Why Is Health Care In America So Fucked Up?

Rambo

Supporter of Possible Sexual Deviants
Moderator
Supporter
Messages
33,020
 

Pimpernel Smith

Well-Known Member
Messages
8,163
Last edited:

CodPiece

Well-Known Member
Messages
55

Many pharma startups target the elderly, last-stage cancer patients. People are willing to pay thousands to extend their lives a few extra weeks or months, and FDA is likely to give conditional approval. Doesn't work? Who cares? At least we tried...

Stuff like this undermines affordable healthcare.
 

Dropbear

Member in Good Standing
Messages
6,532
D1C0DBAA-CCC4-464F-BD99-C16EDCCAD9C1.jpeg
 

Fwiffo

Well-Known Member
Supporter
Messages
11,255

"Compared with white Americans, whose average life expectancy at birth dropped by about 1.4 years between 2018 and 2020, the average Hispanic American’s decreased by just under 3.9 years. The average lifespan of a Black American decreased by 3.25 years."

The headline is misleading. Did we have coronavirus causing drops in 2018 and 2019?

"To make lasting changes and to close the racial gap in health outcomes, Creary said the nation needs to invest in long-term trust, and that starts with anti-racist medical training for physicians.

'If I have a disease that a doctor doesn’t understand, my life is threatened,' she said. 'If I am a Black or brown person and you don’t have anti-racist training, my life is threatened in the same way.'"

A physician without anti-racist training cannot treat a black or brown person without threatening their life? I thought human physiology was all the same regardless of colour.

What about yellows?
 

güero

Well-Known Member
Messages
1,113
Recent family example: Twins in NICU for three weeks (well like 10 days NICU and the rest regular newborn unit), including both parents as guests, total cost to patient <2k€ which is likely a „mistake“ and will go at least close to zero after some discussion. Cost to insurance company about 26k€ (for the babies, plus some unknown k€ for mother’s insurance company).
 

Journeyman

Well-Known Member
Supporter
Messages
4,092
I don't know if this is accurate, because I haven't checked.

However, if it is true, it is ridiculous:


 

Rambo

Supporter of Possible Sexual Deviants
Moderator
Supporter
Messages
33,020
I don't know if this is accurate, because I haven't checked.

However, if it is true, it is ridiculous:


Accurate. Hell, depending on the market it could be even more expensive.
 

Thruth

Created the finest posts in internet forum history
Moderator
Supporter
Messages
20,894

Thruth Thruth this one has your name written all over it
A very real issue and a very shitty article.

Too bad they are not using empirical evidence either.

Ferris: Most doctors will end up working for a large health care organization or a hospital with quite a bit of oversight, but the vast majority of dentists in the U.S. open up their own practices, so they mostly answer to themselves. There are ethical guidelines and codes that they’re supposed to follow, but there isn’t somebody looking over their shoulder day to day.

Medical billing fraud in the US is estimated to be around 70 billion per year (3% of total spent) and dental fraud is estimated to be 13 billion (10% of total spent).

Ferris: You will hear words like “experience.” Some dentists will even say “dentistry is an art.” And it’s like, well, I don’t really know if I want an artist performing surgeries in my mouth.

An art and science is the commonly used phrase. The art refers to the aesthetics of shape and shade in restoration. Do you want your restored teeth to look like natural teeth? The science is the technology and technique. But indeed research into outcomes of treatment is a more recent focus.

Laura: If you go back to the 1700s or 1800s, dentistry wasn’t considered a medical profession.

Neither was surgery. Both surgeons and dentists arose from the guild of barber-surgeons. The red on the barber pole represents blood. One of the reasons surgeons in the UK are still referred to as Mr. and not Dr. That dates back to the 1100's when Pope Alexander III forbade monks from letting blood. The barbers took over the leaches, tooth pulling and hacking off limbs.

Corporate dentistry is a burgeoning problem. Corporate medicine has long been engrained in the system.

