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Kurt Ullman

In article ,
(Don Klipstein) wrote:

SNIP from here - I see a big point to make.

The overall big problem is a big set of a lot of problems, and none of
the individual problems alone is an impressive percentage of the total.
Actually the point I was trying to make, must missed it, is that
people tend to get involved in their little part as being the end-all
and be-all (If only we could kill off all of Big Pharma we could have
medical Nirvana-- not the band, although I would suggest that is
probably closer to reality...by I digress). Instead we need to look at
EVERYthing and see what can be nibbled away within the various parts.

The case is the same for USA excessive energy consumption.

Back to healthcare - so cost of arguably excessive number of fancy
diagnostic devices is less than 5%. Does that figure include cost of
building and maintaining the building space for these devices and paying
total payroll costs of all staff involved in acquiring and posessing and
maintaining these things (and their associated building space, including
climate control, electricity consumed by the device and computers
necessitated by the device, and lighting?) and patient scheduling?
Of course it does, since that is from what the total payments
are and if there is extra money (or profits if you prefer reality), by
definition all of those are included.

High cost of prescription drugs in USA due to protectionism? In USA,
a USA-manufactured FDA-approved prescription drug can cost less after 2
international border crossings (via illegal "reimportation") than after
zero international border crossings.
Low cost of others due to governmental price fixing may be a better
way to put that. Especially when you look at Canada and some of Western
Europe where the non-regulated generics actually cost more than in the
US.
One of the really interesting things about US reform will be what
happens with drug prices elsewhere. I have always wondered if the US is
really subsidizing other countries.

How about how USA values "star doctors"? A surgeon that has
above-average experience becomes more desirable and gets to charge more
from whoever can get him a raise and/or "the latest and greatest"
toys^H^H^H^Htools. At expense of other surgeons becoming less desirable
by having less experience with big-money proceedures.
Not in the US. The charges (especially for MCare and at least
Blues that I am familiar with) are the same no matter who is doing the
cutting. The stars get extra money from the Hospitals because of the
number of patients they bring in (and there is a reflection of greatness
to other areas that might actually bring in more general patients), the
amount of contributions they garner, and in some cases, how much
research money they are able to drum up.

How about hospital nurses being like the doctors by need of making
themselves impressive, taking on needs of impressive continuing education?
It does appear to me that some of that is necessary, but I suspect that
also gets taken to an excess. An RN already has a 4-year college degree,
and in more-prestigious hospitals I sense need for continuing education
that is much of the way worth a master's degree within 20-25 years - along
with working as hard as a restaurant worker does.

CE is a good thing, especially as quickly as things change in
medicine.

What's so bad about bed linen changings and easier drug administrations
and basic body function readings being done by a "Licensed Practical
Nurse"? (Demeaned into "Let's Pretend Nurse" vs. "Real Nurse".) An LPN
requires about 2 years of secondary education, often at a "community
college" ("Associate Degree") or maybe at a trade school, and afterwards
takes a licensing test and if passing becomes officially qualified to
administer drugs even injected ones.
This is happening to many places. Of course, most of us RN use the
bed linen changes and basic body function readings to assess the
patient. Bed sores? Any indications of pain (breathing, grimacing, etc.)
as they move around? Talking to them while doing these things lets us
look at mental function, elicits complaints, etc. Easier drug
administrations give us an opportunity to look for some of the subtler
side effects that might be missed.
Interesting there are many studies showing that all RN staffs
actually save money because their patients tend to be discharged
earlier, problems caught earlier, etc.

--
I want to find a voracious, small-minded predator
and name it after the IRS.
Robert Bakker, paleontologist