Why Is Health Care In America So Fucked Up?

ballmouse

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People do not understand the limitations of data and predictive analytics, at least with what's possible today. I worked on a project where we sold the HR department on an analytics dashboard to better understand employees. Everyone was supportive of the idea and though that they would get deep insights and learn more about the employees.

The reality was that there was not nearly enough data. There was not enough meaningful data. And even if there were both of the above, are you really going to make decisions just based on some data points without doing a qualitative investigation to double check the data?

In all, it was a huge waste of time and money. Yet the project was spun as a huge leap in analytical prowess and the project leads essentially started up their own fiefdom to sell more of these projects to clients.

I agree that data is meant to be a guide. Maybe it asks a question to investigate. It really doesn't replace very much in the process even though it appears to give 'the answer'. That 'answer' is more like a conversation starter or hypothesis. Rather than use it as an asset to apply to existing methodologies, people just want to replace the entire process with this.

Unfortunately, there is a huge push for analytics (see Moneyball in sports and all those other buzzwords like big data and AI in other fields) so people blindly accept it without much question or understanding that it's an additional asset and not a replacement for an entire process.
 

Journeyman

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Grand Potentate

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Interesting story from The Atlantic magazine on how massive numbers of largely (or even totally) unnecessary procedures are performed in the US, with a couple of procedures in particular way out ahead of the rest in terms of numbers - primarily surgery to repair a torn meniscus in the knee joint, and fusing some vertebrae together:

doctors are worse than cops
 

Grand Potentate

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Money shot
When LeBron James hit a long, go-ahead three pointer with a minute left in a play-in game versus the Warriors last May, dozens of concession workers at the Chase Center in San Francisco lost their health care for a month. That’s because, according to the union chief who represents them, concession workers at the Chase Center only receive health care through their jobs if they work ten games a month.

The Warriors played six scheduled regular season home games in May plus a home play-in game versus the Grizzlies to bring the total to seven. Had the Warriors beaten the Lakers they would have been guaranteed at least three more home playoff games in May.

“LeBron hitting a three shouldn’t cost people their health coverage,” said Anand Singh, president of UNITE HERE local 2, the union that represents 930 concession workers at Chase Center and Oracle Park, where the Giants play. “It’s absolutely ridiculous to take away workers’ health care in a pandemic over something that’s no fault of their own. That’s one of the reasons we have chosen to fight.”
 

Journeyman

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^Interesting and concerning article. The aged care regulator in Australia just got a large injection of funds following a royal commission into aged care (a royal commission is essentially an independent investigation, usually headed by a retired judge assisted by a bunch of lawyers, commissioned by the government and imbued with powers to seek out evidence).

The sector is generally pretty well-run in Australia but there were some dodgy operators who were neglecting residents. The national regulator has now been given increased powers, including the ability to impose sanctions and other tougher measures to ensure compliance with the aged care quality standards.

The quality of aged care is an important topic, for a couple of reasons:
- Just about everyone gets old and so will most likely require aged care at some stage; and
- Quite a number of countries, including Australia, have ageing populations and so the number of elderly people requiring care is going to increase in coming years.

Here's an article on the Australian aged care situation that prompted the royal commission:

 

Grand Potentate

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Grand Potentate

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Their Baby Died in the Hospital. Then Came the $257,000 Bill.​

A New York family had good health insurance. But the bills for their daughter’s care started showing up and kept coming.
 

formby002

Identifies as a Barn Owl
Messages
2,432
People do not understand the limitations of data and predictive analytics, at least with what's possible today. I worked on a project where we sold the HR department on an analytics dashboard to better understand employees. Everyone was supportive of the idea and though that they would get deep insights and learn more about the employees.

The reality was that there was not nearly enough data. There was not enough meaningful data. And even if there were both of the above, are you really going to make decisions just based on some data points without doing a qualitative investigation to double check the data?

In all, it was a huge waste of time and money. Yet the project was spun as a huge leap in analytical prowess and the project leads essentially started up their own fiefdom to sell more of these projects to clients.

I agree that data is meant to be a guide. Maybe it asks a question to investigate. It really doesn't replace very much in the process even though it appears to give 'the answer'. That 'answer' is more like a conversation starter or hypothesis. Rather than use it as an asset to apply to existing methodologies, people just want to replace the entire process with this.

Unfortunately, there is a huge push for analytics (see Moneyball in sports and all those other buzzwords like big data and AI in other fields) so people blindly accept it without much question or understanding that it's an additional asset and not a replacement for an entire process.
Technocratic solutions to human problems.

What could possibly go wrong...
 

formby002

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Thruth Thruth come get your people they’re acting up again

Unrelated to this, a question.

How does your medication consumption per capita compare to the rest of the world?
 

Pimpernel Smith

Tone Deaf Daddy
Messages
10,809
People do not understand the limitations of data and predictive analytics, at least with what's possible today. I worked on a project where we sold the HR department on an analytics dashboard to better understand employees. Everyone was supportive of the idea and though that they would get deep insights and learn more about the employees.

