Wednesday, January 15, 2014
Miscellaneous 175
1) According to a recent study from the University of Virginia, surgical patients on Medicaid were 97% more likely to die prior to discharge than privately insured patients were and 13% more likely to die prior to discharge than patients who didn't have any insurance at all. And, yes, this study DID control for intervening variables such as age, income, geography, surgical procedure, and prior health status. Wow, I guess that there really is a difference between "coverage" and actual healthcare.............2) According to a recent survey from the California Medical Association, 70% of California doctors WILL NOT participate in the Obamacare exchanges this year. Another survey by the New York State Medical Society says that 44% of the physicians in that state will also NOT participate in these exchanges. These are obviously troubling statistics and hopefully these doctors will reconsider.............3) According to a survey from the American Academy of Family Physicians, 19% of the doctors in this country are refusing to accept new Medicare patients and 33% of them are refusing to accept new Medicaid patients. Talk about yet another piss-poor situation and I don't even want to think about what it's going to do to emergency rooms.............4) Oh, and get a load of this one. According to Internal Medicine News, Medi-Cal (the Medicaid agency of California) is currently paying physicians in that state $18-24 a visit. $18-24 A VISIT!!!!! Yowza, huh? And then they wonder why these physicians aren't accepting the damn shit.
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13 comments:
I read the Politifact piece, asshole, and this is what it said - "The U.Va. study, published in 2010, considered how surgical patients fared during their hospitalization based on whether they had private insurance, Medicare, Medicaid or were uninsured. The researchers looked at almost 900,000 major operations across the country and adjusted for many population and health care variables, including age, income, region, type of hospital, type of operation and other health factors.
Even after adjusting for all those things, the payer was still a predictor of poorer outcomes," Dr. Gorav Ailawadi, one of the authors of the paper, told us.
The patients covered by Medicaid had the highest risk. They were 1.97 times more likely to die in the hospital than those with private insurance. Compared to the privately insured, Medicare recipients were 1.54 times more likely to die in the hospital and uninsured patients were 1.74 times more likely.
With adjustments, Medicaid patients also had the longest hospital stays and greatest total costs."......Yeah, there could be other intervening variables but the fact that they controlled for the most obvious ones led me to give this particular study credence. That and the fact that it substantiates numerous other studies none of which give Medicaid patients a better outcome and most of which say that it's worse than nothing. My background, a-hole, is in research and I don't need a moron like you to tell how to decipher statistics.
Do we need to guess who that was directed at?
Yeah, the industry has trouble with Medicare. My wife and I get
an annual 'free' checkup, which seems like a good idea for old folk. This year, the bill came to
$165 for the two of us, the cost
beyond medicare and our supplement
(which costs $2400 a year and has yet to pay a penny). The clinic
bill itself is an accountant's dream; transfers, deductibles, negative entries. Every year I call the clinic business office to
cut the crap and find out exactly
what I was billed for. Of course
we have no doctor: we have a nurse practitioner and I'm sort of glad...they will actually spend some time with a patient.
It seems some doctors even have
problems with the insurance company not paying what the doctor billed. I may take your advice, Will, and stop in Singapore next year for a physical. Too many fat fingers
in a skinny pie here, IMO.
The authors are to conclude what they wish to but so, too, am I, and I DID mention the possibility of other intervening variables so fuck off, wd.......As for my theory pertaining to these crappy outcomes and eventualities, there is a stigma to being on Medicaid and it is entirely possible that providers on an unconscious level give to these people lesser adequate care. I also think that the people with no insurance at all are probably taking better care of themselves and so they also might have a much better chance to do well after a surgery. If America adopted the Singapore model both of these issues would undoubtedly go away.
No, Russ, no need for guesswork here.......BB, what I like about the Singapore model is that it not only reduces the role of government it also reduces the role of these pesky insurance companies (leaving them to cover what insurance was initially started for; emergencies).
We had a family member who had stage 4 colon cancer.....he applied for disability and was approved quickly.Two years later he went on Medicaid,now he also had a supplement.From what I know he received the absolute best care possible....surgery,chemo,radiation,cyberknife.He was in his early 40's,perhaps if he was older it may have been a different story.
I didn't mean to imply that all Medicaid patients receive lousy care (and I'm glad for your family member's recovery), just that on average it doesn't seem to be the case.
Actually Will,I was quite surprised how Medicaid covered his treatment.I would guess age has some bearing on what they approve.
You may not agree with this,but I strongly believe the medical community really doesn't want a cure for cancer....too much money involved in the treatment.
The biggest problem with Medicaid moving forward is the fact that nearly a third of doctors are refusing to accept it and then these folks have to go to the emergency room for a head cold and the taxpayers get thoroughly gouged a grand a pop.......I really think that there is a big market opportunity here for private clinics run by nurse practitioners, RNs, and physicians assistants to start popping up in places like Walgreens, CVS, Walmart, Target, etc..
http://mycpf.cpf.gov.sg/CPF/my-cpf/Healthcare/PvdHC3.htm (straight from the Singapore government) - Again, it sounds a real lot like health savings accounts to me..............And, yes, the prices are in fact quite incredible. A heart bypass operation in the U.S. - $127,000. That same operation in Singapore - $22,000.
Will said...."The biggest problem with Medicaid moving forward..."
So, what do you think of the extreme lunacy of those who insist on Medicaid for all? As with all such efforts, the goal has nothing to do with healthcare, and everything to do with giving more and more power to the most powerful.
Anyway, how would you like everyone in this nation to have a plan that one/third of doctors refuse to deal with?
Will also said: " A heart bypass operation in the U.S. - $127,000. That same operation in Singapore - $22,000."
Easy to see a possibility of immediate health savings. A round trip to Singapore for this surgery for an American still costs one-fifth of the US cost.
Will said: "I read the Politifact piece, asshole"
You need to learn as I have when someone sends you 2,000+ words of lies per day, just look at the name and send to spam.
I normally do but on the smaller missives it's difficult sometimes not to get the gist. I guess that I'm just going to have to try a little harder.
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