A former White House health policy advisor and a direct primary care physician expose the lobbying, incentives, and contract provisions keeping the American healthcare system locked in place.
Now I know why the doctor keeps asking me to go back on Statins!
“Statins are required even when LDL is on target”
I quit using triglycerides when I found they were less than useless and they were only prescribed because of my diabetes. My doctor at the time I quit said “good, you don’t need them!”
2 years later, I quit the statins after reading the dangers as explained by Dr. Aseem Malhotra. Ever since, doctors keep asking me to go back on them. Apparently, as one of the old cartoon characters would say, “there’s gold in them there statin hills.”
Being a resident of Canada, I find this discussion perplexing. Every civilised country in the world has the government taking responsibility for its people's medical needs, the way it takes care of other necessities like policing and firefighting. After all, what are governments for if not to take care of its citizens important needs? Healthcare in Canada is the responsibility of each province and the federal government chips in. It is all paid by the taxpayer, and there is no middleman like insurance companies to waste money on. Certainly it has its problems, like not having enough physicians in some regions, but, overall, people are taken care of when the need arises. The government is aware that costs can be lowered and resources more widely available with a healthier population, and there is effort to do so especially to limit avoidable chronic diseases. A latest effort by the federal government is to require all processed food to have labeled on the front of the package any excessive amounts of unhealthy ingredients like sodium and fat.
"... The deeper problem is contractual. Network agreements prevent employers and providers from cutting out the middleman and paying cash directly. A physician who accepts a cash payment outside their network contract risks violating its terms. Employers who want to steer patients to lower-cost, independently owned facilities have to create workarounds and plausible deniability. ..."
That's true, for someone who participates in a plan that has adopted the network. However, I agree that the network contract would likely not survive a legal challenge if it precluded a licensed professional from treating someone who had no health coverage or someone whose health coverage wasn't through a plan with a network that included that specialty, or Medicare and Medicaid beneficiaries.
Think anesthesiologists, many participate in perhaps one or two networks, but not all networks - and deliver services out of network all the time.
You are right, the #1 problem is the widespread use of networks that are ineffective at controlling prices because the price is set at the BAFTA - best and final total agreement (the lowest a provider will accept to join the network). Plan sponsors often judge the value of the network based on coverage, because that is how participants judge the network (is my provider in the network?)
So, providers must charge employer sponsored plans and those insured in the private exchange 250+% of Medicare Allowable or 350+% of Medicaid Allowable - certainly far, far in excess of the cost of the service, equipment, Rx, etc.
You suggest an ICHRA kind of solution, where employers could make a contribution and wash their hands - funding perhaps $600 per month per person with individual control over what to buy, etc. I think the code already permits employers to provide that so long as the individual submits proof of individual, qualifying coverage.
Of course, that nominal dollar amount is far in excess of the amount most 40 year old healthy workers need, let alone most elementary school age children.
But, $600 a month won't work for the ~20MM adults, ages 18 to 64 (10% of the ~200MM adults), who incur 66% of all medical spend, averaging $20,000+ per capita.
I favor my variant of the Patient Protection and Affordable Care Act of 2010, where we reinvigorate the individual mandate (auto enroll in coverage, not the penalty), coupled with a national stop loss/reinsurance program (with price controls a la Medicare/Medicaid/VA) for those whose medical expenses exceed $25,000 in per person in a calendar year.
When we think we know our Congress is a controlled opposition and then we see one, of who knows how many ways they get sacked into changing from making things right with their constituents, to making things right with their many lobbyists! I'm so thankful there's dedicated health advocates out there fighting for us! Thank you!
Couple of points here:
1) "Journals have deloved into information laundering operations for the pharmaceutical industry," —plos 2006
2) Drug companies are among the biggest criminals on the planet, paying the highest fines of any industry and
3) Drug companies buy advertising to control the journalism industry in America so they do not report on their crimes:
Why You May Have Never Heard that Kansas is Suing Pfizer for Mass COVID Injection Miscarriages & Death: https://old.bitchute.com/video/dP8IeU0vefvj [4.5mins]
Amazing time with IMA, it’s good when you find your tribe!! Thank you so much for the opportunity.
