Comments on: Should you be allowed to refuse health insurance?

By: Anonymous

Anonymous — Wed, 03 Oct 2007 18:35:00 +0000

So what do you think about government subsidized birth-control pills. The college kids are up in arms about paying more for contraception! I say the taxpayer should not have to subsidize recreational sex! S.Jaques

By: Anonymous

Anonymous — Thu, 23 Aug 2007 14:38:00 +0000

I have different topic to discuss about – We always come across lots of patients who do not pay for their services provided by doctor. If those pt needs to be seen again -can doctor refuse to see them atleast until old charges paid? Thanks
Dr.X

By: Mike

Mike — Tue, 21 Aug 2007 01:41:00 +0000

Michael Rack ,with all due respect, if someone gets admnitted to the hospital because they didnt take their lasix, wouldnt you agree that a three or four day hospitalization is more expensive in the long run??? Or when they finally have that MI??? Or the DKA that goes to the ICU for a few days? It ain’t even close.

By: Anonymous

Anonymous — Sat, 18 Aug 2007 21:27:00 +0000

Of course you guys are looking at $$$. Just what cost do you place on a life saved?

By: Michael Rack, MD

Michael Rack, MD — Sat, 18 Aug 2007 05:42:00 +0000

“It cannot cost MORE to prevent these common disease sthan the treatments required for the full blown disease.”
Sure it can, especially if you need to treat 100 people for years to prevent 1 case of serious disease.

By: Mike

Mike — Sat, 18 Aug 2007 02:24:00 +0000

Anon 3:09.. you make no sense. It cannot cost MORE to prevent these common disease sthan the treatments required for the full blown disease. Maybe for some individual ones in the SHORT term, but not overall. And as more drugs become cheaper and generic, the benefit will only rise.

STOP creating more problems for primary care doctors with the craziness and ludicrous staements.

By: Anonymous

Anonymous — Thu, 16 Aug 2007 20:09:00 +0000

Mike, I didn’t say that none of preventive measures are money-savers, only that one cannot make a blanket statement that all preventive measures save money. Some do save money – like non-smoking or vaccinations or maybe diabetes control. Others – like statins for PRIMARY prevention or some of the screening (mammograms) are not. Obviously, the lower the NNT is for a particular group the more like the measure is to be cost-saving.

Anon at 2:21, I didn’t say it was useless either, only that it doesn’t save money. These are two different subjects. Just because something doesn’t save money doesn’t mean it is useless. It is great that we have pap smears and statins, but the insurance shall pay for recommended tests and treatment. However claiming that something “saves money” when it doesn’t leads to employers trying to force these measures on people and penalize people for things like having LDL over 130.

By: Anonymous

Anonymous — Thu, 16 Aug 2007 19:21:00 +0000

Who are you guys saying that preventative tests are useless? I doubt you are medical professionals or you would know how retarded you sound.

Take just one test, a pap test, and tell me it is useless. In the 1950s prior to it being invented more than 35,000 U.S. women a year died from cervical cancer. it was the leading cause of cancer death in American women. 50 years later there is about 4,100 cervical cancer deaths a year. It is now ranked 13 among cancer deaths in women. How can anyone think prevention is useless. It is of great concern when Drs. talk of price of prevention being more important than human life.

By: Mike

Mike — Thu, 16 Aug 2007 15:15:00 +0000

The idea the preventative care costs more made by people here is just so simplistic. Preventative crae concerns so many diseases and disease states, and sometimes doesnt even REQUIRE MEDS. For instance, do you know how many diabetics didnt realize that juice is a no-no until I told them? And strategies to reduce lipids by deit only. Patient sthnak me for explaining these things, and their pathophysiology. Vaccines are another one. And screening colonoscopies, which are a far sight cheaper than treatement of full blown cancer. And NNT etc doesnt apply for those with family histories, excess risk factors etc, so statistics alone are not the proof.

Primary care IS the way to reduce cost and waste (i.e. prevent useless referrals to specialists by mid levels who just arent “comfortable” cause they don’t have enough experience.)

By: Anonymous

Anonymous — Thu, 16 Aug 2007 13:50:00 +0000

“It might, if people got preventative care earlier (i.e. control lipids to prevent the disease, i.e. MI)”

For the 100s time – preventive care is not money-saver. Preventive care is very expensive since you need to treat a lot of people to control their lipids for many years to prevent one case of the desease.
No opinion on the main subject, just tired of hearing about how preventive care is a money-saver as a justification of forcing paople to take preventive drugs or to be screened. Some people need to learn about NNT/NNS.