Laura: I think that the assumption that I would have come in with, and I think a lot of people would come in with, is that you go to the dentist and there is a distinct problem with your teeth. And there’s probably a small number of solutions to that problem. And you would imagine most dentists would agree broadly on what needs to be done. What you’re saying is everyone was identifying different problems, different solutions, they range wildly in price. And that sort of raises this question of what is the science of dentistry? Are there objective things we can agree about here that need to be done as treatments? What does it mean to have healthy teeth, if there’s so much disagreement on diagnosis and treatment?

And second opinions are not regularly sought by Americans for medical diagnoses, right? Because ever doc diagnoses exactly the same?

Daryl: Exactly. And I began to realize that there are—I learned that the term is “dental medical philosophy.” So there are different dental medical philosophies that a lot of dentists physicians have that don’t even begin to get into the space of fraud necessarily but that are just a dentist physician saying, “I’m more aggressive in my treatment plans,” and another dentist physician says, “I’m more conservative, and I want to take a softer approach.” And you don’t know, as a consumer, what type of philosophy your dentist physician has.

Daryl: That’s exactly right. And they made it very clear to me, “We are not a regulatory agency.” There are certain standards that dentists have to keep in order to be considered an ADA-qualified dentist, But as far as going in and investigating what’s going on, the ADA does nothing like that. A regulation is supposed to exist on the state level in what are called dental boards, but it’s more of an examining body.

The ADA is a national advocacy association, like the AMA not a regulator. Licensing requirements and public protection is a state regulatory function just like medicine. State regulators set guidelines for licensure and maintaining licenses exactly like state medical boards. There is national accreditation of dental schools just as medical schools. National competency examinations for graduating MDs and DMDs/DDS'. Specialty board exams.

Ferris: Exactly. And so there’s something interesting has happened during the pandemic, which is that I think a lot of people have not been going to the dentist nearly as frequently, because we’ve all been trying to sort of avoid anything that isn’t absolutely essential. And of course the maxim that we’ve all grown up with is that you should go to the dentist twice a year, every six months. But it turns out there’s no scientific backing for that maxim, and some scholars have even traced it to a toothpaste commercial from decades ago,

Actually that was the maxim of brushing after every meal which was thought up by Pepsodent although every credible oral health organization uses the evidence-based recommendation of twice daily brushing which has been around since the modern paradigm of dental decay and periodontal disease was established in the 90s.

And people did decrease their dental care-seeking during the pandemic although these clowns did not see the people scrambling to get their pain taken care of during the shutdown and the backlog of treatment because of it.

Daryl: One thing that I looked at in this process and developed some empathy for was the fact that I had a number of dentists tell me, “If I’m only doing the basic care, I’m not able to keep my practice afloat anymore.” Most of the insurance rates were established back in the 1960s and 1970s, and many insurance companies still adhere to those same rates today, the amounts that they’re willing to reimburse dentists for.

In fact, insurance companies have the higher fees so patients are billed at differential rates depending if they have insurance or not.

Laura: This was on a small child with their first set of teeth. I mean, what’s even the point in doing that kind of work on teeth the child is not going to ultimately have anyway?

Daryl:
Especially think about it for a child, the fear associated with going to the dentist for the rest of your life started with an experience where you had this baby root canal that was needless.

Alex: It intuitively makes sense that there would be a lot of unnecessary treatment and outright fraud on children’s dentistry because the evidence will literally all just fall out. You’re not going to catch it on an x-ray years later on.


Yes, why treat children's teeth at all with baby root canals? Maybe because doing nothing could kills them? The medical establishment did not do anything to save Deamonte Driver. Analgesics to kill the pain were cheaper than the antibiotics to kill the infection. Children should die of brain abscesses secondary to decay because they are on the welfare.


And hey, concerned parent, brush you kids teeth and stop shoving sugars into their mouth.

A topic worth discussing but such a shitty layperson driven article full of misinformation that detracts from the problem.
 

Rambo

Supporter of Possible Sexual Deviants
Moderator
Supporter
Messages
33,020
i
A very real issue and a very shitty article.

Too bad they are not using empirical evidence either.

Ferris: Most doctors will end up working for a large health care organization or a hospital with quite a bit of oversight, but the vast majority of dentists in the U.S. open up their own practices, so they mostly answer to themselves. There are ethical guidelines and codes that they’re supposed to follow, but there isn’t somebody looking over their shoulder day to day.

