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Because your sources aren't proving what you think they do. The Oregon trial was only two years long and it actually did report some health improvements, diabe

by vilmosi 10y ago

Because your sources aren't proving what you think they do. The Oregon trial was only two years long and it actually did report some health improvements, diabetes and depression in particular. It also found improvements across a lot of other medical issues, they were just considered statistically insignificant (given it was only two years, not really a surprise). The RAND experiment found that money does reduce unnecessary medical treatment (and therefore reduces costs). But it also found that it reduced necessary treatment too. I agree that the exact numbers and costs are controversial, but basically everyone aggress that it improves the quality of life for everyone. And even if preventing disease is costlier, isn't better that fewer people get a serious disease in the end?! Also, here's a study that supports preventative care. There's many more if you just look for it. http://www.medscape.com/viewarticle/735245 http://www.medscape.com/viewarticle/735245

yummyfajitas 10y ago
The Oregon trial had no effect on diabetes. It caused people to consume more diabetes medication which the authors speculate might make them healthier. You are correct that having insurance made people feel better. So what? It also found improvements across a lot of other medical issues, they were just considered statistically insignificant... And you've just demonstrated that you have goals here other than finding truth, or perhaps you just don't understand hypothesis testing. Your medscape article is just a press release parroted by some innumerate reporter. Further, the article is focused on stuff like "stop smoking" and "stop drinking" support, not medical interventions. The full study isn't even linked.
- vilmosi 10y ago
  >>> The Oregon trial had no effect on diabetes. It caused people to consume more diabetes medication which the authors speculate might make them healthier. It increased the rate of diagnosis of diabetes. And what do you mean speculate? What's the point of giving medication if it doesn't help? >>> You are correct that having insurance made people feel better. So what? Treating depression is part of healthcare. >>> And you've just demonstrated that you have goals here other than finding truth I don't think so. I just thought it's an interesting observation. Combined with the fact that it was a short term experiment it makes one think. But you're right, it's not significant. >>> "stop smoking" and "stop drinking" support, not medical interventions Stopping smoking and drinking is part of healthcare. At least in the UK. Perhaps you don't think preventive care works because you don't think improving ones wellness is part of it? Why are insurance companies including preventative care in their packages if it actually costs them money? Here's a study that found a list of preventative measures that do save money: vaccinating children and adults, smoking cessation, daily use of aspirin, and screening for issues with alcoholism, obesity, and vision failure. http://www.nejm.org/doi/full/10.1056/NEJMp0708558#t=article http://www.nejm.org/doi/full/10.1056/NEJMp0708558#t=article But you're right. In part. Other preventative measures do not save money. Like preventing heart attacks by treating hypertension early on with drugs did not save money in the long run. It's more cost effective to let people have heart attacks. But at least the insurance company saves a few bucks (rolls eyes).
  - yummyfajitas 10y ago
    And what do you mean speculate? What's the point of giving medication if it doesn't help? By "speculate" I mean it didn't demonstrably improve health, but the authors speculate that maybe it will later. Stopping smoking and drinking is part of healthcare. At least in the UK. Try to follow the discussion. We were originally discussing the statement "You have a concern - you go to the doctor". andreasklinger proposed that this is why EU medical systems are cheaper. https://news.ycombinator.com/item?id=12331398 https://news.ycombinator.com/item?id=12331398 Your own source - a political op-ed published in a medical journal, disagrees with this claim: Our findings suggest that the broad generalizations made by many presidential candidates can be misleading. These statements convey the message that substantial resources can be saved through prevention. Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not. The fact that obesity reduction might improve health is great, but totally unrelated to the topic at hand. Telling people to stop smoking and being obese != "you have a concern - you go to the doctor". No one disputes that your health will go up if you eat right, exercise and stop smoking. You are arguing against a straw man. Also, your own source does not address the marginal question that I asked. I asked for evidence that "providing more preventative care will either save money or make people healthier". Your article says: In addition to determining which preventive measures and treatments are most efficient, it will be necessary to identify those that are not yet fully deployed and those that could serve a large population and bring about substantial aggregate improvements in health at an acceptable cost. Findings that some cost-saving or highly efficient measures are underused would indicate that current practice is inconsistent with the efficient delivery of health care. Other services might be identified as overused, and such findings would underscore the importance of fashioning policies that provide incentives to shift practice toward more cost-effective delivery of health care. Your article says we need to carefully target which interventions are worthwhile, cut the ones that aren't, and refocus on the underused ones that are. That's not disagreeing with me at all!
    - vilmosi 10y ago
      >>> By "speculate" I mean it didn't demonstrably improve health, but the authors speculate that maybe it will later. It's a fair assumption. Treating an illness with the approved medicine that worked well in the past tends to work in the future too. It takes a lot of mental gymnastics to dismiss both increased diagnoses and treatment as anything but conclusive. >>> Try to follow the discussion. We were originally discussing the statement "You have a concern - you go to the doctor" It doesn't matter what the original point is, I was strictly replying to what you said, with quotes. Are you following? >>> Your own source - a political op-ed published in a medical journal, disagrees with this claim: The quote you posted really isn't. It says some save money, some don't. I gave examples what the study found to be cost effective, while the majority were not. Sometimes the answer is not black and white. >>> Telling people to stop smoking and being obese != "you have a concern - you go to the doctor". Isn't? Free-at-the-point-of-use obviously does increase usage of services, meaning people will be told to stop smoking more often. Those two concept are directly linked. >>> Your article says we need to carefully target which interventions are worthwhile, cut the ones that aren't, and refocus on the underused ones that are. That's not disagreeing with me at all! Again, isn't? It clearly says some interventions are worthwhile and some not. So let me get me straight, you think that if giving away nicotine replacement drugs is costing more money than cancer treatment, we should stop telling people to stop smoking?

