Outcome-based research, "misused" to deny spinal surgery. A prediction.
Looks very interesting. As it is close to an hour, I haven't had time to watch it though I read all descriptive notes. I am struck by the fact that it appears to deal with spinal surgery, as a type.
One help in getting what I want will naturally be the government itself.
This reminds me to mention this important issue. I said elsewhere I was "tilting at windmills". Not really. Since spinal surgery - the more complex, the truer - is the most expensive single health problem facing the health-care industry, the govt. has a STRONG interest in addressing its efficacy for cost control. (Alzheimer's and long-term care cost more, but they don't involve a single treatment choice).
Why should they want to pay for surgery which is not only massively expensive, but which may lead to disability and further surgery down the line? Even if it leads to aggravated need only a significant percentage of the time, it will still be cause for govt. concern and probable intervention.
Except for people enabled by surgery to remain in the taxpaying workforce (the higher the bracket, the more worthwhile) - outcome research showing net increased cost, could, probably WILL - mean approving far fewer operations under Medicare, maybe even for younger adults covered by govt. programs. I wonder what the "Minimal H-care standards" list will eventually include re covered spinal treatments and what the criteria for qualification will be!
Outcome-based treatment research is a two-edged sword.
Even with Medi-gap coverage ("Advantage" plans appear on the point of being phased out), those who depend on Medicare and other plans, are likely to be faced with having coverage for a growing list of procedures DENIED! Depending on what such quantitative rsx reveals, patients risk having treatment/surgery denied if and when the total cost to the System proves to be "not worth it" - and not according to the pt's preference!
With spinal surgery this will necessarily mean examining the total cost, including over time. The cost of more surgery or pt disability, must be factored into the equation - not merely the initial high outlay. This research is bound to happen because of cost factors, not to please patients like me. Besides, it is largely a matter of data collection and organization (i.e., cheap) rather than actual clinical research.
If patients DO turn out to fare worse globally, bad things will happen to our choices! This is truest, of course, of older patients like me who may not be deemed to be worth "fixing" temporarily, especially, if it looks like we will need more surgery when we are even older and less able to withstand the rigors.
I argue the need for "meta-studies", to facilitate OUR most informed choices - not those of the actual payers, govt or not. Nevertheless, this research and the figures emerging from it, are certain to be used as rationales to remove choice from our hands, especially for seniors.
UGH. But after all, the value of complex spinal surgery is really THE classic issue of possibly "wasted" late-life care, in the utilitarian sense that appears to be the guiding principle of Obama's savings plan. To reiterate, I don't refer, of course, to children/adolescents nor to younger adults, but to older adults; moreover, as Pooka points out elsewhere, their medical outcomes are qualitatively better than those of older adults who have complex problems in correction and recovery.
Originally posted by titaniumed
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One help in getting what I want will naturally be the government itself.
This reminds me to mention this important issue. I said elsewhere I was "tilting at windmills". Not really. Since spinal surgery - the more complex, the truer - is the most expensive single health problem facing the health-care industry, the govt. has a STRONG interest in addressing its efficacy for cost control. (Alzheimer's and long-term care cost more, but they don't involve a single treatment choice).
Why should they want to pay for surgery which is not only massively expensive, but which may lead to disability and further surgery down the line? Even if it leads to aggravated need only a significant percentage of the time, it will still be cause for govt. concern and probable intervention.
Except for people enabled by surgery to remain in the taxpaying workforce (the higher the bracket, the more worthwhile) - outcome research showing net increased cost, could, probably WILL - mean approving far fewer operations under Medicare, maybe even for younger adults covered by govt. programs. I wonder what the "Minimal H-care standards" list will eventually include re covered spinal treatments and what the criteria for qualification will be!
Outcome-based treatment research is a two-edged sword.
Even with Medi-gap coverage ("Advantage" plans appear on the point of being phased out), those who depend on Medicare and other plans, are likely to be faced with having coverage for a growing list of procedures DENIED! Depending on what such quantitative rsx reveals, patients risk having treatment/surgery denied if and when the total cost to the System proves to be "not worth it" - and not according to the pt's preference!
With spinal surgery this will necessarily mean examining the total cost, including over time. The cost of more surgery or pt disability, must be factored into the equation - not merely the initial high outlay. This research is bound to happen because of cost factors, not to please patients like me. Besides, it is largely a matter of data collection and organization (i.e., cheap) rather than actual clinical research.
If patients DO turn out to fare worse globally, bad things will happen to our choices! This is truest, of course, of older patients like me who may not be deemed to be worth "fixing" temporarily, especially, if it looks like we will need more surgery when we are even older and less able to withstand the rigors.
I argue the need for "meta-studies", to facilitate OUR most informed choices - not those of the actual payers, govt or not. Nevertheless, this research and the figures emerging from it, are certain to be used as rationales to remove choice from our hands, especially for seniors.
UGH. But after all, the value of complex spinal surgery is really THE classic issue of possibly "wasted" late-life care, in the utilitarian sense that appears to be the guiding principle of Obama's savings plan. To reiterate, I don't refer, of course, to children/adolescents nor to younger adults, but to older adults; moreover, as Pooka points out elsewhere, their medical outcomes are qualitatively better than those of older adults who have complex problems in correction and recovery.
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