# Would More Nurse Practitioners Reduce Health Care Costs?



## MoonRiver (Sep 2, 2007)

The walk-in clinic I go to for minor health problems, like a bad cut or poison ivy, uses nurse practitioners. I believe the way this particular clinic works is it is in a group of 4 clinics and there is a supervising doctor.

*Nurse practitioners* are advanced registered nurses educated and trained to provide health promotion and maintenance through the diagnosis and treatment of acute illness and chronic condition. According to the International Council of Nurses, an advanced practice registered nurse (APRN) is "a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A master's degree is recommended for entry level."[1] wikipedia​Nurse practitioners in these states have full practice authority. That means they can diagnose, prescribe, and treat patients without physician oversight. other states require some level of oversight.
Alaska, Arizona, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Iowa, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, Vermont, Washington, Wyoming.​There are currently about 200,000 NP in US. Let's say we increased the number to 300,000 in 5 years. Do you think it would lower the cost of healthcare?

Hint: There are slightly less than 5,000 Walmart stores in US.


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## geo in mi (Nov 14, 2008)

Whenever I'm seen by a CNP, the charges are the same as the M.D..

geo


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## MoonRiver (Sep 2, 2007)

geo in mi said:


> Whenever I'm seen by a CNP, the charges are the same as the M.D..
> 
> geo


Yes, but what if Walmart had a clinic in every store staffed with NP's and charged a lower cash rate than insurance rate. If you have a $5000 deductible, wouldn't you use Walmart whenever possible instead of paying full rate at doctor's office?


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## Bearfootfarm (Jul 13, 2006)

MoonRiver said:


> Yes, but what if Walmart had a clinic in every store staffed with NP's and charged a lower cash rate than insurance rate. If you have a $5000 deductible, wouldn't you use Walmart whenever possible instead of paying full rate at doctor's office?


If Wal-Mart had a clinic with all the necessary equipment, they couldn't charge a lot less and remain in business for long. There's a lot more to the cost than just the Dr.


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## Yellowsnow (May 11, 2016)

No. All of the medical crap has been bought up by giant corps like Wellspan, and the DR's, Nurses pay homage to them. They want stability and go with the flow. We all get screwed in the end.

Don't deviate from your Over Lords designation.


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## Bellyman (Jul 6, 2013)

If the insurance and medicare payment for medical services continues to be the norm, I don't see how things are going to get any cheaper. 

I would LOVE to see more doctors hang out their shingle, "No insurance accepted. Pay by the minute."


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## ed/La (Feb 26, 2009)

Single payer, Medicare for all. Like almost ever country in world. Eliminate the middle man, the insurance companies. I am sure they make a lot of money. I do not think it will happen because their lobbyist donate/buy off congress


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## MoonRiver (Sep 2, 2007)

Bearfootfarm said:


> If Wal-Mart had a clinic with all the necessary equipment, they couldn't charge a lot less and remain in business for long. There's a lot more to the cost than just the Dr.


If Walmart was opening 4000+ clinics, I imagine they could get a sizable discount.

I'm not talking about emergency care. The equipment they need is standard, off the shelf type products. They already buy probably more drugs than any other company in US, plus bandages, ointments, etc.


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## MoonRiver (Sep 2, 2007)

ed/La said:


> Single payer, Medicare for all. Like almost ever country in world. Eliminate the middle man, the insurance companies. I am sure they make a lot of money. I do not think it will happen because their lobbyist donate/buy off congress


If US became single payer, where would Canadians go for treatment?


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## Forcast (Apr 15, 2014)

Bellyman said:


> If the insurance and medicare payment for medical services continues to be the norm, I don't see how things are going to get any cheaper.
> 
> I would LOVE to see more doctors hang out their shingle, "No insurance accepted. Pay by the minute."


Saw a doc for 1 min bill $169.00. True. I sat in the exam room waiting for him to come back in. He didn't. Aid came in wondered why i was still here. Its the same price for me to see doc or np. Dentist is different if you get a student its half price.