by vilmosi 10y ago

yummyfajitas 10y ago

The Oregon trial had no effect on diabetes. It caused people to consume more diabetes medication which the authors speculate might make them healthier. You are correct that having insurance made people feel better. So what? It also found improvements across a lot of other medical issues, they were just considered statistically insignificant... And you've just demonstrated that you have goals here other than finding truth, or perhaps you just don't understand hypothesis testing. Your medscape article is just a press release parroted by some innumerate reporter. Further, the article is focused on stuff like "stop smoking" and "stop drinking" support, not medical interventions. The full study isn't even linked.

vilmosi 10y ago
>>> The Oregon trial had no effect on diabetes. It caused people to consume more diabetes medication which the authors speculate might make them healthier. It increased the rate of diagnosis of diabetes. And what do you mean speculate? What's the point of giving medication if it doesn't help? >>> You are correct that having insurance made people feel better. So what? Treating depression is part of healthcare. >>> And you've just demonstrated that you have goals here other than finding truth I don't think so. I just thought it's an interesting observation. Combined with the fact that it was a short term experiment it makes one think. But you're right, it's not significant. >>> "stop smoking" and "stop drinking" support, not medical interventions Stopping smoking and drinking is part of healthcare. At least in the UK. Perhaps you don't think preventive care works because you don't think improving ones wellness is part of it? Why are insurance companies including preventative care in their packages if it actually costs them money? Here's a study that found a list of preventative measures that do save money: vaccinating children and adults, smoking cessation, daily use of aspirin, and screening for issues with alcoholism, obesity, and vision failure. http://www.nejm.org/doi/full/10.1056/NEJMp0708558#t=article http://www.nejm.org/doi/full/10.1056/NEJMp0708558#t=article But you're right. In part. Other preventative measures do not save money. Like preventing heart attacks by treating hypertension early on with drugs did not save money in the long run. It's more cost effective to let people have heart attacks. But at least the insurance company saves a few bucks (rolls eyes).
- yummyfajitas 10y ago
  And what do you mean speculate? What's the point of giving medication if it doesn't help? By "speculate" I mean it didn't demonstrably improve health, but the authors speculate that maybe it will later. Stopping smoking and drinking is part of healthcare. At least in the UK. Try to follow the discussion. We were originally discussing the statement "You have a concern - you go to the doctor". andreasklinger proposed that this is why EU medical systems are cheaper. https://news.ycombinator.com/item?id=12331398 https://news.ycombinator.com/item?id=12331398 Your own source - a political op-ed published in a medical journal, disagrees with this claim: Our findings suggest that the broad generalizations made by many presidential candidates can be misleading. These statements convey the message that substantial resources can be saved through prevention. Although some preventive measures do save money, the vast majority reviewed in the health economics literature do not. The fact that obesity reduction might improve health is great, but totally unrelated to the topic at hand. Telling people to stop smoking and being obese != "you have a concern - you go to the doctor". No one disputes that your health will go up if you eat right, exercise and stop smoking. You are arguing against a straw man. Also, your own source does not address the marginal question that I asked. I asked for evidence that "providing more preventative care will either save money or make people healthier". Your article says: In addition to determining which preventive measures and treatments are most efficient, it will be necessary to identify those that are not yet fully deployed and those that could serve a large population and bring about substantial aggregate improvements in health at an acceptable cost. Findings that some cost-saving or highly efficient measures are underused would indicate that current practice is inconsistent with the efficient delivery of health care. Other services might be identified as overused, and such findings would underscore the importance of fashioning policies that provide incentives to shift practice toward more cost-effective delivery of health care. Your article says we need to carefully target which interventions are worthwhile, cut the ones that aren't, and refocus on the underused ones that are. That's not disagreeing with me at all!
  - vilmosi 10y ago
    >>> By "speculate" I mean it didn't demonstrably improve health, but the authors speculate that maybe it will later. It's a fair assumption. Treating an illness with the approved medicine that worked well in the past tends to work in the future too. It takes a lot of mental gymnastics to dismiss both increased diagnoses and treatment as anything but conclusive. >>> Try to follow the discussion. We were originally discussing the statement "You have a concern - you go to the doctor" It doesn't matter what the original point is, I was strictly replying to what you said, with quotes. Are you following? >>> Your own source - a political op-ed published in a medical journal, disagrees with this claim: The quote you posted really isn't. It says some save money, some don't. I gave examples what the study found to be cost effective, while the majority were not. Sometimes the answer is not black and white. >>> Telling people to stop smoking and being obese != "you have a concern - you go to the doctor". Isn't? Free-at-the-point-of-use obviously does increase usage of services, meaning people will be told to stop smoking more often. Those two concept are directly linked. >>> Your article says we need to carefully target which interventions are worthwhile, cut the ones that aren't, and refocus on the underused ones that are. That's not disagreeing with me at all! Again, isn't? It clearly says some interventions are worthwhile and some not. So let me get me straight, you think that if giving away nicotine replacement drugs is costing more money than cancer treatment, we should stop telling people to stop smoking?