Board 8 > Politics Containment Topic 271: Two Turds With One Stone

(+) Yeah! (+)

LordoftheMorons posted...

Its not someone might abuse it. Its a ton of people will abuse it, raising costs for everyone.

Heres a similar example. I dont know if Bernies everything is covered includes this (I hope not!), but lets say it included coverage for alternative medicine. Theres nothing to discourage this; its free! Say that, because of this, 10% of spending ends up going to shit that doesnt work. This benefits nobody; in fact, it hurts people because theyre putting off real treatment. And everybody pays more because of it! The same can occur even for procedures/meds with some merit when theyre being used at the wrong time (common example: a patient demands antibiotics for a viral infection).

Now if you have copays/deductibles, theres incentive not to do this. And on average, everybody is now paying less because it cuts down on unnecessary spending. And Im not saying that copays/deductibles need to be nearly as large as they are now, or that they cant, e.g., scale with income or something. They serve an actual purpose in helping to correctly align incentives.

...So in your doomsday scenario, doctors become total idiots and just give people whatever they want?

Tell me more.

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Corrik7 posted...

Where it is gonna skyrocket is mental health costs.

The more I think about it, the more I am shaky on it and the details are probably where it is gonna lose me at.

If this isn't 100% covered medical then what is the point. If it is 100% covered, then people are going to be going for any old thing regardless of the actual need.

Is it so bad if people are getting medical care for any old thing? People in other countries do get treated for any old thing and their health is better for it.

Now, we might have to open some more medical school so we have more doctors, and maybe some of those doctors - the ones treating colds and cat scratches, say - wouldn't make as much money. Is that supposed to be bad?

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MoogleKupo141 posted...

Wouldnt the doctor just not prescribe them then?

Depends on the doctor. It's apparently a pretty widespread problem:
https://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html

(Another reason antibiotic overprescription in particular is bad is that it accelerates thee evolution of antibiotic resistant bacteria, particularly when people only finish part of their prescription).

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As someone who had a pretty severe mental health crisis, I wish there was less stigma and more assistance in getting help before it reaches a breaking point.

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ok but that sounds like an issue with doctors, not an issue with Medicare for all
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I don't think LotM is wrong on the point of unnecessary prescriptions being a problem/patients being able to badger some doctors into them.

I don't know how widespread it is and I don't agree with the greater moral hazard issues he's presenting but that particular example isn't unfounded IMO.

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StealThisSheen posted...

...So in your doomsday scenario, doctors become total idiots and just give people whatever they want?

Tell me more.

It is about people going to the doctor for no reason, not cuz doctors are prescribing for nothing.

The problem is if you have a ton of people going to the doctor cuz their kid has a temp of 98.9 because they are worried they might have a fever because they figure it can't hurt it is free anyways.

Like I said, the gritty details is where the idea is gonna excel or not. Problem is we have no idea what the details would be if it were to pass congress (which it never will- at least as is)

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xp1337 posted...

I don't think LotM is wrong on the point of unnecessary prescriptions being a problem/patients being able to badger some doctors into them.

I don't know how widespread it is and I don't agree with the greater moral hazard issues he's presenting but that particular example isn't unfounded IMO.

I think that's an issue regardless of medical program in the US though. That's like, a different subject because that needs to stop now lol

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LordoftheMorons posted...

Depends on the doctor. It's apparently a pretty widespread problem:
https://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html

(Another reason antibiotic overprescription in particular is bad is that it accelerates thee evolution of antibiotic resistant bacteria, particularly when people only finish part of their prescription).

Oh, so it's an already existing issue with doctors and thus not really applicable as a M4A boogeyman. Cool.

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Suprak the Stud posted...

I swear Hillary Clinton really needs to get a hobby at this point.

but she's running out of targets committing suicide!
hating bernie and blaming him for the world's ruin is all she has left.

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Yeah, Corrik, I don't think you need to be worried about people faking mental health issues to get treatment. Who wants to be getting mental health treatment? The one single place there may be some faking is with people getting ADD diagnoses to get advantages when taking tests in school, but that also isn't a thing that costs a lot - those people are trying to get that diagnosis so they can cheat on tests with as little expense as possible.

