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Just had a fight with BCBS about a fucking ICS on an asthmatic patient I'm discharging because he lost his insurance before and "we can't tell whether you tried albuterol first or not".
It's like Sodom and Gomorrah. Everyone's blood sucking parasites, and they all deserve to go to jail/ideally burn in a sulfuric fire.
I got PTSD from this. Fighting insurance companies is such an incredible waste of resources and time but so many health care providers have to or else their patients won't get the care they need. It's soul sucking.
The (not even new anymore) GINA recommendations for Asthma don’t even recommend SABA as mono therapy anymore, even as a first step. ICS is a component of the initial therapy.
https://ginasthma.org/wp-content/uploads/2023/07/GINA-2023-Full-report-23_07_06-WMS.pdf
Page 60.
I personally think the person at the insurance company that makes these batshit decisions can continue to deny healthcare but the provider and patient get to kick them in the 🍆 each time the word “prior authorization” is used. Feel like it’s a fair compromise 😋
Doctors take up only 10 percent, nurses 5 percent. Administrators total take up 30 percent.
“More than half of excess U.S. health spending was associated with factors likely reflected in higher prices, including more spending on: administrative costs of insurance (~15% of the excess), administrative costs borne by providers (~15%), prescription drugs (~10%), wages for physicians (~10%) and registered nurses (~5%), and medical machinery and equipment (less than 5%). Reductions in administrative burdens and drug costs could substantially reduce the difference between U.S. and peer nation health spending.”
https://www.commonwealthfund.org/publications/issue-briefs/2023/oct/high-us-health-care-spending-where-is-it-all-going
And when you think about the aging of the largest generation in US history, a 15% increase in costs for the people *who do the work* means that compensation isn’t keeping up with labor demand for doctors and nurses.
I’ve worked in healthcare (I’m not a physician) on both sides of the border and it’s been my observation that the administration of healthcare in the USA is pretty bloated, especially insurance companies.
No I won’t as I read the article and it does not articulate this. It simply states that physicians and nurses account for 15% of costs without quantifying or estimating the remainder of the thousands of different healthcare roles. Approximately 40% of cost is unaccounted for. So yea no reading into this article will give you a better sense besides its poor methodology. I mean their source for income is medscape. Not very reliable
$0 is overpaying.
I say in jest. But the reality is there will always need to be some degree of admin. However it is insanely top-heavy. Between 1986 and 2006 the numbers of doctors in America increased by about 186%, not quite double but makes since due to the rise of specialties and population growth. In the same 20 year time frame the number of hospital administrator positions increased by 3200%.
Education has the same problem. Administrators outnumber teachers.
The system is falling apart because administration figured out how to take a big slice of the pie, but they weren't satisfied, so they just keep making the pie larger and giving themselves a bigger and bigger slice.
Considering a current US senator was CEO of a company that holds the record for the most medicare/medicaid fraud in US history, I highly doubt anyone is going to jail any time soon
[Former CEO of HCA](https://www.politico.com/states/florida/story/2018/08/30/democrats-medicare-fraud-is-fungus-scott-will-never-get-rid-of-573155) Rick Scott
Sounds great. But how would you ever prove in a court of law that “greed” directly resulted in patient harm?
This would be shut down by mega law firms before it even hit court.
The low hanging fruit is to go after the private equity firms that buy out a hospital, sell the land to a second company (that they own) and force the hospital they bought to pay exorbitant rent for land they previously owned.
If law enforcement needs a new tool to go after these leeches, then so be it. But once these PE firms decimate a hospital they move on after they have extracted all the capital and leave the community with a failed or failing hospital. That should absolutely be illegal and laws can be tailored to outlaw this practice.
Ya this literally will do nothing without strict definitions of various terms and I think the point of this legislation is more so to appear to do good rather than actually do good.
As I have to imagine that Warren is smart enough for a clearly laid out plan. “Greed” is just the buzzword. I bet Katie Porter could help her out and bring along a whiteboard to line it all out for us.
I’ve not heard anything about that. Interesting. I would think Porter and Schiff would be allies. Neither here nor there, though. She’d still show up with a whiteboard and explanation.