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## geo in mi (Nov 14, 2008)

WalMart Nurses??? Will they be Chinese?



geo


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## Jolly (Jan 8, 2004)

ed/La said:


> Single payer, Medicare for all. Like almost ever country in world. Eliminate the middle man, the insurance companies. I am sure they make a lot of money. I do not think it will happen because their lobbyist donate/buy off congress


Louisiana did socialized medicine. It was called the Charity Hospital System, later DHH, then LSU HCSD (I might have missed an incarnation of two).

So whether you liked it or not, that's what single payer government owned hospital healthcare looks like.


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## Jolly (Jan 8, 2004)

NPs are not doctors by any stretch of the imagination. They do not have the depth of knowledge that medical school imparts. They can be valuable members of a treatment team, if used correctly.

Some of the sudden rise in their numbers are attributable to a couple of different things:

1. Reimbursement. There are scenarios where more money can be gotten from Medicare or Medicaid for a NAP visit than for a physicians visit, when you look at overall expense. It's good business practice.
2. Doctor shortages. With current earning possibilities, less guys want to pursue careers in family practice than what is needed. For many things, you can use NPs to bridge the doctor gap.


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## MoonRiver (Sep 2, 2007)

Jolly said:


> 2. Doctor shortages. With current earning possibilities, less guys want to pursue careers in family practice than what is needed. For many things, you can use NPs to bridge the doctor gap.


That was basically my point. All the talk about healthcare reform doesn't reform healthcare at all. I'm suggesting we need a cheaper option for basic healthcare needs, and the easiest way to do that is to flood the market with skilled health practitioners who can perform basic services, either without or with limited physician supervision.

Then allow insurance companies to have 2 rates for certain diagnosis and treatments - one for doctors and one for NPs. Also make sure government regulations make it practical for businesses like Walmart and pharmacies to open clinics in their stores. Break big healthcare's hold on health care delivery.


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## mnn2501 (Apr 2, 2008)

No, eliminating the middle man (insurance) would reduce costs. Every insurance company has different requirements that all doctors offices must have at least one full time person to handle it and larger offices have whole departments devoted to insurance claims. Add to that government regulation (much of which is make-busy work). I know many people hate the idea of single payer, however it could be done independently with government oversight (kind of like the post office)


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## Nevada (Sep 9, 2004)

I suppose that having more doctors or nurse practitioners would help reduce medical costs a little, but that's not where the money is going. CMS reports that Medicare spends just under $1000/mo on the average Medicare patient, or close to $12,000/year. Office visits to your primary care physician only represent a small part of that, usually not more than a few hundred per year. Even if you could cut primary care physician fees in half it wouldn't do much to lower overall medical costs.


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## mnn2501 (Apr 2, 2008)

Jolly said:


> So whether you liked it or not, that's what single payer *government* owned hospital healthcare looks like.


 Make it independent only subject to congressional oversight - like the Post Office.


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## no really (Aug 7, 2013)

Nevada said:


> I suppose that having more doctors or nurse practitioners would help reduce medical costs a little, but that's not where the money is going. CMS reports that Medicare spends just under $1000/mo on the average Medicare patient, or close to $12,000/year. Office visits to your primary care physician only represent a small part of that, usually not more than a few hundred per year. Even if you could cut primary care physician fees in half it wouldn't do much to lower overall medical costs.


Average of 12,000 a year! Dang, need to tell my Grandmother she is way behind the curve in her expenses.


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## gerold (Jul 18, 2011)

MoonRiver said:


> If US became single payer, where would Canadians go for treatment?


I worked in Canada for years. I loved there health care system. No worry about health care and dental care. A lot more advanced and better Doctors then in the U.S. The U.S. has a lot of no good Doctors and cost are really out of line. There are some good hospitals and Doctors but many more poorly rated hospitals and Doctors. Check out your Hospital and Doctor ratings before selecting health care.


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## MoonRiver (Sep 2, 2007)

Nevada said:


> I suppose that having more doctors or nurse practitioners would help reduce medical costs a little, but that's not where the money is going. CMS reports that Medicare spends just under $1000/mo on the average Medicare patient, or close to $12,000/year. Office visits to your primary care physician only represent a small part of that, usually not more than a few hundred per year. Even if you could cut primary care physician fees in half it wouldn't do much to lower overall medical costs.