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I live in Canada, and the last time I did a just to be safe checkup I was a few days into a strep throat infection and was already taking antibiotics. I wasn't getting better all that fast and my parents were leaving the country, so we figured we'd go in to be safe. I spent the rest of the day on a saline and antibiotic drip because it turns out my kidneys were shutting down. I didn't even feel all that bad, almost zen or something. But that trip likely saved my life. If I would have had to pay for it, I don't think I would have gone.

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We have dozens of examples of other countries with single payer healthcare. How likely is it that we are going to be the one country that tries it and gets a disastrous result? When we can observe other countries and model our system after the ones that look like they are working well?

I mean, I guess if we put the Democrats in charge of this, they could probably run us into the ground, but if we get Bernie leading this and a team of Republicans managing the details, there should be no problem.

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Corrik7 posted...

Where it is gonna skyrocket is mental health costs.

The more I think about it, the more I am shaky on it and the details are probably where it is gonna lose me at.

If this isn't 100% covered medical then what is the point. If it is 100% covered, then people are going to be going for any old thing regardless of the actual need.

the devil is definitely in the details, though the point would be everyone having a super rich plan as opposed to crap. even if it's not free and you go on something like $20, it's significantly lower than most plans. does everything need to be covered, no, just a lot. that goes for modern insurance policies too when it comes to a variety of drugs that can cost tens of thousands a month.

mental health being covered better would be great. there's somehow mix of diagnosing people too much and doing it wrong, resulting in doing it too little for where it's needed.

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Wait, where are people being over-diagnosed with mental health issues
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red sox 777 posted...

We have dozens of examples of other countries with single payer healthcare. How likely is it that we are going to be the one country that tries it and gets a disastrous result? When we can observe other countries and model our system after the ones that look like they are working well?

I mean, I guess if we put the Democrats in charge of this, they could probably run us into the ground, but if we get Bernie leading this and a team of Republicans managing the details, there should be no problem.

i still think this result would probably get us closest to the australian model.
amusingly, the one candidate who pushed for that one was tulsi.

realistically presidents can only do a very, very few select items so if bernie makes his entire presidency focused on 1) healthcare, and 2) climate change, there's little else he can do. and of that, stuff like the GND just ain't passing, thankfully.

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red sox 777 posted...

Yeah, Corrik, I don't think you need to be worried about people faking mental health issues to get treatment. Who wants to be getting mental health treatment? The one single place there may be some faking is with people getting ADD diagnoses to get advantages when taking tests in school, but that also isn't a thing that costs a lot - those people are trying to get that diagnosis so they can cheat on tests with as little expense as possible.

I didn't say anything about faking. I said the cost for it will skyrocket.

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MoogleKupo141 posted...

ok but that sounds like an issue with doctors, not an issue with Medicare for all

It's partially an issue with doctors (and antibiotics are already cheap, so for them in particular it might not get that much worse if they were free), but the same thing would presumably happen with other medication/procedures (there's a reason pharmaceutical companies spend money on advertising). Antibiotic overprescription is one that I specifically knew was currently a huge issue even now.

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Jakyl25 posted...

Wait, where are people being over-diagnosed with mental health issues

did you miss the excess of people on Ritalin, Prozac, etc? ADD/ADHD is notoriously overdiagnosed. there's a big problem with adolescent mental disorders being done wrong and has been for at least 20 years now. quick google check just got me this.

https://www.psychologytoday.com/us/blog/side-effects/201710/adhd-is-now-widely-overdiagnosed-and-multiple-reasons

i'm sure there's a lot of info out there but a lot of it will come down to misdiagnosis done on young boys/teenage boys. once you get to adults this isn't as big a problem but we're definitely overdoing our kids.

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I just learned that there's seperate codes for hospital insurance reporting injury by waterfowl attack and injury by waterfowl attack while recovering from a waterfowl attack. There's a code for burns caused while jetskiing. There's a lot of staff on board just to do insurance paperwork. Being able to ax that department would save a fortune based on that alone, let alone the much stronger negotiation the government could do.

