3 ms·

Part of that is because it’s far cheaper to catch (say) cancer at an early stage and treat it than it is to catch it at stage 3 or 4 and spend potentially milli

Part of that is because it’s far cheaper to catch (say) cancer at an early stage and treat it than it is to catch it at stage 3 or 4 and spend potentially millions on a possibly preventable catastrophe. There is fairly strong evidence that if the cost of routine preventative care isn’t paid by insurance, quite a lot of people opt to skip it because they can’t afford it, leading to worse outcomes.

jdlshore 5y ago
> leading to worse outcomes. Do you have evidence of this part specifically? Because the Oregon Experiment found no improvement in health outcomes in a large randomized trial of low-income recipients of Medicaid. (Partly because their health was generally good in the first place.) https://en.wikipedia.org/wiki/Oregon_Medicaid_health_experiment https://en.wikipedia.org/wiki/Oregon_Medicaid_health_experim...
- hanniabu 5y ago
  I had no health insurance so put off on a specialist i needed to see until i could sign up for medicaid (can only apply at the end of the year for some retarded reason). Just putting my issues off for 4 months turned an easy thing to fix into needing to spend the past 8 months in and out of the doctors and hospital.
  - Volundr 5y ago
    If the plural of anecdote is data, when the ACA was first rolled out, someone close to me discovered they had colon cancer. They had been having symptoms for quite some time, but had been managing them with home treatment, the first day the had insurance they went to get it checked out. Lucky they did, as devastating as it was (and continues to be, turns out your chemo is brutal and having large sections of your colon removed isn't great either) their doctors already weren't sure they could treat it effectively. While they credit the ACA with saving their life, had we had some form of socialized medicine from the start, this likely would've been caught much earlier, treated much more easily, and with significantly less long term effects. I couldn't easily find studies on preventative care leading to better outcomes, but given how many diseases (like cancer for example) can go from easily treatable to a catastrophic nightmare depending on how early they are detected, I find it hard to believe that easy, cheap (or free) access screenings would have no effect on outcomes, though I realize how treacherous it can be to rely on instinct instead of data.
    - jdlshore 5y ago
      Counterintuitive as it may be, the Oregon Experiment showed increased costs. It did show an improvement is psychological outcomes, I presume due to peace of mind, because their wasn’t a corresponding increase in psychiatric medication.
      - freeone3000 5y ago
        Did the increase in cost also come with an increase in outcomes? I don't think it's counterintuitive that people who couldn't afford healthcare see a doctor, you'll see a lot of issues; did we see a decrease in medical issues across the population?
        jdlshore 5y ago
        No, there was no increase in health outcomes.
      - hanniabu 5y ago
        I imagine this test isn't sufficient because just like with me and this other commenter, many would be going to the doctor to catch up on care they've been missing. Over a longer time period and with having this from the start of your life, I'm sure the costs would end up lower m
- t-writescode 5y ago
  It’s the entire model to Kaiser Permanente, so it’s working for someone.
  - WillPostForFood 5y ago
    It’s the entire model It is part of large complicated model. If it was their entire model they wouldn't be operating medical offices and hospitals. It is the whole package that helps them control costs.
    - deleted 5y ago
      [deleted]
    - t-writescode 5y ago
      It is my understanding that obligatory routine care is a major component of Kaiser’s model. In the experience of those I know who use Kaiser, effectively, if they come in for something and their routine checkups are out of date, they’re obligated to get that routine checkup (at the same time due to streamline of service), before they can get what they came in for. From this, I derived the argument that routine checkups are a *major* component of Kaiser’s system, to the point that, given the flow of discussion, I felt it appropriate to call it “their whole model”. I’m sorry my hyperbole was too far.
      - ak217 5y ago
        Kaiser has no specific preventative care requirements and does not withhold care if you are not up to date on some schedule. In fact Kaiser works pretty much exactly like any other HMO with the main difference being that insurance is in-house (but a different department, so insurance screwups still happen, but at least the hospital and the insurance are not constantly fighting each other with you stuck in the middle). Well that and with Kaiser it's a lot easier to tell who is in network (they never commingle in and out of network care).
        co_pilates 5y ago
nradov 5y ago
The Accountable Care Act (Obamacare) requires most health plans to cover several screening services at no cost to the patient. https://www.healthcare.gov/coverage/preventive-care-benefits/ https://www.healthcare.gov/coverage/preventive-care-benefits...