It might for a young couple with 3 kids that has a $5000 deductible.


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## MoonRiver (Sep 2, 2007)

gerold said:


> I worked in Canada for years. I loved there health care system. No worry about health care and dental care. A lot more advanced and better Doctors then in the U.S. The U.S. has a lot of no good Doctors and cost are really out of line. There are some good hospitals and Doctors but many more poorly rated hospitals and Doctors. Check out your Hospital and Doctor ratings before selecting health care.


*More than 52,000 Canadians travelled abroad for health care last year, study finds*

"In 2014, 52,513 Canadians travelled beyond our borders to seek medical treatment, compared with 41,838 in 2013. The numbers suggest that the Canadian health care system could not comply with the needs and demands of a substantial number of Canadian patients, according to the study."
http://nationalpost.com/news/canada...inds/wcm/fd7f9f40-ea48-4422-bb97-520174d8324a
So I ask again, if US adopts single payer, where will Canadians (and Americans) go to get treatment not readily available is US?


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## no really (Aug 7, 2013)

And many travel outside the US for healthcare.

*More than one million Americans will leave the US for medical care this year*

Health care has become so expensive in the United States that a growing number of Americans (and their employers) are finding it more cost efficient to fly across the globe for certain medical procedures.

The savings are so great — and the quality high enough — that a handful of American insurance companies are now encouraging the practice and covering the travel and treatment costs.

http://www.businessinsider.com/more...ll-leave-us-for-medical-care-this-year-2016-8


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## MoonRiver (Sep 2, 2007)

Nevada said:


> I suppose that having more doctors or nurse practitioners would help reduce medical costs a little, but that's not where the money is going. CMS reports that Medicare spends just under $1000/mo on the average Medicare patient, or close to $12,000/year. Office visits to your primary care physician only represent a small part of that, usually not more than a few hundred per year. Even if you could cut primary care physician fees in half it wouldn't do much to lower overall medical costs.


No government plan currently discussed will fix Medicare. I bet at least 25% of senior health care costs could be eliminated by diet, exercise, and other lifestyle changes. 

The problem is big healthcare and big pharma doesn't want healthy seniors.


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## Nevada (Sep 9, 2004)

MoonRiver said:


> No government plan currently discussed will fix Medicare. I bet at least 25% of senior health care costs could be eliminated by diet, exercise, and other lifestyle changes.
> 
> The problem is big healthcare and big pharma doesn't want healthy seniors.


But here's the thing about seniors; they're all going to get sick and die eventually, regardless of lifestyle. But it's not like people over 65 are the only ones who don't take good care of themselves. 

My point wasn't limited to seniors. I was just pointing out that the cost of visiting our primary care physicians represents only a small fraction of total healthcare costs. What's killing the budget are the $400K heart attacks. It seems to me that we have a lot of room for improvement in major procedures.


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## stanb999 (Jan 30, 2005)

The issue isn't insurance, The issue is medical cost. The insurance co can only make 10% like a utility. Break the medical monopoly. Then prices will go down. Make them provide the same cost for all patients. Make them post the rates. Force them out of business if trust/collusion type actions are taken.

Fact is medicine is far from capitalism in the country. It's fascism at it's worst.


I always LOL at the assertion that we have free market healthcare. Try to open a hospital... They will send men with guns.


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## geo in mi (Nov 14, 2008)

MoonRiver said:


> No government plan currently discussed will fix Medicare. I bet at least 25% of senior health care costs could be eliminated by diet, exercise, and other lifestyle changes.
> 
> The problem is big healthcare and big pharma doesn't want healthy seniors.


Putting CNP's in WalMart would place them convenient to a lot of people who need to diet, exercise, and practice healthier lifestyles........

geo


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## MoonRiver (Sep 2, 2007)

stanb999 said:


> The issue isn't insurance, The issue is medical cost. The insurance co can only make 10% like a utility. Break the medical monopoly. Then prices will go down. Make them provide the same cost for all patients. Make them post the rates. Force them out of business if trust/collusion type actions are taken.
> 
> Fact is medicine is far from capitalism in the country. It's fascism at it's worst.
> 
> ...