Medical billing fraud in the US is estimated to be around 70 billion per year (3% of total spent) and dental fraud is estimated to be 13 billion (10% of total spent).

Ferris: You will hear words like “experience.” Some dentists will even say “dentistry is an art.” And it’s like, well, I don’t really know if I want an artist performing surgeries in my mouth.

An art and science is the commonly used phrase. The art refers to the aesthetics of shape and shade in restoration. Do you want your restored teeth to look like natural teeth? The science is the technology and technique. But indeed research into outcomes of treatment is a more recent focus.

Laura: If you go back to the 1700s or 1800s, dentistry wasn’t considered a medical profession.

Neither was surgery. Both surgeons and dentists arose from the guild of barber-surgeons. The red on the barber pole represents blood. One of the reasons surgeons in the UK are still referred to as Mr. and not Dr. That dates back to the 1100's when Pope Alexander III forbade monks from letting blood. The barbers took over the leaches, tooth pulling and hacking off limbs.

Corporate dentistry is a burgeoning problem. Corporate medicine has long been engrained in the system.

Laura: I think that the assumption that I would have come in with, and I think a lot of people would come in with, is that you go to the dentist and there is a distinct problem with your teeth. And there’s probably a small number of solutions to that problem. And you would imagine most dentists would agree broadly on what needs to be done. What you’re saying is everyone was identifying different problems, different solutions, they range wildly in price. And that sort of raises this question of what is the science of dentistry? Are there objective things we can agree about here that need to be done as treatments? What does it mean to have healthy teeth, if there’s so much disagreement on diagnosis and treatment?

And second opinions are not regularly sought by Americans for medical diagnoses, right? Because ever doc diagnoses exactly the same?

Daryl: Exactly. And I began to realize that there are—I learned that the term is “dental medical philosophy.” So there are different dental medical philosophies that a lot of dentists physicians have that don’t even begin to get into the space of fraud necessarily but that are just a dentist physician saying, “I’m more aggressive in my treatment plans,” and another dentist physician says, “I’m more conservative, and I want to take a softer approach.” And you don’t know, as a consumer, what type of philosophy your dentist physician has.

Daryl: That’s exactly right. And they made it very clear to me, “We are not a regulatory agency.” There are certain standards that dentists have to keep in order to be considered an ADA-qualified dentist, But as far as going in and investigating what’s going on, the ADA does nothing like that. A regulation is supposed to exist on the state level in what are called dental boards, but it’s more of an examining body.

The ADA is a national advocacy association, like the AMA not a regulator. Licensing requirements and public protection is a state regulatory function just like medicine. State regulators set guidelines for licensure and maintaining licenses exactly like state medical boards. There is national accreditation of dental schools just as medical schools. National competency examinations for graduating MDs and DMDs/DDS'. Specialty board exams.

Ferris: Exactly. And so there’s something interesting has happened during the pandemic, which is that I think a lot of people have not been going to the dentist nearly as frequently, because we’ve all been trying to sort of avoid anything that isn’t absolutely essential. And of course the maxim that we’ve all grown up with is that you should go to the dentist twice a year, every six months. But it turns out there’s no scientific backing for that maxim, and some scholars have even traced it to a toothpaste commercial from decades ago,

Actually that was the maxim of brushing after every meal which was thought up by Pepsodent although every credible oral health organization uses the evidence-based recommendation of twice daily brushing which has been around since the modern paradigm of dental decay and periodontal disease was established in the 90s.

And people did decrease their dental care-seeking during the pandemic although these clowns did not see the people scrambling to get their pain taken care of during the shutdown and the backlog of treatment because of it.

Daryl: One thing that I looked at in this process and developed some empathy for was the fact that I had a number of dentists tell me, “If I’m only doing the basic care, I’m not able to keep my practice afloat anymore.” Most of the insurance rates were established back in the 1960s and 1970s, and many insurance companies still adhere to those same rates today, the amounts that they’re willing to reimburse dentists for.

In fact, insurance companies have the higher fees so patients are billed at differential rates depending if they have insurance or not.

