3201

One of my political heroes. As well as Churchill, somewhat oddly.

3202

If not for WW2 Churchill would have been one of the worst politicians in British history. But he pulled it out in the end. Have to give him that. We now return to your regularly scheduled obamacare thread.

3203

And yet the NHS still produces better outcomes for less money than the U.S. system. American Healthcare: worse than a British dumpster fire!

3204

This is generally true over the last n years, even with the gradual deterioration of the NHS under the Tories.

However, the current crisis is verging on catastrophic from what I read, with crucial, lifesaving surgeries postponed due to emergency conditions in A&R, and all nonessential procedures canceled or suspended indefinitely. People are dying for want of beds and for want of attention during the flu season in some hospitals, according to reports in the Guardian.

3205

It’s difficult to have efficiency if you have no enforcement.

There’s a whole branch of health care springing up like a weed everyone in the US right now, where you have these 24 “medical” providers popping up in shopping centers, next to Subway and the local Thai restaurants. Their whole schtick is that they label themselves an “ER”, and so they can bill at ER rates. Which they either get away with, or kick the bill to the patient.

Meanwhile rural hospitals are shuttering. Because of medcal coding. Literally whole industries are being created because of how they code their invoices.

That’s the kind of inefficiencies that are destroying the health care system in the country, and what we need government for. Government isn’t efficient, but it IS good at improving market efficiencies, through enforcing rules, regulations and proper practices. The more stagnant and absent government is here in the US, the more inefficient and rent seeking the markets are becoming.

3206

My understanding (I might have some insider info) is that it’s pretty serious but not catastrophic, with the more damming reports being not really that common. It’s mostly hospital based, with a few hospitals really overworked and in direr straits (some almost closed), but the majority doing fine. Despite the strains to the system, it keeps working and maintaining standards (so far,it’s serious).

Also, the cause it’s not the NHS but it’s dismantling, so it’s not the consecuence of a public health care system, but of the erosion of it. It could be solved with some new regulations (or repeal of late regulations) and better management . A manufactured crisis in the context of pushing a political goal, and not a systemic issue with the system as it was before the changes.

3207

Of course. NHS would be just fine if it was funded properly, if its Tory controllers weren’t trying to destroy it, and if it wasn’t being constantly attacked by attempts at privatization.

3208

My wife was a medical coder. The last company she worked for was sourcing the coding out of the country. ACA was to make coding even more invasive but I am not sure the new codes have ever been fully implemented as I think the wife was still using the old codes as of two years ago.

3209

Interesting new JAMA study on comparing cost of Us health to other high income countries. We spend more but not a great deal more. 3 key factor in Us spending: labor costs, drug prices and admin costs. To reign in labor costs basically means cutting pay to docs and nurses a fairly unpopular reform. Admin costs seems easy to cut but lower admin costs does not mean efficiency and can easily mean the opposite.

A real key is drug costs which can be lowered, especially if generic approval can be accelerated.

3210

True. And with regard to nurses, we really can’t do that. We already have a serious nationwide shortage of nurses, and we have for some time.

But doctors are another story. Of the highest-paying jobs in America, the top 10 includes 9 medical specialties. The other spot is occupied by “CEO’s.”

Doctors in the US also have higher insurance costs than almost anyone else, and medical school is $35 - $60k per year just for tuition. You have to delve these rabbit-holes, too, if you want to lower overall costs.

3211

Jeebus that drives home just how much of a bubble silicon valley compensation is.

3212

Point of order:

It’s “rein in.”

3213

I’m not sure I put much credence in that terrible business insider article. Most their articles or crap and that one seems like it fits the mold completely.

3214

Actually, that’s a point of information. </smarm>

3215

Or pedantry, I suppose. ;-)

3216

So here we are.

3217

Two of Virginia’s ObamaCare insurers are requesting significant premium hikes for 2019, according to initial filings released Friday.

Both Cigna and CareFirst BlueCross BlueShield cited policies advocated by the Trump administration, including the repeal of ObamaCare’s individual mandate, as part of its justifications for the increases.

Cigna is proposing an average premium increase of 15 percent for its 103,264 customers in Virginia, with a range of increases from 6.4 percent to 40 percent.

CareFirst is proposing a 64 percent increase for its approximately 4,500 customers in the commonwealth, citing an increase in sicker people entering the marketplace.

3218

I’m pretty sure the proper response to the health care crisis today is get the cheapest plan, pay the deductible, pay a bit on the giant, unpaid bill, then throw it away.

3219

Who could have imagined this would happen with the individual mandate repealed!? Apart from anyone who knows how insurance works, that is?

3220

“it’s unfair to have healthy people pay to subsidize sick people!”

“That’s literally how insurance works.”