Many of our experiences with the medical system confirm this article, e.g. the kid’s seriously sprained finger’s splint upgraded to a full-arm splint in the bill to the insurance company, which we accidentally saw. One of our neighbors works in the billing department of the Gargantuan For Profit Health Care company that did that and said that fraud is standard.
25% of medical costs are paying for the administrative overhead in hospitals and insurers. I think there is no way to estimate how much the upcoding costs, 3% cited in the article is surely far too low. I read about another federal case against overbilling Medicare every few months, often $1B in overbilling. That seems to be the threshold for detection, in fact.
Another large percentage is a result of medicine’s inherent conflict of interest in recommending treatments and the few alternatives. One of our family’s members had a fairly serious medical problem following a surgery that ended up requiring an ER visit, followed by 2 days in the hospital. I am convinced that a proper medical record system would have noticed that the individual was prone to exactly that problem under that circumstance, and would have prescribed more frequent blood tests to monitor the situation. That is a cheap blood test, maybe $50, and it might have taken 5 of them, one every morning and evening for the few days after surgery. Treatment would have been $250 worth of IVs. Those are what they ultimately did, but so expensively.
Those IVs could have easily been done by my MD of 15 years ago, who provided them to correct the original problem, but was driven out of business by the medical establishment. He was the last competition to the ER and the hospital, so $500 became $10,000, or however much the hospital ultimately bills the insurance company.
All of the standard procedures in hospitals increase costs, e.g. in the ER they were putting an IV in one arm at the same time they were drawing blood from the other. It wasn’t that kind of emergency, where seconds were essential, but ERs can’t know that and must assume the worst. Costs follow the assumptions. And assumptions and standard procedures follow the money flow.
The medical system routinely performs miracles, no question. No question, medical people are the best and the brightest, trained to the highest standards. Also, no question, the medical profession as a whole is in a conflict of interest position, and individual practitioners the same. The system has massively consolidated and fuzzed responsibility as it has done so.
The current ‘health care system’ cannot be reformed, obviously. It must be ended. We are doing all this to ourselves, it will continue until we stop supporting this model of health care.
Meanwhile, we all suffer because medical costs continue to climb far past the rate of inflation, now also getting out of control, and the effectiveness of the overall system continues to decline, e.g. our death rates are going up, autism rates continue to climb, we don’t have effective antibiotics for bacteria killing more and more people, along with minor stuff like the obesity epidemic. It isn’t a health care system, it is a disease treatment system.
It isn’t any individual player that produces those perverse consequences, the people MDs depend upon for their livelihood dying like flies, it is the structure and incentives within the structure and the cash flow. More or less money from Washington can only have a local and short-term positive effect, but make a bad system larger and more powerful the year after that. End the licensing boards, end the regulations of who can do what, why and how. Begin again with a clean slate and let people and their internet sort it all out. We will anyway, this system can’t be sustained, people are already overloading the ERs. That can’t last.
I predict that the first changes will come from foreign MDs dealing with patients via video and a local nurse, sending orders for blood tests to cut-rate labs here in the US or from across the border in Mexico, and prescriptions to an international pharmacy, delivered by US mail. I bet that is already happening within Mexico’s diaspora, maybe Philippines. I know there are MDs trained overseas practicing in the US as acupuncturists, herbalists, … who treat their fellow nationals. No doubt their treatments go past what is legal, ditto international pharmacies. :
This is an excellent summary of the state of play, Stasis Quo + minions and dependents vs the rest of us. The methods to use in providing collective intelligence is the key issue :
I am reading and re-reading Jordan Greenhall’s writings. This next one I had linked to before. Reading it this time, I am struck by how our individual minds map meaning onto his words. Mine, of course, are not different words than his, nor used differently, so the critique applies to me. Surely I will find some reason to prefer mine as I write this.
My view is that his explanation assumes as much as it explains, and in the assumptions lie all of the meaning. The assumptions are put there by education, culture, … but have received relatively little critical thinking, at least among the chattering classes. Some philosophers are far more critical than I can be.