Or we could just require that health insurance actually be insurance. I wonder if we even need anything besides catastrophic health insurance coupled with health savings accounts.


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## MoonRiver (Sep 2, 2007)

geo in mi said:


> Putting CNP's in WalMart would place them convenient to a lot of people who need to diet, exercise, and practice healthier lifestyles........
> 
> geo


Put the clinic at one end and the pharmacy at the other. That's about 1/4 mile walk (parking lot to clinic, to pharmacy, to parking lot).

And Walmart sells organic fruits and vegetables.


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## Nevada (Sep 9, 2004)

MoonRiver said:


> Or we could just require that health insurance actually be insurance. I wonder if we even need anything besides catastrophic health insurance coupled with health savings accounts.


People can't afford routine care anymore. They need to normalize occasional doctor visits with regular monthly insurance payments.


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## Bearfootfarm (Jul 13, 2006)

mnn2501 said:


> Make it independent only subject to congressional oversight - *like the Post Office*.


They are going broke and have been for years.


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## Darren (May 10, 2002)

mnn2501 said:


> Make it independent only subject to congressional oversight - like the Post Office.


LMAO!


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## MoonRiver (Sep 2, 2007)

Nevada said:


> People can't afford routine care anymore. They need to normalize occasional doctor visits with regular monthly insurance payments.


But for people who actually pay for their insurance, deductibles are $5000 and up. That's more than most families pay per year on healthcare, so they likely would come out ahead with catastrophic insurance and a health savings account. Instead of paying the $5000 out of pocket, they would pay it with the hsa.


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## Darren (May 10, 2002)

Doc already was a DVM and had her PhD in immuniopathology before becoming a nurse practitioner. She enrolled in what then was an innovative bridge program to bring those with an appropriate bachelors degree into nursing. She went through the full program lasting three years w/o getting credit for any of her previous course work. After 18 months she was an RN and after 18 more she had a masters degree and was a family practitioner. She wanted to practice was is now called integrative medicine. The point is the time frame and number of candidates it would take to graduate enough nurse practitioners to make a difference to reduce health care costs. It's longer than most would expect.

The other factor is the enmity nurse practitioners face from MDs. That's a constant. Generally western states are more progressive in recognizing the ability of a nurse practitioner and treating them as the equivalent of MDs. Not so in much of the East. Some nurses can't break out of the AMA approved model which is another factor limiting available candidates.


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## Lisa in WA (Oct 11, 2004)

Darren said:


> Doc already was a DVM and had her PhD in immuniopathology before becoming a nurse practitioner. She enrolled in what then was an innovative bridge program to bring those with an appropriate bachelors degree into nursing. She went through the full program lasting three years w/o getting credit for any of her previous course work. After 18 months she was an RN and after 18 more she had a masters degree and was a family practitioner. She wanted to practice was is now called integrative medicine. The point is the time frame and number of candidates it would take to graduate enough nurse practitioners to make a difference to reduce health care costs. It's longer than most would expect.
> 
> The other factor is the enmity nurse practitioners face from MDs. That's a constant. Generally western states are more progressive in recognizing the ability of a nurse practitioner and treating them as the equivalent of MDs. Not so in much of the East. Some nurses can't break out of the AMA approved model which is another factor limiting available candidates.


"Integrative" meaning she's wants to practice woo?
Might want to call her "Duck" instead of "Doc" because she's into quackery. (snort)

https://sciencebasedmedicine.org/integrative-medicine-versus-alternative-medicine/


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## no really (Aug 7, 2013)

Lisa in WA said:


> "Integrative" meaning she's wants to practice woo?
> Might want to call her "Duck" instead of "Doc" because she's into quackery. (snort)
> 
> https://sciencebasedmedicine.org/integrative-medicine-versus-alternative-medicine/


I use acupuncture with good results for pain. Much more effective and less problematic than pain killers. But that's just my experience.