EDIT: Apparently there's 68000 billable codes. Yeesh.

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LordoftheMorons posted...

I am for taking drastic action on climate change by the way. I just dont want dumb unrelated stuff like a job guarantee thrown in.

I know everyone's on healthcare atm but I'm gonna take a quick aside to point out these things aren't unrelated. "Drastic climate action" will directly result in tens of thousands of Americans losing their jobs, and therefore they need guaranteed jobs if they want them...which can be working on the climate action plan.

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HeroDelTiempo17 posted...

I know everyone's on healthcare atm but I'm gonna take a quick aside to point out these things aren't unrelated. "Drastic climate action" will directly result in tens of thousands of Americans losing their jobs, and therefore they need guaranteed jobs if they want them...which can be working on the climate action plan.

I think I remember discussing this specific point with you before, but I draw a big distinction between creating a ton of jobs specifically to transition to a reduced carbon economy (imo good) and a job guarantee which is an open ended commitment to provide jobs to anyone who wants one whether we need them or not (imo bad)

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Yeah, guarantee is another not happening thing, government should not be doing that. It's a socialist measure that only ends badly.

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Wanglicious posted...

did you miss the excess of people on Ritalin, Prozac, etc? ADD/ADHD is notoriously overdiagnosed. there's a big problem with adolescent mental disorders being done wrong and has been for at least 20 years now. quick google check just got me this.

https://www.psychologytoday.com/us/blog/side-effects/201710/adhd-is-now-widely-overdiagnosed-and-multiple-reasons

i'm sure there's a lot of info out there but a lot of it will come down to misdiagnosis done on young boys/teenage boys. once you get to adults this isn't as big a problem but we're definitely overdoing our kids.

I can give a very good example of overdiagnosing.

My fiancee has depression and anxiety. This leads to her overly worrying that she has things wrong and that her kids have stuff wrong.

Without my knowledge, she took my son to a psychiatrist.

Now autism and adhd at a kid at such an age of 3 is pretty much diagnosed based on testimony of the parent. So a woman with depression and anxiety who doesn't see things correctly at times is advising a psychiatrist on whether my kid has these disorders. He in a 30 minute session diagnosed my child with adhd and autism.

Had all these appointments and plans ordered up for my kid. Was talking about possibly starting medicine for it if it didn't improve etc.

Because my girl has anxiety and thinks a child being a brat and acting up some was something wrong.

So, I flipped the fuck out because our kid clearly has zero issue and I didnt want him falsely diagnosed. So I emailed this doctor anonymously and started a dialogue with him and explained all the situation with my kid anonymously and asked if that is behavioral or if it is psychological as autism/adhd.

He agreed it was clearly biological. Only with this dialogue exchange with the doctor did my girl agree to a SECOND OPINION with us both present. At the second opinion, the lady who did it clearly agreed it was a misdiagnosis and it wasn't even close on the scale.

My girl was trying to get him diagnosed and was trying to apply for social security for my kid behind my back all for something that didn't exist at all, and it was happening because of her anxiety and depression that a doctor let dictate to him the diagnosis.

Misdiagnosis' happen all the time.

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LordoftheMorons posted...

I think I remember discussing this specific point with you before, but I draw a big distinction between creating a ton of jobs specifically to transition to a reduced carbon economy (imo good) and a job guarantee which is an open ended commitment to provide jobs to anyone who wants one whether we need them or not (imo bad)

Yeah but the GND is a long-term infrastructure overhaul of the entire country that will last at least for the next 30 years assuming it aims for 2050. There's gonna be a couple specific jobs that need doing laying around.

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Now autism and adhd at a kid at such an age of 3 is pretty much diagnosed based on testimony of the parent.

My wife is a child clinical psychologist and I can assure you that at least for autism, that is not true. There is extensive screening that goes into an autism diagnosis. A child usually does not even go to a psychiatrist for that sort of diagnosis (there is a lot of variation state to state so I shouldn't say anything too definitively).

EDIT: I cannot obviously guarantee that all doctors follow the approved guidelines and for borderline cases doctors can indeed be "bullied" into a misdiagnosis by an insistent parent.

