other item in the post made, that one cannot claim great saving along the order necessary for the funding of the healthcare bill under discussion by stressing 'prevention.'

The point is that there will be great funding requirements, far more than claimed by the administration, for Obamacare.

Actually, my initial comment(s) were regarding preventive medicine in general, and not how it relates to nationalized healthcare. In particular, I thought of the post because I saw a patient who is new to Medicare and I told her essentially that she can say goodbye to her annual preventive visits because Medicare will have nothing to do with them.

And let's not forget the record of government officials' ability to estimate the cost of healthcare programs:
"In fact, every federal social program has cost far more than originally predicted. For instance, in 1967 the House Ways and Means Committee predicted that Medicare would cost $12 billion in 1990, a staggering $95 billion underestimate. Medicare first exceeded $12 billion in 1975. In 1965 federal actuaries figured the Medicare hospital program would end up running $9 billion in 1990. The cost was more than $66 billion.
In 1987 Congress estimated that the Medicaid Special Hospitals Subsidy would hit $100 million in 1992. The actual bill came to $11 billion. The initial costs of Medicare's kidney-dialysis program, passed in 1972, were more than twice projected levels.
The Congressional Budget Office doubled the estimated cost of Medicare's catastrophic insurance benefit — subsequently repealed — from $5.7 billion to $11.8 billion annually within the first year of its passage. The agency increased the projected cost of the skilled nursing benefit an astonishing sevenfold over roughly the same time frame, from $2.1 billion to $13.5 billion. And in 1935 a naive Congress predicted $3.5 billion in Social Security outlays in 1980, one-thirtieth the actual level of $105 billion.

However, the estimated cost of preventive care would be extremely easy to calculate. It would be cost of one physical exam, cholesterol panel, sugar, kidney, liver, anemia, thyroid, prostate or pap smear/mammogram, for each person once a year, plus colonoscopy every 10 years. I could come up with a total calculation for you, likely within a $billion. And that number would only increase if the population increased.

The savings would come when women who had never had mammograms were diagnosed with very early breast cancer requiring only a lumpectomy and nothing else, instead of being diagnosed very late requiring $millions of dollars of chemo, radiation, surgery, hospitalizations, nursing home, hospice care, and loss of work.

Precisely.

Common sense tells you that preventative/maintenance health care is cost-effective. The direct and indirect costs of just one condition alone, diabetes (lol), costs $174 billion a year (that was from 2007, most likely has increased). Treatment itself is expensive, of course, but add to that the cost of all the complications (every system in the body is affected), lost work days and lost productivity from earlier death, disability, etc.

I'm not even for sure they factored in the extended costs of those complications... the complications of the complications, as it were.

I'm constantly amazed that people who wouldn't think of allowing their automobile to run until it broke down, never changing the oil or getting a tune up or whatever, think it's just fine that for far too many we're practicing crisis management instead of healthcare in this country.

 

[xotoxi]

3. Another free market idea aimed at better quality is have warranties for surgery as we do for cars. 17% of Medicare patients who enter a hospital re-enter within 30 days because of a problem connected to the original surgery. The result is that a hospital makes money on its mistakes!

I don't believe this AT ALL.

17% is far too high. There is not a 17% complication rate for any surgery.

Plus, the 30 day readmission is far less likely to be a "hospital mistake" then it is to be an "expected complication".

 

[editec]

Up to a degree, and once you'ver reached a certain age, I suppose, annual checkups are a good thing.

But if you're under 40, and feeling well, I basically think if it ain't broke don't fix it.

 

[xotoxi]

But I don't think you meant that the figure in " I could come up with a total calculation for you,..." would approach the actual cost of the ObamaCare plan, did you?

No.

But (again), this thread has nothing to do with Obama's plan. Just medical care in general.

 

[editec]

Bear in mind, folks, that iatrogenesis is the 4th most prolific killer in the USA.

We know that it pays to get checkups for certain things at certain ages, and certainly if you're prone (genetically) to some diseases it probably pays to get checked out per medical advise.

But I do think that some Americans are hypocondriacal, and medical care isn't without risk.

If you're not sick, don't got to the doctor is my advise.

