AMERICAN MEDICINE:
 

Начинаю новую тему, ибо прежняя исчезла вместе с её создателем ( или если где и есть в недрах gруппы, я её не могу отрыть).
Здесь предлагается обсуждать всё, что прямо или косвенно касается медицины. *Pre- and post-Obamacare.

Начинаю новую тему, ибо прежняя исчезла вместе с её создателем ( или если где и есть в недрах gруппы, я её не могу отрыть).
Здесь предлагается обсуждать всё, что прямо или косвенно касается медицины. *Pre- and post-Obamacare.

First thing we need to do is to make a distinction between medicine and Healthcare system.

в СССР народ с детства предупреждали: государство вылечит вас бесплатно.
То бишь, не горюй - кури и пей на здоровье, зарабатывай насморк, инфаркт, гемморой, рак и травмы.
Врачей взяли на госзарплату. То есть, будешь получать зряплату одинаковую и за насморк, и за инфаркт, и за тавмы, и за рак...
Ну на кой такому врачу лечить ? Все равно зряплата в конце месяца будет нищенской....
и дедушка Ленин со своего гробика небось приговаривает обамке:"Пхавильным путем идете, товахищ"..

BTW, we can post here anything related to medicine, that's why I made the theme more general that just healthcare.
We can share medical news too.
But the political aspect will probably prevail here. (H)

So , here you go.
The truth about the real cost of Obamacare was hidden until the Congress voted.
Pelosi's way of transparency she promised.

Congressional Budget Office estimates released Tuesdaypredict the health care overhaul will likely cost about $115 billionmore in discretionary spending over ten years than the original costprojections.
The additional spending — if approved over the years by Congress —would bring the total estimated cost of the overhaul to about $1trillion…
The CBO released the estimates in response to a request fromCalifornia Rep. Jerry Lewis, ranking Republican on the HouseAppropriations Committee. A spokeswoman for Lewis said the inquiry was filed before the House voted on the bill…
The CBO estimated in March that the net cost of the overhaul wouldbe $788 billion over 10 years, but cautioned that it couldn’t make anestimate of the discretionary costs without more time and information.

on American medicine:
it is the best medicine in the world when it comes to dealing with acute, severe, life-threatening illness, surgery and trauma.
Unfortunately, when it comes to managing chronic conditions it has long way to go.

In what way do you think the chronic care is inferior? What contributes to this? The human factor ( patients) or the system?

pochemu srazu smotret' na SSSR kak primer? chto drugix primerov net?

Потому что это самый лучший пример государственной системы.
Потому что с такой системой - это приведёт к таким же результатам. Или результаты, то есть конец замечательного Советского строя тоже будем обсуждать?

********tinyurl.com/2fj975f
This video is highly ( highly!) educating about the perils Obamacare represents to the American surgical specialty.
Watch it, educate yourself. It's a bit long, but worth it. The informative stuff comes about second third of the video till the end.

Hey, Maria..
great link.. i actually enjoyed it ( aside from the monotonous delivery, the dude has to work on it ). Sending it to my wife too.

I am sending to my husband too. He was saying for years now how the lawyers meddling with the residents training really undermining the future of surgical specialty. All the preceptors of surgical residents are not happy seeing how this new rule is harming the training process.

Great article in Wall Street Journal

ObamaCare vs. Small Business

1. For decades small business owners have been telling anyone who wouldlisten that they need health-care reforms that lower costs. ButPresident Obama and his allies in Congress pushed through a law thatwill dramatically raise health-care costs and increase the overall costof doing business. What's more, the federal mandate requiring thatnearly all U.S. residents carry health insurance by 2014 seriouslythreatens our basic constitutional rights and individual freedoms.
Thisis why the National Federation of Independent Business (NFIB), onbehalf of small business owners nationwide, has joined the lawsuit with20 states mounting a constitutional challenge to this devastating newhealth-care law.

2.This law is death by a thousand cuts for small business owners.According to the Congressional Budget Office (CBO), the overhaul willcost about $115 billion more than first projected, bringing the totalto more than $1 trillion. Small businesses will also now have to dealwith an onslaught of new taxes and burdensome paperwork.
Supporters say the law will significantly help small businesses,focusing on the much-talked about small business tax credit. But thereality is that the tax credit is complex and very limited becausefirms qualify based on number of employees and average wages. Thecredit, which is only available for a maximum of six years, puts smallbusiness owners through a series of complicated "tests" to determine ifthey qualify and how much they will receive. Fewer than one-third ofsmall businesses even pass the first three (of four) tests to qualify:have 25 employees or less, provide health insurance, and pay 50% of thecost of that insurance.