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## Darren (May 10, 2002)

Lisa in WA said:


> "Integrative" meaning she's wants to practice woo?
> Might want to call her "Duck" instead of "Doc" because she's into quackery. (snort)
> 
> https://sciencebasedmedicine.org/integrative-medicine-versus-alternative-medicine/


Doc was not exactly ahead of her time, but probably among the front runners. Being a Buddhist dating back to her childhood in the Philippines, she has a perception and later education that many do not. FWIW, Integrative medicine is now mainstream. I had the good fortune to meet a Chinese doctor at the Center of Integrative Medicine. You can add to your knowledge base here, Lisa:

http://cim.umaryland.edu/


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## Lisa in WA (Oct 11, 2004)

Darren said:


> Doc was not exactly ahead of her time, but probably among the front runners. Being a Buddhist dating back to her childhood in the Philippines, she has a perception and later education that many do not. FWIW, Integrative medicine is now mainstream. I had the good fortune to meet a Chinese doctor at the Center of Integrative Medicine. You can add to your knowledge base here, Lisa:
> 
> http://cim.umaryland.edu/


Oh for sure they provide it...people demand woo.

https://www.forbes.com/sites/scienc...e-at-the-university-of-maryland/#477682a37326

still no scientific evidence that proves it works. Its greatest value is as a placebo.


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## Lisa in WA (Oct 11, 2004)

Wasn't Doc the halfwit claiming she could diagnose Hillary via news video?

I think your hormones are clouding your thinking, Darren.


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## Bearfootfarm (Jul 13, 2006)

Nevada said:


> People can't afford routine care anymore.


Sure they can, but no one gets "routine care".
Everyone gets individualized care based on a large number of variables.


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## Jolly (Jan 8, 2004)

Jolly said:


> NPs are not doctors by any stretch of the imagination. They do not have the depth of knowledge that medical school imparts. They can be valuable members of a treatment team, if used correctly.
> 
> Some of the sudden rise in their numbers are attributable to a couple of different things:
> 
> ...





stanb999 said:


> The issue isn't insurance, The issue is medical cost. The insurance co can only make 10% like a utility. Break the medical monopoly. Then prices will go down. Make them provide the same cost for all patients. Make them post the rates. Force them out of business if trust/collusion type actions are taken.
> 
> Fact is medicine is far from capitalism in the country. It's fascism at it's worst.
> 
> ...


 The cost comment is pretty good. A lot of cost shifting occurs in the hospital. different carriers are billed at different rates. Would simplify things a lot if there were two prices posted: A) cash and B)insurance.

Problem comes with the 800 pound guerilla Medicare. When they post their assignments for such and such procedure and you look over the list and find 25% of the items are going to cost you money, not make money, what are you (hospital you) going to do? Where will you make up the money?


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> "Integrative" meaning she's wants to practice woo?
> Might want to call her "Duck" instead of "Doc" because she's into quackery. (snort)
> 
> https://sciencebasedmedicine.org/integrative-medicine-versus-alternative-medicine/


My doctor is an integrative doctor (Internal Medicine). An integrative doctor is largely one that realizes what they were taught in medical school often doesn't work in the real world.


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## stanb999 (Jan 30, 2005)

Jolly said:


> The cost comment is pretty good. A lot of cost shifting occurs in the hospital. different carriers are billed at different rates. Would simplify things a lot if there were two prices posted: A) cash and B)insurance.
> 
> Problem comes with the 800 pound guerilla Medicare. When they post their assignments for such and such procedure and you look over the list and find 25% of the items are going to cost you money, not make money, what are you (hospital you) going to do? Where will you make up the money?



Should the educated buyer , aka insurance pay more or less? Anti-trust action if they charge the individule underduress more. Plus negating the contract for services. Plus jail time for the offenders. This would square it with the rest of commerce.


If there is a hurricane aka emergency. Can I charge more for my gas? A health issue easily fits the destination of an emergency. Emergency should be treated the same as voluntary. Plastic surgery is cheap...


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> My doctor is an integrative doctor (Internal Medicine). An integrative doctor is largely one that realizes what they were taught in medical school often doesn't work in the real world.


Of course, you have to say that if you believe in the woo.


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## Yellowsnow (May 11, 2016)

Not one single person in the USA, that is in favor for Single Payer, can explain how it's going to be paid for.

