What really causes health care costs to rise

Rush keeps saying the brozen package health plan in the exchange will cost a family of 4, $16,000 to $20,000 a year.
 
I did and guess what. You can't get a cost to the patient, as detailed in the article I pointed to.
Wholesale cost seems to be around $55/200ug. Found an article in Critical Care Nurse that thinks
the cost for therapy for a 70kg patient ranges from $114 to $342. But that's cost, not what a patient pays.




The IV tubing manufacturer has tested and 72 hours is how long you can safely use the tubing and stay in the limits for
dosing the patient with stuff leaching out of the tubing. Some of the stuff leaching out is
bad, none of it is particularly good. When a leachate harms mouse fibroblasts or mutates
salmonella typhimurium, you sure as hell don't want to be dosing a kid with it. These tests
they certainly did to gain FDA approval to market the tubing.


what would you think an average adult icu patient weighs these days? How many "ug" do you think is in one 200cc bag? Keep googling.

Leachate smeachate. You're telling me the tubing changes normal saline toxic? When normal saline is shipped in the same material as the tubing is manufactured out of ? Yet the bag can sit for months as long as that magical expiration date hasn't become current? Right.
 
what would you think an average adult icu patient weighs these days? How many "ug" do you think is in one 200cc bag? Keep googling.

So what are you saying? That the patient cost is something,,,, I don't know. Seems like
you haven't got an argument here but maybe I just don't understand.


Leachate smeachate.

Maybe now I understand. You don't have an argument so you're posting something/anything to
indicate you disagree. But don't have an argument.

You're telling me the tubing changes normal saline toxic? When normal saline is shipped in the same material as the tubing is manufactured out of ? Yet the bag can sit for months as long as that magical expiration date hasn't become current? Right.

Any time you want an education on FDA biocompatibility requirements and the application of ISO10993,
just let me know. Would be happy to quote a couple hours of training time to you.
 
He kept repeating "24,000 word" with emphasis. If there's any real interest in what he said, I think his show transcripts are archived on his website.

His "argument" is that the article is too long for his listeners to read?

Remember that Rush is an entertainer, a good one, but not a reporter.
 
Way too long for me. Didn't take the time to check the good entertainer's transcript? http://www.rushlimbaugh.com/daily/2013/02/26/assault_on_for_profit_medicine_begins

Please explain the brilliant reporter/entrepreneur Brill's article to us. Simple and brief now so we can follow...

Right after the first break, Rush agrees with Brill.
Rush said:
And, by the way, he's right about something. It's expensive because somebody pays for it. But it's not the patient. Well, ultimately it is, but the patient doesn't know it. There is no direct relationship between the consumer and the provider in health care.


Then goes off on his entertainment jag. Ignores the actual argument and expounds on how leftists
want to keep people from making money. How "check your facts sturd" came from his show is a
quandary.

And no, can't make it simple and brief as it's not. Ignorance is easier for
some but it doesn't make good policy decisions and if I'm the only person
in the US that can actually sit through a few pages of reading and
comprehending, that's OK. Lowest common denominator can place their
vote same as me and I'll just make sure I can make a living from whatever
we end up with.
 
How "check your facts sturd" came from his show is a
quandary.

May have had something to do with the "standard of care" thing.

Too bad you couldn't explain it but great that you will get by. Crony capitalists do very well today...
 
May have had something to do with the "standard of care" thing. .

Huh? Rush doesn't even mention that. And I was as incredulous as anybody, as mentioned
in an earlier post, that this isn't already part of tort law.


Too bad you couldn't explain it but great that you will get by. Crony capitalists do very well today...

Too bad you can't find the time to read and understand it. Hopefully, you do very well too.

I wish I owned a congresscritter. Sure would make things easier.
 
Huh? Rush doesn't even mention that. And I was as incredulous as anybody, as mentioned
in an earlier post, that this isn't already part of tort law.

Too bad you can't find the time to read and understand it. Hopefully, you do very well too.

I wish I owned a congresscritter. Sure would make things easier.

Think I now understand the tort misunderstanding.

I understand the article too and I may have alluded to a simpler explanation earlier in this thread.

I don't own a congresscritter but I do have a LilCritter. [video=youtube;yBe42BLhMBw]http://www.youtube.com/watch?v=yBe42BLhMBw&feature=player_detailpage[/video]

Think I'm done going around in this tread also...
 
I pay for disability. 100%. i also pay the first $1,000.00 per year out of pocket medical. To help with the $3,000.00 deductible. Then 100% coverage after that.
No one in my company ever exceeds $1,000.00 unless an accident is involved. ( One of my guys got trampled by a cow. not a Kaw. 3 surgerys, much re-hab he paid 2k)


I am for sure a minority. I hope i can take care of my 9 families for years to come cause they sure take care of me.

DD, I work with employers everyday and your in the SMALL minority that pay 100% of healthcare. Your employees should be greatful. Do you also provide DI, and life to them, or they do that voluntary?
 