3. More importantly, the credit is temporary, but health-care costincreases are permanent. When the credit ends, small businesses will beleft paying full price. They'll also be forced to deal with all sortsof new taxes, fees and mandates buried in this 2,000-page law.
Oneof these new taxes is a so-called health insurance fee. It's a massive$8 billion tax (that escalates to $14.3 billion by 2018) on insurancecompanies based on their market share. This tax will be paid almostexclusively by small businesses and individuals because the lawspecifically excludes self-insured plans, the plans that most bigbusinesses and labor unions offer, from having to pay the tax.
Whilethe health insurance fee was designed to "go after" largehealth-insurance companies, the reality is that insurers aren't simplygoing to absorb this new tax; it will be passed on to customers.Specifically, it will be passed on to the plans that 87% of smallbusinesses and individuals buy.

4. A study by the Federal Policy Group published last October foundthat the amount of taxes passed on to the typical family of four couldbe $500 or more per year. Adding insult to injury, the law alsorequires all businesses to issue IRS 1099 forms to document everybusiness-to-business transaction of $600 or more. To someone who'snever run a business, this may sound like nothing. But Congress hopesto raise $17 billion in added tax revenues and fees from this newmandate. That's hardly nothing.
The burden of raising thatexpected revenue falls again on the backs of small business owners whoalready suffer under unmanageable federal paperwork burdens. What'sworse, this new reporting requirement has absolutely nothing to do withhealth-care reform. It was included to help pay for the nearlytrillion-dollar price tag of the bill. Why should small business ownershave to pay for a bill that causes them so much harm? They shouldn't,which is why NFIB is fighting against this law in court.

5. We also believe the health-care law is unconstitutional. Thecenterpiece of this law is an individual mandate requiring virtuallyall Americans to purchase health insurance or pay a fine. We stronglybelieve that the Commerce Clause of the Constitution does not giveCongress the power to force individuals to purchase a private productor face a fine. Requiring individuals to purchase something simplybecause they are alive is unprecedented. The military draft is the onlyexception to this, and Congress's authority to enact the draft isprovided for in the Constitution, unlike this mandate.
Theindividual mandate imposes unique burdens on those small businesspeople, including many NFIB members, who are sole proprietors and theleast able to afford it. These independent men and women rarely canafford to distinguish between their own "personal" resources and thoseof their business.

6. The mandate will now force them to spend money on insurance they maynot want, rather than using those funds to run and grow theirbusinesses.If this law is not overturned, then all citizensshould be prepared for the long arm of the federal government to reacheven further into how we choose to live our lives, spend our money andpursue our own definitions of happiness.
Health-care reform istoo important to be based on an unconstitutional mandate. Smallbusinesses need the judicial system—if necessary, the U.S. SupremeCourt—to overturn this law to protect them from having to pay for astatute that causes them more harm than good and ultimately infringeson all Americans' personal freedoms.




Mr. Danner ispresident and CEO of the National Federation of Independent Business(NFIB), a nonprofit, nonpartisan organization that works to promote andprotect the rights of small businesses to own, operate and grow theirbusinesses.

A Rough Day for Socialism

1. Man, first it turns out that the only people who got jobs last month were temporary census workers, then it turns out that despite spending hundreds of billions on the Environmental Protection Agency over the years the Government can do nothing but twiddle its thumbs when an event requiring the protection of the environment happens. Then, the model system for nationalized health care began to crack.

NHS 'preparing to cut millions of operations': Patients will lose out to ensure ?20bn savings
Millions of patients face losing NHS care as bosses prepare to axe treatments to make ?20billion of savings by 2014, a top doctor has warned.
Among procedures being targeted by health trusts are hernias, joint replacements, ear and nose procedures, varicose veins and cataract surgery.

2.
I wonder if it ever occurred to them to make the cuts by laying off NHS medicrats and leasing out their lavish offices. 30% of new NHS spending (which exploded under the Labour Government) was for "administrative staff," a.k.a. bureaucrats. They also spent a ton of money on new buildings to house the new "administrative staff."
Moonbattery.com

here is some fine statistical analysis for those who claim that we are the best:
***********.commonwealthfund.org/Content/Publications/Fund-Reports/2010/Jun/Mirror-Mirror-Update.aspx
Shame on us!!!!!!

Shame on this "survey":-)
I checked out this "commonwealth fund" -sounds like some Obama -cheering group of activists who fudge data to fit their political agenda.

I did not find any statistical analysis at all in this article, just conclusions based on some survey of patients and physicians: no numbers provided.

We are the best. Here's the response:
***********.nationalreview.com/critical-condition/230339/misguided-hit-u-s-health-care/grace-marie-turner
And here's some interesting statistics that I found: ***********.ncpa.org/pub/ba649

We are the best. Here's the response:
***********.nationalreview.com/critical-condition/230339/misguided-hit-u-s-health-care/grace-marie-turner
And here's some interesting statistics that I found: ***********.ncpa.org/pub/ba649

and, of course, this response is from the "unbiased" publication:-D :-D :-D :-D :-D :-D :-D
Can we find something more neutral then The National Review?
Or, to be fair - maybe an alternative set of of statistics?
Using conservatives-pleasing parameters?
Let's compare numbers to numbers, instead of answering to numbers with ideology. ( In all fairness, I agree that ideological bias exist in all statistics). And, would like to draw conclusions based on sets of data instead of somebody's interpretations.