 

[PoliticalChic]

3. Another free market idea aimed at better quality is have warranties for surgery as we do for cars. 17% of Medicare patients who enter a hospital re-enter within 30 days because of a problem connected to the original surgery. The result is that a hospital makes money on its mistakes!

I don't believe this AT ALL.

17% is far too high. There is not a 17% complication rate for any surgery.

Plus, the 30 day readmission is far less likely to be a "hospital mistake" then it is to be an "expected complication".

That data was from "A Prescription for American Health Care"
John C. Goodman, President Center for Policy Analysis
Ph.D, Columbia University, from a speech given at Hillsdale College, February 18, 2009

But if that is not satisfactory,


"The Clinic readmitted 23.6 percent of its heart attack patients, compared with a national rate of 19.9 percent. For heart failure, the Clinic's readmission rate was 29.1 percent, compared with 24.5 percent nationally. For pneumonia, the Clinic was at 23.2 percent, compared with a national rate of 18.2.

Other area hospitals did not fare as poorly in the three areas of readmissions. Most were within the national norm in most categories. University Hospitals Case Medical Center scored worse than average in heart failure readmissions (27 percent), and was within the norm in the other areas. UH's Bedford Medical Center had worse rates of readmissions for heart failure and pneumonia."
High percentage of hospital patients readmitted, report says; Clinic rates worse than average - cleveland.com

Data exist on the morbidity and mortality of patients undergoing pancreaticoduodenectomy (PD), but there are few reports about hospital readmissions after this procedure. Our aim was to evaluate the number of and reasons for readmission after PD and the factors influencing readmission. We reviewed the initial hospitalization and readmissions for 1643 patients undergoing PD compared patients requiring readmission to patients that did not require readmission. Twenty-six percent of patients were readmitted a total of 678 times after PD. Patients readmitted were younger than those not readmitted (61.8 versus 64.6 years, P < 0.0001). Vessel resection, abscess formation, wound infection, postoperative percutaneous biliary stents, estimated blood loss >1000 ml, and age &#8804;65 years were independently associated with readmission. The length of stay for all patients decreased over time, from 10.5 days in 1996 to 7 days in 2003. The percentage of patients being readmitted also decreased from 33% in 1996 to 20% (P = 0.004) in 2003. The readmission rate after PD was 26%.
ScienceDirect - Journal of Gastrointestinal Surgery : Hospital Readmission After Pancreaticoduodenectomy

CONCLUSION: 44% of patients were readmitted to hospital two years after CABG. The most common reasons for readmission were angina pectoris and congestive heart failure. Four clinical markers predicted readmission: clinical history; acute operation status; postoperative complications; and clinical findings and medication four to seven days after operation.
Predictors of hospital readmission two years after coronary artery bypass grafting.

Twenty-six (14.4%) patients were readmitted within 30 days of hospital discharge. Readmitted patients were older (t=2.12, df=179, P=0.035), and more likely to be unmarried (&#967;2=5.80, df=1, P=0.016), live alone (&#967;2=8.33, df=1, P=0.004), have a history of hypertension (&#967;2=2.731, df=1, P=0.098) and have higher anxiety before surgery (t=1.67, df=175, P=0.097).
Elsevier

Need more?

Is that the sound of crickets I hear?

 

[Neser Boha]

I wish I had went for yearly checkups when I was younger. I was never sick, so I never saw a doctor for twenty-five years. Then when I did go because my skin was turning yellow, I found out all could have been avoided had my condition been diagnosed when I was younger, all from a simple blood test.

The funny thing is though, had I gone for regular physicals and had the normal regimen of bloodwork done every few years, they never would have done the blood test I needed to spot my condition because it is not something they normally test for. All I needed was an iron test to check my blood iron, but this test is not routinely performed unless someone is considered to be anemic. My issue was that I had too much iron instead of not having enough. So in the end, even if I had gone, I probably never would have found out about my condition.

Actually, if you did go for regular annual check-ups there is a very high probability they would've spotted it earlier. In Czech Republic, when I was growing up, it was routine to do bloodwork - and check whether you were anemic, etc. I don't see why there would be any difference in the USA. But then, I also got my shots for small-pox, so... I guess I can't compare.