Termite wrote:He told me that there is no one major problem; that the system is broken from top to bottom. And that one of the biggest problems is rampant greed, from all parties.
Yeah. Starting with patients, who seldom pay much if any of the cost for anything, and thus have no wild fucking clue what they're ordering from the menu.
Step one: Ban insurance, and post the prices for everything online.
Why?
Let's start simple.
Twenty years ago, Zofran was an anti-nausea drug used mainly for cancer chemotherapy patients, and cost Some Ridiculous Amount per dose. Then it was approved for anyone with nausea, because as it turns out, it's very effective, and generally has the fewest side affects for patients.
So for the historians in the audience, tell me please, how in blistering fuck we dealt with the millions of people annually who died from throwing up, shriveled up like raisins because they got a case of the shits because of the Food Court two-Step? There must be vast graveyards full of people who just puked and shit their guts out in the 1950s, '60s, and '70s, right? No? NO?!? You mean
that never happened?!?
So then WTH are there dozens of patients, every night, who line up in the ED everywhere, every night for the "medical emergency" of puking, sometimes all of ONE time???
Q:Take a guess what the average patient is paying for the "lifesaving" treatment of about $20 worth of Zofran, $10 worth (1 liter) of saline solution, and $15 worth of plastic syringes and tubing to deliver it?
A:$0-$50, and the mean is around $10.
Trick answer: you're also paying for your share of half an hour of my time($20-30) plus the cost to build, equip, and maintain this fabulous palace of modern medicine (call it $500, or 1/100,000 x $50M).
Q:So now, guess what the insurance company is paying for your $10-$50 visit?
A: Low-ball number, >$1000-$1500.
So, if you were told you had to spend $1500 of
your own money, or stay home and puke for 24 hours, and probably turn out the same either way in >90% of cases, which would you chose?
And if that shell hit too close to your foxhole, I urge you to man the fuck up and take it.
For instance: Doxycycline, a very common antibiotic, has seen prices skyrocket in the last few years. I don't mean double, triple, or quadruple. I mean 2500%-4000% increase. Why? Aesop? Anyone?
Link: Why generics cost so much
TL;dr answer:
Consolidation.Shortages. Collusion.Prices were too low to begin with. Because they can.
Termite wrote:But it's not just the drug companies; my doctor pays about $300 for a shingles vaccine for Medicare patients, and Medicare will only reimburse him about half of his cost. HALF.
He should thank his lucky stars. The usual Medicare reimbursement ratio is 2%.
So when the hospital bills Medicare $1500, they get $30. And it costs, even at fair market cost with no markup, $575.
Now guess why EDs and hospitals are closing, and doctors are getting out of practice.
Then ask me why your doctor or your parents' doctor isn't taking any more Medicare patients, and never will, and why no one not insane accepts ObamaCare insurance cards.
Then see if you can figure out why all those m*****f*****s end up in the ED, where because of EMTALA we
have to see everyone.
See if you can guess your wait time when everyone is in my ED, and you have a pain in your chest even bigger than the one in my ass, nightly, for the last 20 years.
Guess your outcome when it takes 4 hours to get to you before that magic time-to-cath-lab kicks in.
We are becoming Canada's health care system. QED
Dr. Johnson thinks the system will collapse in the next 10 years or so, and that America will wind up with a 2-tier health care system: independent private care for people who can pay for it, and rationed socialized health care for the masses.
We have that
now.
The thing is, the insurance card you've had since 2010 or 2012 is for
exactly that rationed socialized health care, unless you paid cash for your medical care across the board.
And now you're paying even
more, and getting
less and
worse care than you did before, to subsidize the drunks, junkies, illegal aliens and welfare queens - and their entire monstrous families, who never paid for anything, and never will.
Viva amnesty and affirmative action by any other name!
And if, to solve this problem, they told me I could kill any ten patients a night with no consequences, I would fight tooth and nail for 50 more slots each night. I couldn't solve the problem single-handedly, but I could make quite a dent if it were run as a nationwide trial for about 6 months.
Bonus slide: Guess how much time I waste each night treating people effed up by cigarettes and alcohol, and see if you can guess why I think there should be a death penalty for so much as advocating legalizing even
more drugs.
You want to make medical treatment a cash on the counter business for 100% of society
first, we can talk about "personal choice".
Currently the IRS has its head about two feet up my ass looking for the money to pay for those same people, and has since at least 1964.
Canada is merely being honest about telling the society "Fuck you, go die, eh?"
We've been sneaking up on the exact same damned thing for 50+ years, and telling enormous whoppers about it all along.
/rant #whymybackhurts
Double bonus "This-is-No-shit" slide:
Had a guy who was shot in his driveway by a drive-by gang banger 25 years ago, been a quadriplegic the entire time since as a result, and has recently developed Grand Canyon-sized non-healing ass sores that are going to turn septic and kill him - probably after a few $500,000@ trips to ICU - because government disability and medical assistance won't replace his broken quarter-century old 1990-era wheelchair, nor get him a bed any better than the 1" thick foam mattress one that
gave him the ass sores in the first place, after 24 years without any problems, won't cover any home health care
at all, nor let the hospital spot him - as our optional
charity gift - the required $75 (yes,
seventy-five whole dollars!) co-pay for a new bed that would prevent the sores in the first place.
What A Country!
Un-be-effing-lievable, and I saw it with my own eyes.
"There are four types of homicide: felonious, accidental, justifiable, and praiseworthy." -Ambrose Bierce, "The Devil's Dictionary"