Laura: This was on a small child with their first set of teeth. I mean, what’s even the point in doing that kind of work on teeth the child is not going to ultimately have anyway?

Daryl:
Especially think about it for a child, the fear associated with going to the dentist for the rest of your life started with an experience where you had this baby root canal that was needless.

Alex: It intuitively makes sense that there would be a lot of unnecessary treatment and outright fraud on children’s dentistry because the evidence will literally all just fall out. You’re not going to catch it on an x-ray years later on.


Yes, why treat children's teeth at all with baby root canals? Maybe because doing nothing could kills them? The medical establishment did not do anything to save Deamonte Driver. Analgesics to kill the pain were cheaper than the antibiotics to kill the infection. Children should die of brain abscesses secondary to decay because they are on the welfare.


And hey, concerned parent, brush you kids teeth and stop shoving sugars into their mouth.

A topic worth discussing but such a shitty layperson driven article full of misinformation that detracts from the problem.
told you it would be right up your alley
 

fxh

OG Party Suit Wearer
Supporter
Messages
7,598
A very real issue and a very shitty article.

Too bad they are not using empirical evidence either.

Ferris: Most doctors will end up working for a large health care organization or a hospital with quite a bit of oversight, but the vast majority of dentists in the U.S. open up their own practices, so they mostly answer to themselves. There are ethical guidelines and codes that they’re supposed to follow, but there isn’t somebody looking over their shoulder day to day.

Medical billing fraud in the US is estimated to be around 70 billion per year (3% of total spent) and dental fraud is estimated to be 13 billion (10% of total spent).

Ferris: You will hear words like “experience.” Some dentists will even say “dentistry is an art.” And it’s like, well, I don’t really know if I want an artist performing surgeries in my mouth.

An art and science is the commonly used phrase. The art refers to the aesthetics of shape and shade in restoration. Do you want your restored teeth to look like natural teeth? The science is the technology and technique. But indeed research into outcomes of treatment is a more recent focus.

Laura: If you go back to the 1700s or 1800s, dentistry wasn’t considered a medical profession.

Neither was surgery. Both surgeons and dentists arose from the guild of barber-surgeons. The red on the barber pole represents blood. One of the reasons surgeons in the UK are still referred to as Mr. and not Dr. That dates back to the 1100's when Pope Alexander III forbade monks from letting blood. The barbers took over the leaches, tooth pulling and hacking off limbs.

Corporate dentistry is a burgeoning problem. Corporate medicine has long been engrained in the system.

Laura: I think that the assumption that I would have come in with, and I think a lot of people would come in with, is that you go to the dentist and there is a distinct problem with your teeth. And there’s probably a small number of solutions to that problem. And you would imagine most dentists would agree broadly on what needs to be done. What you’re saying is everyone was identifying different problems, different solutions, they range wildly in price. And that sort of raises this question of what is the science of dentistry? Are there objective things we can agree about here that need to be done as treatments? What does it mean to have healthy teeth, if there’s so much disagreement on diagnosis and treatment?

And second opinions are not regularly sought by Americans for medical diagnoses, right? Because ever doc diagnoses exactly the same?

Daryl: Exactly. And I began to realize that there are—I learned that the term is “dental medical philosophy.” So there are different dental medical philosophies that a lot of dentists physicians have that don’t even begin to get into the space of fraud necessarily but that are just a dentist physician saying, “I’m more aggressive in my treatment plans,” and another dentist physician says, “I’m more conservative, and I want to take a softer approach.” And you don’t know, as a consumer, what type of philosophy your dentist physician has.

Daryl: That’s exactly right. And they made it very clear to me, “We are not a regulatory agency.” There are certain standards that dentists have to keep in order to be considered an ADA-qualified dentist, But as far as going in and investigating what’s going on, the ADA does nothing like that. A regulation is supposed to exist on the state level in what are called dental boards, but it’s more of an examining body.

The ADA is a national advocacy association, like the AMA not a regulator. Licensing requirements and public protection is a state regulatory function just like medicine. State regulators set guidelines for licensure and maintaining licenses exactly like state medical boards. There is national accreditation of dental schools just as medical schools. National competency examinations for graduating MDs and DMDs/DDS'. Specialty board exams.

