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Thread: Health care law may mean less hiring in 2013

  1. #141
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    Re: Health care law may mean less hiring in 2013

    Quote Originally Posted by buck View Post
    So they aren't investing their resources in really helping the patients with techonology, instead investing in a big and bloated bureaucracy? No wonder the left loves them so much.
    Or we're heavily invested in revenue producing healthcare, rather than results orientated healthcare.

    Unnecessary tests and procedures are just another reason why medical care in the U.S. keeps skyrocketing.

    Since MRI scans cost about $2,000 each, their overuse and misuse wastes health care dollars, medical researchers said. “Too often, people try to use the MRI to make a diagnosis,” said Dr. John Froymeyer, director of the McClure Musculoskeletal Research Center at the University of Vermont. “It misleads you often enough that you perform unnecessary surgery, and the results are not very good.”

    Moreover, Dr. Froymeyer said Americans have almost 10 times more spinal disc operations than people in other Western countries, far more neurosurgeons and orthopedic surgeons, and many times more MRI machines. For example, he said, there are more MRI machines in Boston than in all of Canada. Dr. Boyd attributed overuse of MRI's to “insecurity, threat of lawsuits, inexperience and the potential for economic gain.”

    MRIs dont tell
    The reality, however, is that an MRI is nothing more than a picture–one of the most detailed pictures available…but nonetheless just a picture. By revealing details of every nook and cranny of your spine–most if not all of which will have no relevance to your immediate problem–MRIs have a tendency to add to rather than lessen, the confusion of getting an accurate diagnosis. The more detail, the more confusion over what any of it means. For that reason, the MRI is useful only to the degree with which it correlates with other pieces of the puzzle (e.g. symptom details, physical examination findings, and results of other tests). It is no better at providing a definitive answer than is opening up the hood of your car when you hear it making a funny sound. After all, you’re almost guaranteed to find a grimy engine block, a frayed fan belt, a missing oil cap, maybe some smoke around the radiator or any number of other “abnormalities,” but in and of themselves, these things don’t mean much and may have nothing to do with the sound. In fact, they do little more than prompt the same question that most findings on a spine MRI should: “OK, so what?”

    MRI for Back Pain? You Might Want to Think Twice About That… |

    MRIs More Likely To Be Negative When The Doctor Profits : Shots - Health News : NPR

    Doctors: Chill With All the MRIs, EKGs - With so much unnecessary testing, doctors try to rein in excess

    Are MRIs Overused? - Diagnostic Imaging

    http://www.nytimes.com/2011/10/29/he...anted=all&_r=0

    MRI overuse is widespread, and dangerous to patients

    Medscape: Medscape Access
    “We just simply don’t know how to govern” - Rep. Steve Womack (R-AR) a member of the House Budget Committee

  2. #142
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    Re: Health care law may mean less hiring in 2013

    Quote Originally Posted by BWG View Post
    Or we're heavily invested in revenue producing healthcare, rather than results orientated healthcare.
    I have no doubt that Dr's do order unecessary tests for alot of reasons, one of which is defensive medicine. But, I would guess that one of the problem with your point, is that Dr.s in NHS systems are still sending their patients to have MRIs. It's just that those wait times for the MRI are much-much higher there then here. High enough that it could b ecosting lives.

    NHS waiting time increases may cost lives, doctors warn | Society | The Guardian

    By comparison, I had my MRI just a few days after being told by my MD to get one.

    But, the MRI was really just one of countless such examples.

    NHS data shows that while in May 2010, 337 patients had waited beyond six weeks for a colonoscopy, that had risen to 2,313 in May this year. Similarly, the number waiting past six weeks for flexible sigmoidoscopy has jumped from 87 to 1,199, and those waiting for echocardiography from 574 to 2,034 over the same period.
    As further comparison, I was able to schedule my echo within 2 days.

    What I will say, thoguh, is I do like that the MRI/Echo/etc are not performed at my MD's office. Instead, I am sent to a separate and independent location for my tests. I do prefer this to having the test right in the MD's office (Like my old doctor) as I can see the potential for abuse.
    Last edited by buck; 01-10-13 at 02:36 PM.

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    Re: Health care law may mean less hiring in 2013

    Quote Originally Posted by BWG View Post
    Or we're heavily invested in revenue producing healthcare, rather than results orientated healthcare.

    Unnecessary tests and procedures are just another reason why medical care in the U.S. keeps skyrocketing.
    In those cases you describe I think it safe to say that there is a third party involved between the doctor and the patient. Whenever that happens, costs go up. Of course it will go up even more when the government pays for everyone. Any idea that money will be saved, or quality maintained, is an illusion.

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    Re: Health care law may mean less hiring in 2013

    Quote Originally Posted by Grant View Post
    In those cases you describe I think it safe to say that there is a third party involved between the doctor and the patient. Whenever that happens, costs go up. Of course it will go up even more when the government pays for everyone. Any idea that money will be saved, or quality maintained, is an illusion.
    No, the unnecessary test were and are a bigger problem where there is not a third party.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Health care law may mean less hiring in 2013

    Quote Originally Posted by Boo Radley View Post
    No, the unnecessary test were and are a bigger problem where there is not a third party.
    Do you have any evidence at all to support this claim?

