6 ms·

I wouldn't expect it to be clear unless you've studied the area for awhile but all of those are external shocks to the marketplace. Healthcare expenses increas

by pg_bot 7y ago

I wouldn't expect it to be clear unless you've studied the area for awhile but all of those are external shocks to the marketplace. Healthcare expenses increase during wartime since you have to treat newly injured veterans. That statement basically can be interpreted as "people get injured on battlefields and it costs money to treat them".

tptacek 7y ago
First, once again: we have a nationalized health care system for injured veterans. They not only have a separate payer system but also a separate provider system. Second: I have followed health policy for quite awhile, and it's not clear to me at all what impact you believe your parenthetical callouts had on health costs.
- pg_bot 7y ago
  First: I know you're not stupid so I have no idea what you aren't understanding when it comes to veteran care costs increase during wartime. Of course they have a separate payer and provider system. That system is included in the growth rate statistics. It should be fairly obvious that people being regularly shot at have higher healthcare costs. Bankruptcy Law: In 2005 there were 2,000,000 bankruptcy filings, in 2006 there were 600,000. This was a result of the passing of the BAPCPA in 2005. At that point in time 46% of bankruptcies were due to medical bills. This change increased the expected value of delinquent accounts which in turn should lead to lower costs for medical services. Great Recession: People put off non-essential medical expenses, or delay usage of medical services. Someone who might get braces doesn't, someone might take care of a parent themselves instead of hiring an in-home nurse, etc. ACA Signed: Marker for before and after growth rates. ACA Taxes + Exchanges Open: The two main policies of the ACA intended to curb healthcare costs go into effect. I would classify these two years as overestimation of savings and regression to the mean. Most insurance companies had to backtrack after their financial projections did not materialize.
  - tptacek 7y ago
    No, I do not believe veteran health care is included in the statistics you are citing, and I am similarly dubious of your explanations for how each of those other 4 events impacted health care costs, because everything I've read suggests that the impacts are way more complicated than they look (for instance, much of the health cost impact from the "Great Recession" wasn't felt until years after).
    - pg_bot 7y ago
      Here's the dataset that I'm referencing.[0] From the summary documents, "DOD spending in the NHEA excludes spending that occurs outside of the United States." I'm not certain whether this does or does not include forward operating bases. (Post offices count those as being in the United States so I believe they are included; but I could be wrong) Nevertheless it does include domestic spending on veterans. Also, many veterans get care outside the VA. From my own experience working with these people, they cite long waiting times or broken relationships with the government for not wanting to take part in that system. I'm not trying to downplay the complexity of the healthcare market, it's really complex. However, it I were to pick the things the government had control over and impacted the marketplace the most over the last 15 years, I still would pick the same things I did. I could fill several books with other changes that impacted the cost of American healthcare. (switching to e-prescriptions, subsidies for electronic medical records, medicare part D, certificate of need laws, FSA changes, HSA changes, consolidation of pharmacy benefit managers, health system consolidation, the opioid epidemic, the rise of the physicians's assistant, the expanding role of nurse practitioners, etc.) I'd rather spend my time continuing fixing the things I know I can make better. [0]: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...
      - tptacek 7y ago
        Can you give me a deeper link to the specific data from which you drew the table you posted above? There's a lot of stuff hanging off the link you just posted.

by pg_bot 7y ago

tptacek 7y ago

First, once again: we have a nationalized health care system for injured veterans. They not only have a separate payer system but also a separate provider system. Second: I have followed health policy for quite awhile, and it's not clear to me at all what impact you believe your parenthetical callouts had on health costs.

pg_bot 7y ago
First: I know you're not stupid so I have no idea what you aren't understanding when it comes to veteran care costs increase during wartime. Of course they have a separate payer and provider system. That system is included in the growth rate statistics. It should be fairly obvious that people being regularly shot at have higher healthcare costs. Bankruptcy Law: In 2005 there were 2,000,000 bankruptcy filings, in 2006 there were 600,000. This was a result of the passing of the BAPCPA in 2005. At that point in time 46% of bankruptcies were due to medical bills. This change increased the expected value of delinquent accounts which in turn should lead to lower costs for medical services. Great Recession: People put off non-essential medical expenses, or delay usage of medical services. Someone who might get braces doesn't, someone might take care of a parent themselves instead of hiring an in-home nurse, etc. ACA Signed: Marker for before and after growth rates. ACA Taxes + Exchanges Open: The two main policies of the ACA intended to curb healthcare costs go into effect. I would classify these two years as overestimation of savings and regression to the mean. Most insurance companies had to backtrack after their financial projections did not materialize.
- tptacek 7y ago
  No, I do not believe veteran health care is included in the statistics you are citing, and I am similarly dubious of your explanations for how each of those other 4 events impacted health care costs, because everything I've read suggests that the impacts are way more complicated than they look (for instance, much of the health cost impact from the "Great Recession" wasn't felt until years after).
  - pg_bot 7y ago
    Here's the dataset that I'm referencing.[0] From the summary documents, "DOD spending in the NHEA excludes spending that occurs outside of the United States." I'm not certain whether this does or does not include forward operating bases. (Post offices count those as being in the United States so I believe they are included; but I could be wrong) Nevertheless it does include domestic spending on veterans. Also, many veterans get care outside the VA. From my own experience working with these people, they cite long waiting times or broken relationships with the government for not wanting to take part in that system. I'm not trying to downplay the complexity of the healthcare market, it's really complex. However, it I were to pick the things the government had control over and impacted the marketplace the most over the last 15 years, I still would pick the same things I did. I could fill several books with other changes that impacted the cost of American healthcare. (switching to e-prescriptions, subsidies for electronic medical records, medicare part D, certificate of need laws, FSA changes, HSA changes, consolidation of pharmacy benefit managers, health system consolidation, the opioid epidemic, the rise of the physicians's assistant, the expanding role of nurse practitioners, etc.) I'd rather spend my time continuing fixing the things I know I can make better. [0]: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsHistorical.html https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...
    - tptacek 7y ago
      Can you give me a deeper link to the specific data from which you drew the table you posted above? There's a lot of stuff hanging off the link you just posted.