Julia, that study is from a biased publication too. Moreover, it's not even a study, it's BS. I work with medical studies all the time (right now I'm taking a break from reading a long paper in Lancet open on another computer). This one is simply not serious. Instead of using hard data (like outcomes - e.g. European cancer mortality is dramatically higher than the American one) they use purely subjective responses in a survey. They don't even account for cultural differences - e.g. American consumers tend to be more demanding, and the service that they say "sucks" may actually be better than the service that some Europeans rate as "excellent". When people use such obviously flawed methodology, you not it's not a study - it's propaganda.

Ok, then let's place a link to a study you like.
Let's compare data you are interested in.
I'm particularly interested in life expectancy and infant and childhood mortality.
And "Healthy" indexes - rates of lifestyle related diseases, obesity, Metabolic sm, ( or their reduction, etc...).

Julia, life expectancy and infant mortality have nothing to do with the health system, and anyone who mentions those indicators already has a certain agenda.

hmmmm.... please elaborate, I'm listening.
If you will say those are JUST societal factors - I'll disagree.
What are the top 10 indicator of EFFICIENT Healthcare system?
( again, not the availability of good medicine)

OK, we need factors where the system actually makes a difference. I would suggest looking at various diseases and the number of QALYs the system adds on average to each sufferer. If we do this, we should, for example, subtract 9 months or so from life expectancy for people with cataracts in British Columbia who have to wait on average 15 months for cataract removal, while being basically blind, right?

What are the top 10 indicator of EFFICIENT Healthcare system?
( again, not the availability of good medicine)
But availability of good medicine is the most important factor for the Healthcare system to be efficient. (ch)
Also, we have the best access to the different treatment options.

Julia, life expectancy and infant mortality have nothing to do with thehealth system, and anyone who mentions those indicators already has acertain agenda.
Very true!
***********.nber.org/papers/w13429

And "Healthy" indexes - rates of lifestyle related diseases, obesity, Metabolic sm, ( or their reduction, etc...).
But how are rates of lifestyle related diseases indicative of the greatness of the healthcare? If slobs want to be slobs, no doctors can change that behavior. Imagine if Americans lived in Europe? The rates of lifestyle related diseases there would have been so much greater. It has nothing to do with the healthcare. Europeans drive cars less:-) , and eat less junk food.

Speaking of costs, I'm not actually sure that costs per QALY here are actually higher than in Europe or Canada, especially for all treatments.

Что меня удивляет в американской медицине - разные стоимости услуг для людей и страховых компаний. Например, доктора высылают счет на $300, но страховая компания (говорю о своих двух страховщиках) оплачивает только $100, ссылаясь на некие договорные *отношения или разрешенный (кем?) предел оплаты. Но если вы без страховки и платите свои наличные, то оплата будет в несколько раз больше. Как же это понять? Где здравый смысл? Если бы оплата была такая же как платит страховая компания, то многие люди, буть может, отказались бы от страховки. Мне кажется важным вопрос: меняет ли реформа Обамы этот порядок? Будет ли незастрахованный платить столько же, сколько получает врач от страховщика? Изменит ли реформа Обамы этот порядок тройной оплаты незастрахованным человеком?

Ничего удивительного в этом нет. Многие вообще не платят. Причём во многих случаях по закону им не могут отказывать в лечении, даже если сразу ясно, что не заплатят (в позапрошлые выходные водитель скорой и его невеста - медсестра в ER - рассказали мне, как некоторые женщины вызывают скорую, чтобы на халяву сделать тест на беременность и сэкономить $1 - стоимость этого домашнего теста в аптеке). Поэтому люди без страховки по сути платят за себя и за того парня.
Реформа Обамы всё меняет в том смысле, что за проживание в США без медицинской страховки теперь можно будет попасть в тюрьму. Как когда-то в Совке за проживание без прописки. А вообще, ситуация, я думаю, резко изменится, потому что очень резко увеличится количество людей без страховки (я думаю, миллионов до ста).

Ниче не понял:
за проживание в США без медицинской страховки теперь можно будет попасть в тюрьму. *А вообще, ситуация, я думаю, резко изменится, потому что очень резко увеличится количество людей без страховки.
Все в тюрьму что ли попадут?

Andrej,
I had another question: the question about the difference in the payments by insurance companies and by independent persons. Your answers explains why the payments are high. My question is Why are they non-equal?

Because insurance companies have leverage in negotiations. So they largely avoid paying for others. Individuals don't.