Have any of you in favor of Single Payer been to the DMV? Are you on Medicare? For some reason you need to buy secondary medical insurance right? Anyone have to go the VA? Anyone hear about the VA lately?

The government can't do anything these days without screwing us or paying their "friends" back. If you want single payer, fine. Lets get the corrupt cronyism under control first, and focus on the spending, and the theft of our money. Then we can have a real discussion on single payer.


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## hunter63 (Jan 4, 2005)

Lisa in WA said:


> Of course, you have to say that if you believe in the woo.


I believe in "pitching Woo".....
Just saying...

THe more people in line that give you care...all have their hand out....How would a NP make thing cheaper?


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## AmericanStand (Jul 29, 2014)

no really said:


> Average of 12,000 a year! Dang, need to tell my Grandmother she is way behind the curve in her expenses.


 It's likely she will catch up in the last yearlong her life.


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## AmericanStand (Jul 29, 2014)

The VA healthcare system seems to work pretty well. 
And it is huge.


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## Yellowsnow (May 11, 2016)

AmericanStand said:


> The VA healthcare system seems to work pretty well.
> And it is huge.


No it doesn't, and it's not 400 million people huge.


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## no really (Aug 7, 2013)

AmericanStand said:


> It's likely she will catch up in the last yearlong her life.


Well she's 86 and still going strong. Has a DNR, with no interest in prolonging her life once things start giving out.


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## Bearfootfarm (Jul 13, 2006)

AmericanStand said:


> The VA healthcare system seems to work pretty well.
> And it is huge.


You're kidding, right?


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## Darren (May 10, 2002)

hunter63 said:


> I believe in "pitching Woo".....
> Just saying...
> 
> THe more people in line that give you care...all have their hand out....How would a NP make thing cheaper?


Doc started out by doing house calls like the MDs of long ago. She was able to get donations of supplies from Walmart and others so that her costs were low. When you compare reimbursement, NPs in family practice make about 60 to 75% of what a MD in family practice does.


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## Nevada (Sep 9, 2004)

MoonRiver said:


> But for people who actually pay for their insurance, deductibles are $5000 and up. That's more than most families pay per year on healthcare, so they likely would come out ahead with catastrophic insurance and a health savings account. Instead of paying the $5000 out of pocket, they would pay it with the hsa.


I selected an HMO, which has no deductible at all.


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## Nevada (Sep 9, 2004)

MoonRiver said:


> My doctor is an integrative doctor (Internal Medicine). An integrative doctor is largely one that realizes what they were taught in medical school often doesn't work in the real world.
> 
> 
> Lisa in WA said:
> ...


There is a HUGE following of people who believe that. Dr. Oz's audience is evidence of that. Basically, they believe the following.

1. Doctors don't really understand diseases or how to treat them.
2. Prescription medications that doctors prescribe aren't good for you, and probably do more harm than good.
3. If you eat right and take the right supplements you won't need to see a doctor or take prescription medications.

I know a lot of people who really seem to believe that. But it concerns me. I wouldn't want anyone to not see a doctor because he doesn't think a doctor knows enough to help him.


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## no really (Aug 7, 2013)

Nevada said:


> I selected an HMO, which has no deductible at all.


How does that work for those who live where this option is not available. This is medicare gap right? How does that translate for those not on medicare, ya know your normal working younger people?


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## Lisa in WA (Oct 11, 2004)

Nevada said:


> There is a HUGE following of people who believe that. Dr. Oz's audience is evidence of that. Basically, they believe the following.
> 
> 1. Doctors don't really understand diseases or how to treat them.
> 2. Prescription medications that doctors prescribe aren't good for you, and probably do more harm than good.
> ...


It's also a big problem with veterinarians. People have access to online information and think they know more than doctors or vets.
Problem is, htey don't have the education, knowledge and experience as a framework to even know what sources they believe are legitimate and what isn't. 
It's like reading online about flying and then trying to tell the pilot of a 747 how to do his job. 
It doesn't work that way.


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## Nevada (Sep 9, 2004)

no really said:


> How does that work for those who live where this option is not available. This is medicare gap right? How does that translate for those not on medicare, ya know your normal working younger people?