jdlshore 5y ago

> leading to worse outcomes. Do you have evidence of this part specifically? Because the Oregon Experiment found no improvement in health outcomes in a large randomized trial of low-income recipients of Medicaid. (Partly because their health was generally good in the first place.) https://en.wikipedia.org/wiki/Oregon_Medicaid_health_experiment https://en.wikipedia.org/wiki/Oregon_Medicaid_health_experim...

hanniabu 5y ago
I had no health insurance so put off on a specialist i needed to see until i could sign up for medicaid (can only apply at the end of the year for some retarded reason). Just putting my issues off for 4 months turned an easy thing to fix into needing to spend the past 8 months in and out of the doctors and hospital.
- Volundr 5y ago
  If the plural of anecdote is data, when the ACA was first rolled out, someone close to me discovered they had colon cancer. They had been having symptoms for quite some time, but had been managing them with home treatment, the first day the had insurance they went to get it checked out. Lucky they did, as devastating as it was (and continues to be, turns out your chemo is brutal and having large sections of your colon removed isn't great either) their doctors already weren't sure they could treat it effectively. While they credit the ACA with saving their life, had we had some form of socialized medicine from the start, this likely would've been caught much earlier, treated much more easily, and with significantly less long term effects. I couldn't easily find studies on preventative care leading to better outcomes, but given how many diseases (like cancer for example) can go from easily treatable to a catastrophic nightmare depending on how early they are detected, I find it hard to believe that easy, cheap (or free) access screenings would have no effect on outcomes, though I realize how treacherous it can be to rely on instinct instead of data.
  - jdlshore 5y ago
    Counterintuitive as it may be, the Oregon Experiment showed increased costs. It did show an improvement is psychological outcomes, I presume due to peace of mind, because their wasn’t a corresponding increase in psychiatric medication.
    - freeone3000 5y ago
      Did the increase in cost also come with an increase in outcomes? I don't think it's counterintuitive that people who couldn't afford healthcare see a doctor, you'll see a lot of issues; did we see a decrease in medical issues across the population?
      - jdlshore 5y ago
        No, there was no increase in health outcomes.
    - hanniabu 5y ago
      I imagine this test isn't sufficient because just like with me and this other commenter, many would be going to the doctor to catch up on care they've been missing. Over a longer time period and with having this from the start of your life, I'm sure the costs would end up lower m
t-writescode 5y ago
It’s the entire model to Kaiser Permanente, so it’s working for someone.
- WillPostForFood 5y ago
  It’s the entire model It is part of large complicated model. If it was their entire model they wouldn't be operating medical offices and hospitals. It is the whole package that helps them control costs.
  - deleted 5y ago
    [deleted]
  - t-writescode 5y ago
    It is my understanding that obligatory routine care is a major component of Kaiser’s model. In the experience of those I know who use Kaiser, effectively, if they come in for something and their routine checkups are out of date, they’re obligated to get that routine checkup (at the same time due to streamline of service), before they can get what they came in for. From this, I derived the argument that routine checkups are a *major* component of Kaiser’s system, to the point that, given the flow of discussion, I felt it appropriate to call it “their whole model”. I’m sorry my hyperbole was too far.
    - ak217 5y ago
      Kaiser has no specific preventative care requirements and does not withhold care if you are not up to date on some schedule. In fact Kaiser works pretty much exactly like any other HMO with the main difference being that insurance is in-house (but a different department, so insurance screwups still happen, but at least the hospital and the insurance are not constantly fighting each other with you stuck in the middle). Well that and with Kaiser it's a lot easier to tell who is in network (they never commingle in and out of network care).
      - co_pilates 5y ago

nradov 5y ago

The Accountable Care Act (Obamacare) requires most health plans to cover several screening services at no cost to the patient. https://www.healthcare.gov/coverage/preventive-care-benefits/ https://www.healthcare.gov/coverage/preventive-care-benefits...