The reality was that there was not nearly enough data. There was not enough meaningful data. And even if there were both of the above, are you really going to make decisions just based on some data points without doing a qualitative investigation to double check the data?

In all, it was a huge waste of time and money. Yet the project was spun as a huge leap in analytical prowess and the project leads essentially started up their own fiefdom to sell more of these projects to clients.

I agree that data is meant to be a guide. Maybe it asks a question to investigate. It really doesn't replace very much in the process even though it appears to give 'the answer'. That 'answer' is more like a conversation starter or hypothesis. Rather than use it as an asset to apply to existing methodologies, people just want to replace the entire process with this.

Unfortunately, there is a huge push for analytics (see Moneyball in sports and all those other buzzwords like big data and AI in other fields) so people blindly accept it without much question or understanding that it's an additional asset and not a replacement for an entire process.
The thing with those analytical dashboards it's a quick visual buzz. Good for displays of KPI's, trends in the business, but for strategic decision making for the next 10 years? The big push now is analytics for compliance functions e.g. vendors committing fraud, facilitation payments to government officials, state owned enterprises, etc. Good look with that.

The move from a process-driven operation, to a data one strikes me as full of possible gaps. You cite a good example there, HR can be a very subtle art based on assessing character and potential, not easily measured by raw data. The compliance function - the very nature of being a bent bastard, is that you're going to be astute in not facilitating any measurable trend or data pattern.
 

Thruth

Big Winter Daddy
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is that your reality Grand Potentate Grand Potentate ? Neglecting your teeth but paying to get inked? because I can see little black nubs in her mouth and tats on her arm. While her dental plan may only pay for 20% of major work it pays close to 100% for regular preventive care so that one does not develop little black nubs for teeth which takes years to occur unless you are a meth head.

I do agree that not taking any personal responsibility for what happens to oneself is reality these days.
 

Grand Potentate

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is that your reality Grand Potentate Grand Potentate ? Neglecting your teeth but paying to get inked? because I can see little black nubs in her mouth and tats on her arm. While her dental plan may only pay for 20% of major work it pays close to 100% for regular preventive care so that one does not develop little black nubs for teeth which takes years to occur unless you are a meth head.

I do agree that not taking any personal responsibility for what happens to oneself is reality these days.
The reality is that no matter the person’s hygiene habits the shock of the American health care system smacking you in the face is something we ALL face. Hell this woman has dental insurance and a fat lot of good it’s doing her.

She might not be starring in the next Colgate commercial but that doesn’t mean she isn’t worthy of care.
 

Thruth

Big Winter Daddy
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The reality is that no matter the person’s hygiene habits the shock of the American health care system smacking you in the face is something we ALL face. Hell this woman has dental insurance and a fat lot of good it’s doing her.

She might not be starring in the next Colgate commercial but that doesn’t mean she isn’t worthy of care.
Not every universal health care plan has dental insurance. Canada doesn't. Not everyone has an NHS style dental system either. I guess the difference is that our welfare dental plans are better.
 

Grand Potentate

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Not every universal health care plan has dental insurance. Canada doesn't. Not everyone has an NHS style dental system either. I guess the difference is that our welfare dental plans are better.
everything about your health system is better. you heard her video. how much would that work cost there?
 

Thruth

Big Winter Daddy
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everything about your health system is better. you heard her video. how much would that work cost there?
she quoted just over a thousand ($1034) for her root canal and crown, which is surprisingly affordable for the US and Canada. A root canal is typically $1000+ and a crown is $1000 in both countries. My dental school charges patients $600 for a crown.

She has a dental plan that pays 20% of major costs, which is not great but most only cover 50% max of major procedures. So she is on the hook for $827. $70 per month for 12 months if she was offered a payment plan, which she wasn't. There are also third party revolving credit plans that will charge interest.

I am not saying that is not expensive for many people. 25% of Canadians avoid the dentist annually due to cost and that sneaks up into lower middle class. it hits the working poor the most because they have no dental insurance through work.

There are only a handful of countries that fully subsidize dental care. Most don't. Dental is not one of those health care issues where the US is the absolute worst in term of costs and insurance.
 

Grand Potentate

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She has a dental plan that pays 20% of major costs, which is not great but most only cover 50% max of major procedures. So she is on the hook for $827. $70 per month for 12 months if she was offered a payment plan, which she wasn't. There are also third party revolving credit plans that will charge interest.
i believe the 20% was already factored into the $1k price but i'm not 100% on that one. we also have the same interest bankruptcy spirals.

I am not saying that is not expensive for many people. 25% of Canadians avoid the dentist annually due to cost and that sneaks up into lower middle class. it hits the working poor the most because they have no dental insurance through work.
clearly this woman wasn't wealthy.

There are only a handful of countries that fully subsidize dental care. Most don't. Dental is not one of those health care issues where the US is the absolute worst in term of costs and insurance.
right but yet you wondered why her teeth looked like shit. maybe she hasn't been able to afford the help she's needed?

My dental school charges patients $600 for a crown.
btw this is RIDICULOUSLY cheap. how long is the wait for poor people to get subsidized care? here its minimum 1 year to get on the list.
 
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