It's Medicare Advantage. In my case, I opt for UnitedHealthcare to administer my Medicare through a private HMO plan. There is no premium beyond maintaining Medicare Part B premiums. In fact it costs less than straight Medicare because prescription coverage is included without a Part D premium.

Before I was on Medicare I had a UnitedHealthcare HMO through the Nevada state exchange (Obamacare). It wasn't quite as generous as Senior Dimensions, but the plan was priced at about $550/month. Medicare pays more like $1000/month in premiums to Medicare Advantage providers, so there's more money available to take care of us.

I would really like to see Medicare for everyone.

Keep in mind that I live in a large city where medical care is inexpensive to provide. People who opt to live in rural areas aren't going to see plans as generous as mine.


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## Nevada (Sep 9, 2004)

Lisa in WA said:


> It's also a big problem with veterinarians. People have access to online information and think they know more than doctors or vets.
> Problem is, htey don't have the education, knowledge and experience as a framework to even know what sources they believe are legitimate and what isn't.
> It's like reading online about flying and then trying to tell the pilot of a 747 how to do his job.
> It doesn't work that way.


A better analogy might be someone watching Fox News and deciding he knows more about global warming than climate scientists know.


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## ChocolateMouse (Jul 31, 2013)

"Not one single person in the USA, that is in favor for Single Payer, can explain how it's going to be paid for."

Well that's not so hard to think about. But it requires a deeper understanding of societal and economic functions. And it also helps to have a bit of compassion mixed in.
(warning, big ol rant/explanation on insurance ahead from not an expert)

The way health insurance works to is through buying power. Using this buying power they rig and regulate the market simultaneously. The hospital charges you $100,000 for a cancer treatment and the insurance company calls them and laughs and says "We're not paying 100,000. We will pay you $50,000 because if you don't accept our offer we'll no longer work with your hospital and you'll loose tons of patients.". Then the hospitals themselves charge more to people without insurance to try to keep profit margins and pay high-cost specialists. This forces people to buy insurance to keep alive. If, instead, the majority of the nation were united behind a single buying power that also happened to be the power that regulates trade and drug industries, the ability to negotiate prices at every level becomes apparent. There would be NO way that drug companies could do things like double the cost of epi-pens or HIV treatments for profit. It just wouldn't be able to happen.
The insurance industry itself is a bloated industry that is exclusively a red tape industry. The way insurance works in theory is it's a risk-and-resource pool. In a group of 100 random people, everyone will have SOME health issues, but some more than others. If everyone pools their resources together to cover their health insurance costs the sick people get regular care, are more productive for it, the healthy people have a backup plan in emergencies, and as a group they are more productive and there's less risk and worry. Now what this means is that people who stay very healthy for a long time without emergencies end up paying a lot of money they shouldn't "have to" for the people who are sicker, but because they help the sicker people along, the sicker people contribute more to the system overall and if something DOES happen to the healthy person, the sicker people can keep the boat afloat. This is good for society, economic growth, communal wealth, etc. In practice, however, insurance companies exist to siphon some of that money (15%-25%) off to pay a host of paper pushing employees, investors, and CEOs. But in it's rawest form, insurance as a risk-resource pool works.
An example of this is my sister, who has Rheumatoid Arthritis at 30. She's got a degree, she's worked full time her whole life, and on her medications she functions normally, pulling in some 30K a year. Without her medications, she pulls in nothing and is non functional. Let's say her care costs 12K a year. There's also person B, a healthy person who makes 30K a year. Both her and person B need 20K a year to survive. On her own, my sister doesn't make enough to pay for her medication, and so can't get her medication. When left on her own, she makes 0K a year and person B makes 30K a year, which gives 30K a year to the local economy, business, etc. When she splits the costs with person B, they each make 24K a year, so person B makes less per year, but still has plenty to survive. My sister also makes 24K a year in this situation. Collectively they give 48K a year to the local economy because my sister can function. Pooling resources becomes more efficient for the community and economy as a whole. No individual is an island. No matter how much you claim to be self-made their are always people pooling resources to help eachother out. This is what taxes, in their purest form, are. The more the resources are pooled, the more effective they become. That's how we do everything from build roads to fund military.