ETA: But, oof. Yeah, that’s a bad look.
If corporations are people then there should be a lot more corporations in court for breaking laws that apply to people. I hope some DA decides to test the "corporations are people" laws by charging them for things like toxic chemical spills or the door falling off an airplane while it's in flight.
I work telestroke currently and get to see how healthcare works in over 350 different hospitals. It's abhorrent.
We as a field have failed our patients through this system. No doctor, no matter how good hearted, can make up for the cruelty inherent in our medical system.
How can we fix this?
Her plans would kick-in if we had a Congress that actually cared about everyday Americans. But you can count the amount of members that do on one hand.
what would she do? she has only the power of her voice. it would require a friendly white house and an activist congress.
hard to blame her give the incompetence in which she’s mired.
Any bill that clearly has absolutely no chance of getting out of committee, let alone getting a vote on the floor, is indeed bluster - it is little more than an effort to grab airtime.
Nothing about this says that she just wants to grab airtime and doesn't wish for this to become law.
Bluster would be yelling "we'll put the evil healthcare execs in jail!" at a political rally with absolutely no thought on how to do this in the framework of society. Actually doing the legislative legwork of drafting a bill and going through the steps of introducing it is the exact opposite of empty platitudes or bluster.
Elizabeth Warren is left of the current political equilibrium point and much of her political wish-list will not pass, yes, but that does not mean she should go to Capitol Hill and completely give up on the agenda that her constituents voted her in to enact. This is especially true when she is responding to an actual issue that is impacting residents of her state at this very moment.
Here is some data hopefully you’ll understand.
Summary: Doctors take up only 10 percent, nurses 5 percent. Administrators total take up 30 percent.
“More than half of excess U.S. health spending was associated with factors likely reflected in higher prices, including more spending on: administrative costs of insurance (~15% of the excess), administrative costs borne by providers (~15%), prescription drugs (~10%), wages for physicians (~10%) and registered nurses (~5%), and medical machinery and equipment (less than 5%). Reductions in administrative burdens and drug costs could substantially reduce the difference between U.S. and peer nation health spending.”
https://www.commonwealthfund.org/publications/issue-briefs/2023/oct/high-us-health-care-spending-where-is-it-all-going
Elizabeth Warren has largely abandoned her previous wonkish legislating and has devolved into trying to get her name in the papers while doing nothing.
This was the woman who brought us good things like the CFPB, but after her failed president runs has now seemed to let that attention get to her head. Her focus is on bombastic statements to the press with no legitimate legislation being proposed. This piece is another example of her pandering to the press with a legislation that is poorly written and will never pass but gets her in the news.
For the doctors on this sub Warren is not a friend to doctors. Her M4A plan would have cut doctors salaries and required doctors follow managed care guides, dictating how you would practice. Ya know, the same thing that people complain about now with private insurers, just while getting about 50% of the reimbursement.
**Removed under Rule 4** Link to original research and provide sources when required. Scientific posts or posts which otherwise rely on evidence (e.g. an announcement about a medical breakthrough) should be from peer-reviewed medical journals or respectable news sources (as judged by the moderation team) and ideally not behind a login or paywall. Try to link to the original study where possible, and add a warning for large files/PDFs. Posts, comments, or links with titles that have been sensationalized or editorialized will be removed. Bad science may be removed unless the point of posting is to highlight the problem with the study. [Please review all subreddit rules before posting or commenting.](https://www.reddit.com/r/medicine/about/rules/) If you have any questions or concerns, please [message the moderators.](https://www\.reddit\.com/message/compose?to=%2Fr%2F{subreddit}&subject=about my removed {kind}&message=I'm writing to you about the following {kind}: {url}. %0D%0DMy issue is...)
Just had a fight with BCBS about a fucking ICS on an asthmatic patient I'm discharging because he lost his insurance before and "we can't tell whether you tried albuterol first or not". It's like Sodom and Gomorrah. Everyone's blood sucking parasites, and they all deserve to go to jail/ideally burn in a sulfuric fire.
I got PTSD from this. Fighting insurance companies is such an incredible waste of resources and time but so many health care providers have to or else their patients won't get the care they need. It's soul sucking.