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Suprak the Stud posted...

My wife is a child clinical psychologist and I can assure you that at least for autism, that is not true. There is extensive screening that goes into an autism diagnosis. Your child would not even go to a psychiatrist for that sort of diagnosis.

EDIT: I cannot obviously guarantee that all doctors follow the approved guidelines and for borderline cases doctors can indeed be "bullied" into a misdiagnosis by an insistent parent.

The screening is dictated by parent diagnosis. For example, fixation. He says does your son have fixations. She goes YES HE IS FIXATED WITH LAWN MOWERS! He goes hmmm well yes fixations on lawn mowers and vacuums is common in autism. Etc etc.

I go to the second lady. She is doing her scale test or whatever. She mentions fixations. She says he does. I say he doesn't. She asks us both to explain. She says blah blah blah like the other psychiatrist said he has fixations on lawn mowers. I explain, that he likes to cut the grass but he isn't fixated on it. If I go to do it, he wants to do it too. He isn't fixated on it. That he likes certain things and sticks to them in phases then drops them completely for his new thing he is into. This is like cars into sharks into super heroes into etc etc.

She agrees this is clearly not a fixation when explained. When the first doctor assessed fixation based on her testimony of his home life.

The first doctor agreed it wasn't autism when we discussed it anonymously. It was only with her testimony that he diagnosed him with autism.

I mean, if you are going to sit here and call me a liar regarding it Suprak I'm gonna lose my shit on you. I sat here and talked to people about it on this site about how much I was losing my shit over it as the situation even happened.

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"Hello,

I am curious is it actually Mild Autism or is it conditioning if a child only experiences issues in regards to tantrums / other mild autism symptoms with only one parent but displays no signs with the other parent / babysitters.

My 3 year old regularly has tantrums and episodes with his mother to the point it drives her insane. However, with myself or a babysitter he does not have these tantrums at all unless the mother is also present with us.

He does exhibit initial shyness and initial separation anxiety from his mother. However, acts normally around others once he spends a little time around them. Also, he is fine after accepting that his mother has actually already gone and crying won't make her come back relatively quickly.

It is to the point that the child will freak out with a tantrum in her presence, but if you carry him 20 feet away from her and say she left, he immediately stops and acts entirely normal.

I personally think this is conditioning learned from as early as birth with always coming to the child any time he cried and giving into the child every time he cried or acted up to try and get him to stop the behavior.

I think this is learned as a way of manipulating a parent to get the child's way, and that is also only employed with the parent he knows that can be manipulated and is not used with the parent/babysitters he knows it will not work with.

Is this mild autism or is this conditioned behavior, in your opinion?

I am under the impression that for something to be mild autism that the behavior has to be universal and not only exhibit under specific circumstances (like only around a single person).

I ask because a psychiatrist diagnosed our child with mild autism recently, which according to your article/blog it states that parent reporting is major in establishing a diagnosis due to subtle symptoms, with only the mother present to state how the child is with her and without myself present to explain the lack of presence of the behavior around others.

Could this lead to a misdiagnosis or does behavior not have to be universal in mild autism?

Thanks for your time."

"Good question.
What you describe is behavioral and would not be considered signs of autism (tantrums...). Very common that a child shows worst behavior for Mom (mother's always get the worst of it), but is better with Dad or others. Hope that helps. "

Copy and pasted excerpt from our conversation.

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I didn't call you a liar because:

I cannot obviously guarantee that all doctors follow the approved guidelines and for borderline cases doctors can indeed be "bullied" into a misdiagnosis by an insistent parent.

And I also revised my initial statement because there is statewide variation on certain aspects of accreditation. I however disagree with your generalized statement because I do not believe that to be true. Because you had a bad experience does not mean that is the norm in the field and typically a child clinical psychologist or psychiatrist will make diagnosis in conjunction with a GP and take into account many factors including how your child is hitting developmental guidelines in addition to parent testimony and direct interaction with the child themselves.

