paydelay and poverty and time spent in hospital

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alexanderr's image Posts 42
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Joined 5 Apr '11 Email user

As someone who is not a US citizen I would like to ask:

If you take longer to pay are you poorer?

If you are poorer you are more likely to be ill(I would think yes).

Does more time in hospital mean they fix a richer patient (who presumably can afford the cost of a longer stay in hospital) better or that the patient was more ill?

Who gets blamed most in the media for poor health care- vendors or doctors?

 
Chris Raimondi's image Rank 38th
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I haven't looked at the PayDelay much, but my understanding was it was how long it took HHP to pay the vendor - not the member paying HHP.  I was assuming this might have something to do with claims still being processed, delays in providers sending it in - or whatnot.  I could be wrong, but I don't think a paydelay indicates the member is poor in any way shape or form.

But to answer your questions from my viewpoint as a US citizen:

1) If you are poor - you probably don't have any health insurance - and wouldn't be able to pay anything near what would be needed for any type of care.  You wouldn't be delayed paying - you wouldn't pay.

2) Yes - everything I have read suggests that you are more likely to be sick if you are poor.

3) Not necessarily IMHO - there would be cases of people having crappy health insurance being kicked out earlier, but this doesn't necessarily mean they would get fixed better.  There are a lot of unnecessary hospital stays, surgeries, and whatnot - some of which offer little if any benefit to the patient.  There are a lot of confounding variables when trying to look at things this way.

4) Doctors don't usually get blamed by the media.  There is a segment of the US (not me) that believe that doctors do everything possible to make/keep people sick.  This is why you see ads like "Weight Loss Secrets Doctors Don't Want You to Know".  By and large though - most main stream media publications in the US portray doctors as being part of the solution - not the problem.

Vendors isn't really a term you hear much in the media.  I think the blame falls into two/three camps:

republicans/conservatives are more likely to blame trial lawyers (ridiculous IMHO)

democrats/liberals are more likely to believe health insurance companies are to blame for being greedy and trying to cut corners

Keep in mind - I am not sure how popular the PCP(HMO) system is outside the US.  You may want to read more about that - as that is probably what you are trying to get at (which is more likely to help you win this contest - info on vendors or PCP).  Primary Care Providers (Not everyone has these - some have PPOs - and I really don't know that much about other forms - or even thses forms) are sort of responsible for the care of a patient.

I belong to a PPO - and can see whoever I want - and the health insurer pays.  If I had an HMO - I have to get a referral first.  If I have a headache – I can go to a brain surgeon tomorrow and ask his opinion and the insurance will pay (probably – haven’t tried this, but I think they would).  If I had an HMO – this wouldn’t happen (unless the PCP thought I needed to see one).  This leads to me to believe that a PCP might correlate better with outcome than specific vendors, but they probably will both be useful for different reasons.   Some of the stuff under vendors I would suspect don’t correlate very well.  I doubt where you get your blood drawn/lab work done matters much (once everything else is taken into account).

 
alexanderr's image Posts 42
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Joined 5 Apr '11 Email user
thanks for those answers-very helpful! I am in the UK and here you see doctors for free and get operations for free but pay for medicines unless you are older than 65 or unemployed in which case the medicines are free too.We find the US system ("pay or die") very harsh on poor people!
 
Sarkis's image Posts 41
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Joined 5 Apr '11 Email user

alexanderr wrote:

thanks for those answers-very helpful! I am in the UK and here you see doctors for free and get operations for free but pay for medicines unless you are older than 65 or unemployed in which case the medicines are free too.We find the US system ("pay or die") very harsh on poor people!

Check out Michael Moore's movie Sicko. The part that stuck in my head from the Sicko was the part about a man who decided to keep his ring finger over his middle finger. It also nicely compares US system with EU system, especially as it relates to maternity care. Cheers!

 
Tapani's image Posts 9
Joined 30 Apr '11 Email user

Thank you Chris for attempting to explain the US system. While your explanation is still a bit US centric, at least I got a bit better view of how it works over there, In many EU countries you don't have to know anything about how it works even in your own country. You go to see a doctor when you need to, and it's all free (tax paid).

Going on a tangent regarding Sarkis comment: There is a (imho) good documentary about different health care systems in the world named "Sick around the world", free to watch on PBS Frontline. http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld

Let's just say that the best health care systems are neither in Europe or the Americas :-) (according to the documentary)

 
inf2207's image Posts 9
Joined 28 Apr '11 Email user

Tapani wrote:

rding Sarkis comment: There is a (imho) good documentary about a different health care systems in the world named "Sick around the world", free to watch on PBS Frontline. http://www.pbs.org/wgbh/pages/frontline/sickaroundtheworld

 "We're sorry, but this video is not available in your region due to rights restrictions" :(

 
Jason Morris's image Posts 11
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I do not think a correlation between pay delay and increased sickness exists. Since there are so many myriad of reasons for a pay delay trying to quantify this into a contributing variable may be impossible.
 
_JeremyA's image Posts 23
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I don't know how helpful PayDelay will be...I just looked at the year over year difference in the two Cancers (given the limited datasets avail) and all the data appears to show is that they had a billing/paying problem in Y1 and Y2 (162+ days for a significant # of claims/clients) which appears to have been fixed in Y3 with most of the PayDelays at ~30 days. I mean, great for their Finance Dept, but not very helpful for an algo. -jba
 
B Yang's image Rank 2nd
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Sarkis wrote:

alexanderr wrote:

thanks for those answers-very helpful! I am in the UK and here you see doctors for free and get operations for free but pay for medicines unless you are older than 65 or unemployed in which case the medicines are free too.We find the US system ("pay or die") very harsh on poor people!

Check out Michael Moore's movie Sicko. The part that stuck in my head from the Sicko was the part about a man who decided to keep his ring finger over his middle finger. It also nicely compares US system with EU system, especially as it relates to maternity care. Cheers!

Believe it or not, there's also a movie called "Michael Moore Hates America", which has a high negative rating correlation with Michael Moore's movies. :)

 
alexanderr's image Posts 42
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Joined 5 Apr '11 Email user

Could long paydelays be indicative of general administrative incompetence in a region in which certain doctors are located? Would more incompetent doctors be found in a region with higher pay delays than average because the employers who appointed the doctors and the regulating health authority are not so good?

So doctors would send patients to hospital when they should not and/or doctors in the regional hospital would admit patients into hospital for a few days when they should not.Why has the paydelay column been included if it is useless?


Do the organisers of this competition know what data is useful and what is not? What potentially useful data have they not given to competitors?

 
oregano's image Posts 3
Joined 27 Apr '11 Email user

alexanderr wrote:

Do the organisers of this competition know what data is useful and what is not? What potentially useful data have they not given to competitors?

 

From what I have read in the forums it sounds like there is a fair amount of information being withheld due to anonymity concerns by HPN...

 

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