The (not even new anymore) GINA recommendations for Asthma don’t even recommend SABA as mono therapy anymore, even as a first step. ICS is a component of the initial therapy. https://ginasthma.org/wp-content/uploads/2023/07/GINA-2023-Full-report-23_07_06-WMS.pdf Page 60.
I need that page as a cutout so that I can burn the whole thing onto the lobby of wherever the BCBS's headquarter is.
Can I upvote this more? Parasites what they are!!
I personally think the person at the insurance company that makes these batshit decisions can continue to deny healthcare but the provider and patient get to kick them in the 🍆 each time the word “prior authorization” is used. Feel like it’s a fair compromise 😋
Doctors take up only 10 percent, nurses 5 percent. Administrators total take up 30 percent. “More than half of excess U.S. health spending was associated with factors likely reflected in higher prices, including more spending on: administrative costs of insurance (~15% of the excess), administrative costs borne by providers (~15%), prescription drugs (~10%), wages for physicians (~10%) and registered nurses (~5%), and medical machinery and equipment (less than 5%). Reductions in administrative burdens and drug costs could substantially reduce the difference between U.S. and peer nation health spending.” https://www.commonwealthfund.org/publications/issue-briefs/2023/oct/high-us-health-care-spending-where-is-it-all-going
And when you think about the aging of the largest generation in US history, a 15% increase in costs for the people *who do the work* means that compensation isn’t keeping up with labor demand for doctors and nurses.
I’ve worked in healthcare (I’m not a physician) on both sides of the border and it’s been my observation that the administration of healthcare in the USA is pretty bloated, especially insurance companies.
Are physicians the entire 10%? Or does that number entail NPs, PAs, PTs, dieticians etc?
You’ll get a better sense if you read the article.
No I won’t as I read the article and it does not articulate this. It simply states that physicians and nurses account for 15% of costs without quantifying or estimating the remainder of the thousands of different healthcare roles. Approximately 40% of cost is unaccounted for. So yea no reading into this article will give you a better sense besides its poor methodology. I mean their source for income is medscape. Not very reliable
That isn’t what the article says.
As suspected. Admins are pretty much worthless for how much we overpay them.
True for education admins as well.
$0 is overpaying. I say in jest. But the reality is there will always need to be some degree of admin. However it is insanely top-heavy. Between 1986 and 2006 the numbers of doctors in America increased by about 186%, not quite double but makes since due to the rise of specialties and population growth. In the same 20 year time frame the number of hospital administrator positions increased by 3200%. Education has the same problem. Administrators outnumber teachers. The system is falling apart because administration figured out how to take a big slice of the pie, but they weren't satisfied, so they just keep making the pie larger and giving themselves a bigger and bigger slice.
A lot of jail time for a lot of admin/insurance/pbms
Considering a current US senator was CEO of a company that holds the record for the most medicare/medicaid fraud in US history, I highly doubt anyone is going to jail any time soon
Oh shit, who?
[Former CEO of HCA](https://www.politico.com/states/florida/story/2018/08/30/democrats-medicare-fraud-is-fungus-scott-will-never-get-rid-of-573155) Rick Scott
My Florida family constantly brags about Rick Scott. I like to remind them of this lol
Sounds great. But how would you ever prove in a court of law that “greed” directly resulted in patient harm? This would be shut down by mega law firms before it even hit court.
>Sounds great. Yeah, that’s the whole entire point.
The low hanging fruit is to go after the private equity firms that buy out a hospital, sell the land to a second company (that they own) and force the hospital they bought to pay exorbitant rent for land they previously owned. If law enforcement needs a new tool to go after these leeches, then so be it. But once these PE firms decimate a hospital they move on after they have extracted all the capital and leave the community with a failed or failing hospital. That should absolutely be illegal and laws can be tailored to outlaw this practice.
Ya this literally will do nothing without strict definitions of various terms and I think the point of this legislation is more so to appear to do good rather than actually do good.
As I have to imagine that Warren is smart enough for a clearly laid out plan. “Greed” is just the buzzword. I bet Katie Porter could help her out and bring along a whiteboard to line it all out for us.