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https://twitter.com/shani_o/status/1231038065595957253?s=21

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Finally a tweet I can love from lotm

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I aim to please

This next one is horrible, though; Trump is now directing a purge of all executive branch officials suspected of disloyalty to him personally:

https://twitter.com/jdawsey1/status/1231036873960775683?s=21

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I don't think there's disagreement that there's a process out there for it that is largely fine.

It's just not done right, is likely too broad, and is misdiagnosed to a very notable degree literally in the millions.

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Kinglicious posted...

I don't think there's disagreement that there's a process out there for it that is largely fine.

It's just not done right, is likely too broad, and is misdiagnosed to a very notable degree literally in the millions.

Misdiagnosis is definitely a thing in young children. Notably with prescriptions to Ritalin in the past which can cause problems in children. There obviously has been a problem with over prescribing opiates. Over prescribing benzos. And with not properly following processes when it comes to recovering process drugs such as Suboxone and such.

I mean, are people going to try and tell me that you are supposed be on Suboxone for 10 years straight.

I don't think there is a debate that there is a ton of bad practice or even shady practice that happens in the medical field.

This doesn't really relate to Medicare for all though.

What does relate to Medicare for all is that while some will say everyone can get the help they need due to no cost limitation, it will also cause a lot of "getting the help you need due to no cost" a lot with people who don't actually need help. This drives up costs, wait times, and etc.

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The shift to autism in this convo is a bit odd to me since it really isnt something you get prescriptions for in and of itself, and its not a mental health issue
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Nelson_Mandela posted...

90% of the posters in this topic are autistic (I don't mean that as an insult)

What's it like being a legitimately awful human being?

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TheRock1525 posted...

What's it like being a legitimately awful human being?

You mean someone who thinks autism is an insult?

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you asked what gets overdiagnosed, the answer is children. ADHD probably the biggest, though anything on the autism spectrum would work too. if you want a different one more common in adults: depression.

that one's wrong almost half the time.

https://www.psychologytoday.com/us/blog/the-truisms-wellness/201609/4-conditions-resemble-depression-arent

main paragraph that stands out hard:

According to a 2012 article in Current Psychiatry, 26 to 45 percent of patients referred for depression did not meet diagnostic criteria for a depressive illness. A 2009 meta-analysis discovered that general practitioners can only correctly identify depression in 47.3 percent of casesand many doctors diagnose depression in people who just dont have it.

basically take any major mental illness that isn't very clear to tell, look up the rates, you'll see a ton.

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Nelson_Mandela posted...

You mean someone who thinks autism is an insult?

Which is you. You think it's an insult and that's why you bring it up.

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Nelson_Mandela posted...

You mean someone who thinks autism is an insult?

That was the "I just kissed a dude but no homo" of posts tbh

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https://twitter.com/realdonaldtrump/status/1230875946334318593?s=21

But socialism is bad, guys
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Seph, delete that post before you get warned for it, bud. Seriously.

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paid for by the...... massive tariff money?.............. that they've been bleeding out?

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Please enjoy this clip of Anderson Cooper telling Rod Blagojevich to bla-go fuck himself:

https://twitter.com/iansams/status/1231027617802989569?s=21

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Another one of these weird multi-candidate (pseudo) endorsements, this time from the American Federation of Teachers (the second largest teachers' union):

https://twitter.com/washingtonpost/status/1231060554544009218

Biden, Sanders, and Warren.

Edit: I guess it's technically not their endorsement, it's a resolution "urging" their members to support one of the three

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Corrik7 posted...

Seph, delete that post before you get warned for it, bud. Seriously.

NKL if you say "no offense" fyi

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Nelson_Mandela posted...

NKL if you say "no offense" fyi

lmfao

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Side note: Fox News is absolutely loving the way Sanders is being treated by the DNC and left-wing media. Almost all of their articles are about proclaiming that the Democratic party is in shambles because they're trying to rig their primary against the frontrunner. Not that they wouldn't be calling the Democratic party in shambles anyway!

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I'm sure that's all in good faith

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I actually think it's a misplay because they're building up Sanders as a sympathetic figure among their fanbase. Maybe they think that he's a shoe-in to beat regardless but Trump has stated in leaked recordings that he's more scared of Sanders than the other candidates, so who knows

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