Obamacare is the law of the land


The point is guys you can’t isolate one part of the system and fix it, you have to fix the entire system simultaneously, imo. And that’s hard to do.


I thought a lot of the newer recommendations for less screening were more to avoid treating cancers that wouldn’t necessarily be a problem. Essentially, if you detect an early stage cancer, the patient is going to freak out and want it gone. However, in many cases that cancer either will actually be handled by your body or is growing so slowly that it won’t actually be fatal in your lifetime. But now you’ve treated it and you’re stuck with side effects for life.


Right. There’s the question of what screenings improve survival or just diagnose.

But another important consideration for radiology testing is the harm done by the mammograms themselves. Starting at 40 every year will pose a small but not insignificant risk of a mammogram-induced cancer in the woman lifetime vs the risk of developing such a cancer before age 50. The American Cancer Society has moved closer to these recommendations (although they still recommend annual from 45 to 55, and biannual from then).

But I brought the previous study up because that’s the one the Spanish system actually uses to establish guidelines. I just wanted to point out those are indeed US recommendations adopted by at least one European public health system.


Yes, that’s another consideration, known as “overdiagnosis”. It applies more to older women, in whom cancer is more common but less aggressive than younger women.

But it’s true that treatment can not only be futile, but in some cases unnecessary. Especially if a woman is elderly and likely to die of some other disease. Again, try to imagine the response when a doctor tells your mother that a mammogram would be a waste of time given her life expectancy.


It’s why those body-imaging centers are such a scam. You hear those advertisements on the radio all the time. But if you do a full PET scan of an average person, there’s always going to be something weird, which inevitability will cause even more and more testing, which is the entire point of those ads. Rake in those insurance/medicaid dollars.


I’m not talking specifically about the boot. There’s no doubt that doctors are better paid in the US than elsewhere in the developed world, so there’s no doubt that as a general statement all doctors are contributing to the problem of higher costs.

I think this is a distraction. Isn’t it a fact that the individual screening tests cost more in the US regardless of how more or less frequently they are recommended? If anything, more frequent screens ought to drive down the cost of each screening; yet it doesn’t.


Not necessarily, there’s also a supply and demand issue (although I doubt its at play here). If you screen too often, you strain resources and access to them could become more expensive.


I was specifically talking about the doctor’s retail operations versus online retail operations. Which is distinct from salary. If you didn’t want to talk about retail operations, then I’m not sure why you replied to me.

It indicates differences in medical approaches of the US and other countries, which is partially rooted in different patient expectations. More testing means more health care spending. If you think that’s a distraction, then you’re not really interested in comparing medical systems as much as finding a scapegoat. As Endigm pointed out, this is a complex, multifaceted problem.

Individual exam costs also differ, but Americans are early adopters of expensive technology in the hope of improving detection and treatment. For example, digital mammography. And again that is driven partially by patient expectations.


I am not really following the current thread path but I just wanted to bitch somewhere. I have a medical condition that has existed since birth, it regards my feet. How does it make sense that every time I want a new pair of shoes I have to get a new prescription? So my $400+ shoes get more expensive because I need to see a freakin doctor first.


I replied to your explicit comparison of those two operations with other conventional non-medical retail operations (specifically shoes, I think) because I don’t think the two are analagous, for stated reasons.

Yes, in a conversation about whether medical prices are too high, I think a discussion about overprescribing services is a distraction. Call me crazy.


With all the admittedly awful things that are part of healthcare system in the US, it was really hopefully to see Ken Burn’s terrific documentary on the Mayo Clinic. It is only 2 hours which is short of Burn documentary, but has the same quality as the rest of his work.

Obviously, the Mayo Clinic with its world wide reputation, attracts the best doctors and nurse which helps patient outcomes. Still I came away that if some how we figure out a way of copying best practice from the Clinic we have a real chance of making healthcare better in the country, and maybe even cheaper.


I got health care at the Mayo Clinic for 9 years thanks to an exceptional work-related health insurance plan. The quality of the services was very good, but the cost was outrageous. As a general rule, it’s rich person’s health care.


It was described in the documentary as a Robin Hood system, they soak the rich in order to subsidize the poor people who can’t pay. It would be interesting to see average cost per patient. Although since Mayo tends to specialist in hard cases, maybe that isn’t a great comparison.


That’s certainly possible. Medical pricing is so opaque to the consumer you really can’t tell.


Mayo is kind of amazing. As far as costs, who fucking knows anymore. One of the good things about living around here is that if things are bad you can go to Mayo and maybe have a chance.


If you can get in and if your insurance covers it. I know people who Mayo would not see because they have some odd system of needing a doctor who knows you and agrees to see you in order for you to get in the system to see anyone else.


So you don’t have to, NPR has kindly picked out the most notable falsehoods:

Not that I think either piece is likely to change many minds. But who knows, maybe there are a few voters out there willing to actually think about the merits of health care policy rather than just going with knee-jerk “big government bad” reactions.

Edit: Also here’s the USA Today’s own page of reactions:


And multitudes of other things. So many things. Shitloads of things.


He’s the best at not knowing things. Truly tremendous at ignorance. People are calling him the don of incomprehension. They are saying he may be the best of all time at being the worst of all time. It’s true. It’s true.


Lifehacker has a nice little summary of the political spin being put on support for pre-existing conditions.

Not much new info here for this crowd, but might be worth sharing to your less-informed acquaintances.