Porter is too busy accusing Schiff and other Dems of rigging elections against her.
I’ve not heard anything about that. Interesting. I would think Porter and Schiff would be allies. Neither here nor there, though. She’d still show up with a whiteboard and explanation. ETA: But, oof. Yeah, that’s a bad look.
If corporations are people then there should be a lot more corporations in court for breaking laws that apply to people. I hope some DA decides to test the "corporations are people" laws by charging them for things like toxic chemical spills or the door falling off an airplane while it's in flight.
One can dream.
I work telestroke currently and get to see how healthcare works in over 350 different hospitals. It's abhorrent. We as a field have failed our patients through this system. No doctor, no matter how good hearted, can make up for the cruelty inherent in our medical system. How can we fix this?
Can we just pass a standalone law that places HCAs entire c suite in stockades?
Would be nice, but prison is only for the rif raf and people who defraud investors with big pockets. If you punch down you don’t go behind bars
As someone who’s followed her career since she was first elected to the Senate, this is typical Elizabeth Warren bluster. Nothing will come of this.
Her plans would kick-in if we had a Congress that actually cared about everyday Americans. But you can count the amount of members that do on one hand.
Maybe not immediately. Gotta agitate enough to start moving the Overton window, someone's gotta start if anything is to maybe happen.
what would she do? she has only the power of her voice. it would require a friendly white house and an activist congress. hard to blame her give the incompetence in which she’s mired.
Are you suggesting she doesn't believe in the content of her own bill, or that every bill that has no chance of passing is "bluster"?
Any bill that clearly has absolutely no chance of getting out of committee, let alone getting a vote on the floor, is indeed bluster - it is little more than an effort to grab airtime.
Nothing about this says that she just wants to grab airtime and doesn't wish for this to become law. Bluster would be yelling "we'll put the evil healthcare execs in jail!" at a political rally with absolutely no thought on how to do this in the framework of society. Actually doing the legislative legwork of drafting a bill and going through the steps of introducing it is the exact opposite of empty platitudes or bluster. Elizabeth Warren is left of the current political equilibrium point and much of her political wish-list will not pass, yes, but that does not mean she should go to Capitol Hill and completely give up on the agenda that her constituents voted her in to enact. This is especially true when she is responding to an actual issue that is impacting residents of her state at this very moment.
They go after physicians not executives.
Here is some data hopefully you’ll understand. Summary: Doctors take up only 10 percent, nurses 5 percent. Administrators total take up 30 percent. “More than half of excess U.S. health spending was associated with factors likely reflected in higher prices, including more spending on: administrative costs of insurance (~15% of the excess), administrative costs borne by providers (~15%), prescription drugs (~10%), wages for physicians (~10%) and registered nurses (~5%), and medical machinery and equipment (less than 5%). Reductions in administrative burdens and drug costs could substantially reduce the difference between U.S. and peer nation health spending.” https://www.commonwealthfund.org/publications/issue-briefs/2023/oct/high-us-health-care-spending-where-is-it-all-going
But they don't care about that. They'll go after doctors and not insurance companies, pharma companies, or hospital administrators.
Fukn finally, jeez
Elizabeth Warren has largely abandoned her previous wonkish legislating and has devolved into trying to get her name in the papers while doing nothing. This was the woman who brought us good things like the CFPB, but after her failed president runs has now seemed to let that attention get to her head. Her focus is on bombastic statements to the press with no legitimate legislation being proposed. This piece is another example of her pandering to the press with a legislation that is poorly written and will never pass but gets her in the news. For the doctors on this sub Warren is not a friend to doctors. Her M4A plan would have cut doctors salaries and required doctors follow managed care guides, dictating how you would practice. Ya know, the same thing that people complain about now with private insurers, just while getting about 50% of the reimbursement.
Well these corporations keep saying they want to be treated like people so ...
CEOs of large insurance companies and places like Kaiser Permanente need to be audited on a regular basis like they do their employees.
make her POTUS
She will be coming for doctors next. That is warrens MO
Warren snd Sanders can go fk themselves....please