Now I know why the doctor keeps asking me to go back on Statins!
“Statins are required even when LDL is on target”
I quit using triglycerides when I found they were less than useless and they were only prescribed because of my diabetes. My doctor at the time I quit said “good, you don’t need them!”
2 years later, I quit the statins after reading the dangers as explained by Dr. Aseem Malhotra. Ever since, doctors keep asking me to go back on them. Apparently, as one of the old cartoon characters would say, “there’s gold in them there statin hills.”
This woman makes a whole lot of sense
How do I find a DPC physician?
Here is some information that might help (short links):
* Resources > Holistic Health (pets too!): https://tinyurl.com/wj4jn8bk
* Resources > Independent Medical Resources: https://tinyurl.com/2e6y938a
Doctor Yourself
Being a resident of Canada, I find this discussion perplexing. Every civilised country in the world has the government taking responsibility for its people's medical needs, the way it takes care of other necessities like policing and firefighting. After all, what are governments for if not to take care of its citizens important needs? Healthcare in Canada is the responsibility of each province and the federal government chips in. It is all paid by the taxpayer, and there is no middleman like insurance companies to waste money on. Certainly it has its problems, like not having enough physicians in some regions, but, overall, people are taken care of when the need arises. The government is aware that costs can be lowered and resources more widely available with a healthier population, and there is effort to do so especially to limit avoidable chronic diseases. A latest effort by the federal government is to require all processed food to have labeled on the front of the package any excessive amounts of unhealthy ingredients like sodium and fat.
"... The deeper problem is contractual. Network agreements prevent employers and providers from cutting out the middleman and paying cash directly. A physician who accepts a cash payment outside their network contract risks violating its terms. Employers who want to steer patients to lower-cost, independently owned facilities have to create workarounds and plausible deniability. ..."
That's true, for someone who participates in a plan that has adopted the network. However, I agree that the network contract would likely not survive a legal challenge if it precluded a licensed professional from treating someone who had no health coverage or someone whose health coverage wasn't through a plan with a network that included that specialty, or Medicare and Medicaid beneficiaries.
Think anesthesiologists, many participate in perhaps one or two networks, but not all networks - and deliver services out of network all the time.
You are right, the #1 problem is the widespread use of networks that are ineffective at controlling prices because the price is set at the BAFTA - best and final total agreement (the lowest a provider will accept to join the network). Plan sponsors often judge the value of the network based on coverage, because that is how participants judge the network (is my provider in the network?)
So, providers must charge employer sponsored plans and those insured in the private exchange 250+% of Medicare Allowable or 350+% of Medicaid Allowable - certainly far, far in excess of the cost of the service, equipment, Rx, etc.
You suggest an ICHRA kind of solution, where employers could make a contribution and wash their hands - funding perhaps $600 per month per person with individual control over what to buy, etc. I think the code already permits employers to provide that so long as the individual submits proof of individual, qualifying coverage.
Of course, that nominal dollar amount is far in excess of the amount most 40 year old healthy workers need, let alone most elementary school age children.
But, $600 a month won't work for the ~20MM adults, ages 18 to 64 (10% of the ~200MM adults), who incur 66% of all medical spend, averaging $20,000+ per capita.
I favor my variant of the Patient Protection and Affordable Care Act of 2010, where we reinvigorate the individual mandate (auto enroll in coverage, not the penalty), coupled with a national stop loss/reinsurance program (with price controls a la Medicare/Medicaid/VA) for those whose medical expenses exceed $25,000 in per person in a calendar year.
When we think we know our Congress is a controlled opposition and then we see one, of who knows how many ways they get sacked into changing from making things right with their constituents, to making things right with their many lobbyists! I'm so thankful there's dedicated health advocates out there fighting for us! Thank you!