4 ms·

If 125% of Medicare is below cost of goods sold then costs need to come down. Medicare reimbursement rates are too high compared to the rest of the world. Nobo

If 125% of Medicare is below cost of goods sold then costs need to come down. Medicare reimbursement rates are too high compared to the rest of the world. Nobody needs to be paid $300 for a 5 minute visit to get a prescription for routine issue. 10 years of training is not necessary for most instances of routine care. Most of it can be done by a midlevel with 4 years of post-high school training. There's no need to require $500 MD visit ($150 from me, $350 from employer/taxpayers) to get tretinoin cream. I should just get it online for $20 like I would in the UK or Australia, no MD involved. Scope of practice laws need to be rewritten. Every instance of "you must have a medical license" should be replaced with "you must uphold standard of care". This will allow companies like CVS or even Amazon to provide a lot of routine care directly to patients through midlevels, software, and operations, with direct government safety oversight. Emergency care with inelastic demand should be federally regulated and socialized. Federal government should determine scope of practice and standard of care. MDs (all of whom are overtrained in the US) should focus on complicated cases and on pushing medical science forward. It's time to move away from archaic Flexner-era cartel.

deleted 7y ago
[deleted]
riahi 7y ago
You can't compare the US standard of care with the rest of the world's standard of care. If you want equivalent costs to the rest of the world, expect the US expectation of care, turnaround time, and time-to-service to decrease drastically. You have a habit of posting in healthcare threads and denigrating physicians. Your favorite replacement (midlevels) do not make less money. They are only paid less money; the hospital gets either equivalent (Oregon) or about 85% of that paid to a physician. You are getting WORSE care for the same price when you see an NP or PA. This is why I personally avoid seeing them. You have a huge trust in the US government that large swaths of the population simply do not have. Have you spoken to many veteran's about their experience in the VA healthcare system? Some VAs with academic affiliations are ok....many...are not. Do you think the government now doesn't already massively regulate healthcare through CMS mandates?
- anonuser123456 7y ago
  >You are getting WORSE care for the same price when you see an NP or PA. I am skeptical of this statement on average.
  - riahi 7y ago
    It's certainly not better.
    - bart_spoon 7y ago
      Well that is a massive difference from “it’s worse”. If Americans are paying so much more than other countries on their health care for something that isn’t leaps and bounds better, then they are getting fleeced. And given how many health outcomes in the US are fairly middling for a country of its size and wealth, it’s not a stretch to assume the health care isnt actually better. At the very least, you can conclude that whatever benefits their are to our stupendous health care are more than offset by the damage done by the prohibitive cost. Fantastic health care isn’t fantastic if people can’t afford it.
  - sushid 7y ago
    You’d agree that an important part of patient care is listening to the patients, correct? In my personal experience, NPs tend to do so. Oftentimes I’m coming in for fairly obvious medical reasons and it’s a painless visit. With doctors, it’s been a crapshoot for me. They adhere to whatever they learned years ago with complete inflexibility. I still recall my high school dermatologist insisting that diet doesn’t affect acne and even showing me some stupid pamphlet to support her argument despite my insistence that it does from anecdotal evidence. Lo and behold it turns out she’s wrong! I doubt she cares since that’s not what she learned 15 years ago in school. Simply put, most doctors don’t give a shit if you don’t fit the general case. If a side effect is not on the label, surely you’re imagining it and we can set up some therapy sessions. It’s bewildering to say the least and very patronizing. Imagine you had a tech lead try and “fix” any bugs you’re encountering without ever bothering to read the code or see what your approach so far has been. They just spitball some suggestions from what they’ve seen before. That’s how it feels.

deleted 7y ago

[deleted]

riahi 7y ago

You can't compare the US standard of care with the rest of the world's standard of care. If you want equivalent costs to the rest of the world, expect the US expectation of care, turnaround time, and time-to-service to decrease drastically. You have a habit of posting in healthcare threads and denigrating physicians. Your favorite replacement (midlevels) do not make less money. They are only paid less money; the hospital gets either equivalent (Oregon) or about 85% of that paid to a physician. You are getting WORSE care for the same price when you see an NP or PA. This is why I personally avoid seeing them. You have a huge trust in the US government that large swaths of the population simply do not have. Have you spoken to many veteran's about their experience in the VA healthcare system? Some VAs with academic affiliations are ok....many...are not. Do you think the government now doesn't already massively regulate healthcare through CMS mandates?

anonuser123456 7y ago
>You are getting WORSE care for the same price when you see an NP or PA. I am skeptical of this statement on average.
- riahi 7y ago
  It's certainly not better.
  - bart_spoon 7y ago
    Well that is a massive difference from “it’s worse”. If Americans are paying so much more than other countries on their health care for something that isn’t leaps and bounds better, then they are getting fleeced. And given how many health outcomes in the US are fairly middling for a country of its size and wealth, it’s not a stretch to assume the health care isnt actually better. At the very least, you can conclude that whatever benefits their are to our stupendous health care are more than offset by the damage done by the prohibitive cost. Fantastic health care isn’t fantastic if people can’t afford it.
- sushid 7y ago
  You’d agree that an important part of patient care is listening to the patients, correct? In my personal experience, NPs tend to do so. Oftentimes I’m coming in for fairly obvious medical reasons and it’s a painless visit. With doctors, it’s been a crapshoot for me. They adhere to whatever they learned years ago with complete inflexibility. I still recall my high school dermatologist insisting that diet doesn’t affect acne and even showing me some stupid pamphlet to support her argument despite my insistence that it does from anecdotal evidence. Lo and behold it turns out she’s wrong! I doubt she cares since that’s not what she learned 15 years ago in school. Simply put, most doctors don’t give a shit if you don’t fit the general case. If a side effect is not on the label, surely you’re imagining it and we can set up some therapy sessions. It’s bewildering to say the least and very patronizing. Imagine you had a tech lead try and “fix” any bugs you’re encountering without ever bothering to read the code or see what your approach so far has been. They just spitball some suggestions from what they’ve seen before. That’s how it feels.