Ferris: Exactly. And so there’s something interesting has happened during the pandemic, which is that I think a lot of people have not been going to the dentist nearly as frequently, because we’ve all been trying to sort of avoid anything that isn’t absolutely essential. And of course the maxim that we’ve all grown up with is that you should go to the dentist twice a year, every six months. But it turns out there’s no scientific backing for that maxim, and some scholars have even traced it to a toothpaste commercial from decades ago,

Actually that was the maxim of brushing after every meal which was thought up by Pepsodent although every credible oral health organization uses the evidence-based recommendation of twice daily brushing which has been around since the modern paradigm of dental decay and periodontal disease was established in the 90s.

And people did decrease their dental care-seeking during the pandemic although these clowns did not see the people scrambling to get their pain taken care of during the shutdown and the backlog of treatment because of it.

Daryl: One thing that I looked at in this process and developed some empathy for was the fact that I had a number of dentists tell me, “If I’m only doing the basic care, I’m not able to keep my practice afloat anymore.” Most of the insurance rates were established back in the 1960s and 1970s, and many insurance companies still adhere to those same rates today, the amounts that they’re willing to reimburse dentists for.

In fact, insurance companies have the higher fees so patients are billed at differential rates depending if they have insurance or not.

Laura: This was on a small child with their first set of teeth. I mean, what’s even the point in doing that kind of work on teeth the child is not going to ultimately have anyway?

Daryl:
Especially think about it for a child, the fear associated with going to the dentist for the rest of your life started with an experience where you had this baby root canal that was needless.

Alex: It intuitively makes sense that there would be a lot of unnecessary treatment and outright fraud on children’s dentistry because the evidence will literally all just fall out. You’re not going to catch it on an x-ray years later on.


Yes, why treat children's teeth at all with baby root canals? Maybe because doing nothing could kills them? The medical establishment did not do anything to save Deamonte Driver. Analgesics to kill the pain were cheaper than the antibiotics to kill the infection. Children should die of brain abscesses secondary to decay because they are on the welfare.


And hey, concerned parent, brush you kids teeth and stop shoving sugars into their mouth.

A topic worth discussing but such a shitty layperson driven article full of misinformation that detracts from the problem.
I'm not up to Fisking the article but there are similar, but probably not quite as egregious, issues here.

The big systemic problem here is that dentistry is effectively de coupled from the health care system.

As you know Health care here is largely free at point of service for all (most) health services but NOT dentistry. So a visit to your GP, if they bulk bill, will be free. GPs can charge a fee on top of Bulk Bill but around 80% of patients are bulk Billed ( Bulk Bill means the GP is compensated by the Gov Medicare to 80% of scheduled fee).

Dentistry - private practice is not part of Medicare (largely due to lobbying by the profession years ago). There is some Public Dentistry funded by state and federal gov but it is limited to low income /welfare recipients and limited and with huge wait lists.

There is a very large cultural difference between USA and here (and I suspect many other countries) the emphasis on the perfect teeth and smile isn't as widespread or as deeply inculcated here as in USA. Even without hearing the accent it is possible here to identify Americans by their perfect symmetrical teeth. Its a curious thing.

I gotta go soon but quickly - by measures there is an oversupply of dentists in Urban Oz - BUT - the expense of setting up practice and income expectations means that the market forces don't work to lower prices, or force dentists to areas of low supply like rural, but instead means there many P/T younger dentists who instead of lowering prices - raise prices in order to afford the lifestyle of BMWs etc .

More later - perhaps
 

Rambo

Supporter of Possible Sexual Deviants
Moderator
Supporter
Messages
33,020

intersection of meds and feds makes for fun times
 

ballmouse

Well-Known Member
Messages
301
I tried to read it, but it was like reading one of those SAT Reading passages where they don't outright get to the point. Maybe I'm getting old.
 

Rambo

Supporter of Possible Sexual Deviants
Moderator
Supporter
Messages
33,020
I tried to read it, but it was like reading one of those SAT Reading passages where they don't outright get to the point. Maybe I'm getting old.
Basically the corporation tried to influence the report saying they were doing shitty things by exerting influence with money
 
Top Bottom