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    Re: Health care law may mean less hiring in 2013

    Quote Originally Posted by Grant View Post
    Do you have any evidence at all to support this claim?
    Well, I know the history, but later when I get to a computer and have time, I'm sure something can be easily googled and Ill link it for you. It was once a huge problem.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Health care law may mean less hiring in 2013

    Quote Originally Posted by Boo Radley View Post
    No, the unnecessary test were and are a bigger problem where there is not a third party.
    How's that? Are Malpractice lawyers somehow outlawed in the PPACA or something? Oh no, that's right, it didn't address tort at all did it? Yeah, couldn't offend a Presidential constituency now could they?
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    Re: Health care law may mean less hiring in 2013

    Quote Originally Posted by j-mac View Post
    How's that? Are Malpractice lawyers somehow outlawed in the PPACA or something? Oh no, that's right, it didn't address tort at all did it? Yeah, couldn't offend a Presidential constituency now could they?
    They are a minor problem. See states with tort reform and notice how little it accomplished (odd how we have to over the same things).

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Health care law may mean less hiring in 2013

    Quote Originally Posted by Grant View Post
    Do you have any evidence at all to support this claim?
    The doctor-owned laboratories performed almost twice as many tests for each patient as other laboratories, at an average cost of $43 per patient compared with $20. Doctor-owned physical therapy centers typically scheduled more visits per patient but employed fewer licensed therapists.

    HEADLINERS - When Doctors Own Their Own Labs - NYTimes.com

    HCA, the largest for-profit hospital chain in the United States with 163 facilities, had uncovered evidence as far back as 2002 and as recently as late 2010 showing that some cardiologists at several of its hospitals in Florida were unable to justify many of the procedures they were performing. Those hospitals included the Cedars Medical Center in Miami, which the company no longer owns, and the Regional Medical Center Bayonet Point. In some cases, the doctors made misleading statements in medical records that made it appear the procedures were necessary, according to internal reports.

    http://www.nytimes.com/2012/08/07/bu...anted=all&_r=0

    The Congressional Budget Office has called the evidence of defensive medicine “not conclusive,” and summarized, “On the basis of existing studies and its own research, CBO believes that savings from reducing defensive medicine would be very small.”i Researchers at Dartmouth College echoed these conclusions, saying, “The fact that we see very little evidence of widespread physician exodus or dramatic increases in the use of defensive medicine in response to increases in state malpractice premiums places the more dire predictions of malpractice alarmists in doubt.”ii

    (snip)

    The GAO has also found that doctors may actually practice “defensively” because it generates more income. They identified “revenue-enhancing motives” as one of the real reasons behind the utilization of extra diagnostic tests and procedures.vi In Florida, health authorities determined diagnostic-imaging centers and clinical labs were ordering additional tests because the majority were physician-owned and the tests provided a lucrative stream of income. Federal law now prohibits the referral of Medicare patients to certain physician-owned facilities, many of which charge double the amount in lab fees.vii As Mello and colleagues commented, “In medicine practiced as a business, defensive medicine is understood and may even be profitable.”viii

    The Truth About


    ANd this is with laws in place to limit such things. It was even a larger problem in the past.

    AUSTAN GOOLSBEE: I think the world vests too much power, certainly in the president, probably in Washington in general for its influence on the economy, because most all of the economy has nothing to do with the government.

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    Re: Health care law may mean less hiring in 2013

    Quote Originally Posted by Boo Radley View Post
    The doctor-owned laboratories performed almost twice as many tests for each patient as other laboratories, at an average cost of $43 per patient compared with $20. Doctor-owned physical therapy centers typically scheduled more visits per patient but employed fewer licensed therapists.

    HEADLINERS - When Doctors Own Their Own Labs - NYTimes.com

    HCA, the largest for-profit hospital chain in the United States with 163 facilities, had uncovered evidence as far back as 2002 and as recently as late 2010 showing that some cardiologists at several of its hospitals in Florida were unable to justify many of the procedures they were performing. Those hospitals included the Cedars Medical Center in Miami, which the company no longer owns, and the Regional Medical Center Bayonet Point. In some cases, the doctors made misleading statements in medical records that made it appear the procedures were necessary, according to internal reports.

    http://www.nytimes.com/2012/08/07/bu...anted=all&_r=0

    The Congressional Budget Office has called the evidence of defensive medicine “not conclusive,” and summarized, “On the basis of existing studies and its own research, CBO believes that savings from reducing defensive medicine would be very small.”i Researchers at Dartmouth College echoed these conclusions, saying, “The fact that we see very little evidence of widespread physician exodus or dramatic increases in the use of defensive medicine in response to increases in state malpractice premiums places the more dire predictions of malpractice alarmists in doubt.”ii

    (snip)

    The GAO has also found that doctors may actually practice “defensively” because it generates more income. They identified “revenue-enhancing motives” as one of the real reasons behind the utilization of extra diagnostic tests and procedures.vi In Florida, health authorities determined diagnostic-imaging centers and clinical labs were ordering additional tests because the majority were physician-owned and the tests provided a lucrative stream of income. Federal law now prohibits the referral of Medicare patients to certain physician-owned facilities, many of which charge double the amount in lab fees.vii As Mello and colleagues commented, “In medicine practiced as a business, defensive medicine is understood and may even be profitable.”viii

    The Truth About


    ANd this is with laws in place to limit such things. It was even a larger problem in the past.
    Who was paying for these procedures? Were they not covered by insurance of some sort?

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