I pay for disability. 100%. i also pay the first $1,000.00 per year out of pocket medical. To help with the $3,000.00 deductible. Then 100% coverage after that.
No one in my company ever exceeds $1,000.00 unless an accident is involved. ( One of my guys got trampled by a cow. not a Kaw. 3 surgerys, much re-hab he paid 2k)


I am for sure a minority. I hope i can take care of my 9 families for years to come cause they sure take care of me.

That is awesome that you do that for your employees. I work for a very large multi-national and my deductable is $6800 for a family of 4.
 
Show me the leachate stuff sturd. I'll get back to you with my point. Been on the four day grind only got time to sleep and work.
 
Show me the leachate stuff sturd. I'll get back to you with my point. Been on the four day grind only got time to sleep and work.

As I said, I'm happy to quote training in biocompatibility. If you have the biology and
chemistry background, at least Cytotoxicity as it applies to tubing kits I could explain
in a couple of hours. Without the bio and chem, might not be possible to adequately
explain.

Here's a place that has a blurb on the test, though I don't think there is
anything about how this really applies, just what they will do.

If you had a copy of ISO10993, you could read -5 Cytotoxicity. Even then
it's not something that's totally obvious how to apply to a real world application.

Here, a sort of explanation of biocompatibility issue, covers cytotox a bit so
might make sense to you if you're willing to read it.
http://www.farm.unisi.it/didactics/barbucci/LEZ_2_biocompatibility_evaluation.pdf

Get some sleep! SX on at noon tomorrow though.
 
If anyone has a bachelor in life/applied sciences they have had enough education to understand the findings. Biology and chemistries with labs cover the terminolgies and tests, not all evidently.

A lot of iv antibiotics are cytotoxic. We still hang them to help the body necros cells if apoptosis isn't getting the job done by itself alone.

Patient response is usually related to infection for all these medical device. (Eg tubing used > 4 days). I guess unless you have a radioactive implant?


Anyway back to "cost" analysis: what does leachate have to do with changing tubing every 4 days from a cost perspective. Central lines and picc lines can stay in for weeks. Wouldn't leachate affect those?
 
A lot of iv antibiotics are cytotoxic. We still hang them to help the body necros cells if apoptosis isn't getting the job done by itself alone.

Yeabut you don't want to cause apoptosis in healthy cells, by accident, because of something in
your tubing (or bag or anything else that touches or communicates with the patient)


Patient response is usually related to infection for all these medical device. (Eg tubing used > 4 days). I guess unless you have a radioactive implant?

That is because everything you are using has been tested for biocompatibility. Otherwise, you'd
have plenty of unwanted patient responses. Unless I misunderstand what you are trying to say
here.



Anyway back to "cost" analysis: what does leachate have to do with changing tubing every 4 days from a cost perspective. Central lines and picc lines can stay in for weeks. Wouldn't leachate affect those?

The time to change the tubing has been determined (now we're getting into what I need to
charge you for) by the manufacturer based on their risk analysis and the results of
biocompatibility testing. In the case of a tubing set, cytotoxicity (I've been
using as an example as it applies specifically to leachates which I mentioned originally),
irritation, sensitization, sub-chronic toxicity, maybe Ames mutagenicity, a couple more
for blood tubing. Depending on the results and how the risk analysis applies, a limit
to the time you can use the tubing set is generally warranted.

I'm assuming the central lines and picc lines have a different risk profile, may
be different material (knowing that there are thousands of alloys of PVC this
is almost certain), and different test results, the manufacturers of your kits
have come up with a different 'replace by' date for IV lines and central lines.

Sure that affects cost but do you really want to chance that the manufacturer
is wrong and you can use stuff longer? There are far better ways to reduce
costs. And far easier ways. Changing FDA rules for medical devices has some
merit but this is one area of their regulatory methods that really doesn't have much
room for change that would improve cost. You want a big change in regulatory
cost? Change the whole 510(k) bullbarf where any new product can either be the same
as a device made before May 28, 1976, and be approved in 90 days, or go through a
whole different process (PMA) that takes a minimum of 2 years.

But that's a whole 'nother subject I'd have to bill you for.
 
You guys talk funny.
What language is that?

When I get an ouchy I put a bandaid on my boo boo.
 
Exactly. I picture them both sitting over a book searching for words and terms to use in their argument. Funny read!
 
Bottom line. This country is in the shitter, not heading there, but in it. Face deep. And there is nothing we can do about it. We are lucky enough to have my wife's health care program from the horse pistol where she works. We pay about $150 per month, and I feel lucky to have it that cheap. We have a health care savings dealio at my job. I don't participate in it. It would cost me roughly 4 times as much, and the amount paid on each claim is fairly high IMO. I just hope that I get some sort of health care deal figured out for retirement some day, that scares me the most. I think most will need to save up a mortgage to be retired and afford health coverage in 25 years.
 
Retirement is not in the cards for many americans.
I have no plans to do so. ( I have a retirement plan, but it is only my back up)
 
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