For example, the movement of rural people into urban settings supposedly is a cause of a change in the zeitgeist. Of course, a different people left the farm than the ones that stayed. Were they pent-up zeitgeist waiting their chance? Many, many changes were happening at the same time, e.g. increasing population, pressure on housing and good farm land that could produce enough to sustain a family at a price they could afford, need for manufacturing labor, immigrant and their lands of origin, local vs global economic conditions, the first generation coming back from the West, …
That vagueness extends into everything, anger has many varieties, there are as many shades of meaning of ‘mother’ as their are ways of being a mother. Very different than F = ma.
Even in physics and chemistry, causes and effects are a syncytium. The concept that some cause produces some effect is solid in physical science, gets fuzzy in the higher levels of physiology of organisms, and in ecological and human social spheres is mere analogy, but it is the basis of all of our explanations in human affairs.
I don’t have a better alternative, agree that our communal understanding is the basis of civilization. But our explanations cannot be precise enough to guide our actions in these areas, a fundamental reason that policies are a bad idea.
Still, interesting reading :
Restating the obvious, reminding everyone of the facts, keeping the memes alive that are needed for protecting everyone’s interests, is a vital service, but I am getting tired of reading and writing the themes and variations, endless examples. One more time :
Ideology does not and cannot work because words are not reality, words and the mental models they represent must be less precise than the things we attempt to describe and understand with them, all of which are interconnected in ways we cannot know and driven by forces we do not know, all in fractile dimensions. Consequently, human reasoning is far from reliable in producing plans, and thus we can best (least costly, fastest, exploration of alternatives) evolve into futures we create with actual living and working. Centralization is destroying that natural evolution, the forced direction of evolution in centralized systems is in methods of gaming the system, exploring the edges of fraud :
Yes, we have to hold ourselves to high standards, otherwise the system stops working. As it has :
There is a discontinuity of thinking in these, it seems to me, wrt the Saudis being the Wahabis that the Arab Spring supposedly having pressure applied for DC-London’s benefit. Meyssan is an inside observer, so the overall picture fits with some of the other things I have read. But Meyssan presents a very different view of the divisions and forces within the supposedly anti-ISIS coalition as compared to any other I have seen. It is also another view of Trump’s administration, its cooperation with Russia and Iran to end the ME wars.
I linked to the third of these a few days ago, further evidence that very little of the reality of the situation in Syria has filtered into general discussion :
We are responsible for very many deaths and hungry people in Yemen. I am not aware of any interest among my fellow citizens which could justify that :
Escalation of politics in the Deep State :
Paul Kersey seems like an interesting author, from this review. It is another of the many books I would like to read, but who has the time? :
Brains make a difference in mortality rates. Who could have guessed? :
My take on this is that any system with rules can be gamed, and the financial system is the ultimate gamer. No subsidies, no taxes, … and we can know what things cost and be able to plan. Otherwise, not so much :
Finally Congress gets around to following its constitutional role in declaring war. Why just now? None of the wars have been based on any reality, e.g. ISIS is entirely a US-Saudi-Israeli creation, a tool to collapse Syria so the Saudis could put a pipeline through Syria and thus compete with Russian gas in Europe :
Yes, you can’t describe our political system as just Left Right any more, but you never could. The Libertarians’ formulation has always been a first dimension of Freedom vs Authoritarian and a 2nd dimension of social conservative vs social liberal. Those are the minimum number of dimensions needed to even have a discussion, it is easy to add more, e.g. sexual liberation vs traditional religious values. Even that is too simple, and the article discusses many other dimensions to the Trump vs non-Trump supporters.
Left vs Right, with the right being fascist in tendency, has been propaganda as long as I have understood anything about politics. The Left can be and has been fascist also, they just call it something else.
I supported Trump, as many did, because he was the least evil, as Clinton is a criminal, a war criminal and a war monger, representative of the Deep State and the Israeli-Neocons. The article didn’t discuss any of those dimensions :
This is fun. Parrots acting like people :