We currently spend a bit over 1 trillion on healthcare in the US yearly. A 5% tax increase on households earning more than 400K a year (that is, $4000 a year per person in the top 1% of earners) and a %2 increase on the top 5% of earners ($2000/person/year) , plus a 1% tax increase on the top 10% of earners ($1000 from people who make 125K/year or more) adds up to a good 100-200 billion per year. Single payer healthcare (preferably on a state-based level) would be the end of for-profit insurance, the profits of which would be easy to translate into the budget as well, giving another 100 billion or more to the medicaid/medicare funding. That's reaching around 1.3 trillion which is honestly getting awfully close as it is to the $2trilliion that conservatives cite as the expenses it would cost for medicare for all under the current model. And it will cost that much, for a little while.

Then, with single payer healthcare, the system can be simplified and refined. Making the regulation very simple and the policies simple and universal cuts out the red tape. Nobody has to deal with customizing plans with "emergency care" or "chronic care" or "preexisting conditions". Everyone is just covered. Have citizenship? Have a green card? Have a permanent residency in X state? You're covered. That simple. If you need to go to the doctor, you go.
But this also requires a cultural shift in America. A large percentage of this country views going to the doctor as an emergency-only situation or that going to see a doctor for minor problems is wrong, a waste of resources, or you're weak if you see the doctor. Young people or healthy people are even discouraged from buying insurance altogether, with attitudes like "why give your money away to other people, it's your money". Instead, going to the doctor must be viewed as a positive contribution to society. Preventive care is mostly cheaper than emergency care, so wellness as a whole needs to be a big, new focus in America. It's not easy to change peoples attitudes that way, to get them behind a societal wellness program that requires potential self-sacrifice, but we've done it before. A lot of people on this site are very fond of those propaganda concepts when they're applied to victory gardens and the like. We have a new wave of incensed nationalism in this country so RIDE it with a program towards health wellness for the nation (with additional focus on healthy eating and self-care it could also make steps towards a healthier food system as well). With additional focus and guaranteed government money moving towards preventive care (which also saves TONS of lives btw, but lets not bring morals into a fiscal argument, shall we?) the preventive care market will become more competitive and cheaper each year.

Over the course of a 10-25 year period, the costs will balance out and start to drop. The economy itself will be in a much stronger position, because as detailed above, a rising tide raises all boats. More people who were previously unable to work will be capable of doing so. Spending on emergency services will plummet. The economic status of the country will improve and spending 1.5 trillion a year on healthcare won't be so crazy any more. By the end of our generation healthcare would be self-sustaining.

Now all of this is theoretical and simplified of course. There's a million billion little factors to take into account. It would be chaos for a little while (especially on the stock market), as many giant sweeping reform policies are. And none of this works until you take money out of politics, remove bribery from drug companies, insurance companies, etc. It doesn't work unless you get rid of cronyism, and probably set term limits. It doesn't work if you have an every-man-for-himself attitude. It doesn't work if you don't invest in health and technology sciences. Of course things can go wrong. But it CAN work. It would probably work best on a state-based level with federal oversight to make sure that interstate trade functions. And other countries have implemented similar systems with sweeping success. Because it really is a rising tide that raises all boats, and the country would (probably) be better for it. It's not EASY but it's POSSIBLE.


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## Darren (May 10, 2002)

Nevada said:


> There is a HUGE following of people who believe that. Dr. Oz's audience is evidence of that. Basically, they believe the following.
> 
> 1. Doctors don't really understand diseases or how to treat them.
> 2. Prescription medications that doctors prescribe aren't good for you, and probably do more harm than good.
> ...


Doctors run the gamut. Based on recent experience there are some that are on top of developments. On the other end there are some that seem to have stopped learning after graduation with the exception of the drug company handouts. Some take an active interest. Some see you as just another slotted into the appointment schedule. Those may review your medical history before they see you. That's where trouble can start. Never assume a doctor knows you medically ... ever.

The question is whether you or your advocate has the background and knowledge to be an informed user of health services. Recently I've seen two instances of failures that could have been life threatening and another where a marginal doctor accurately understood what was going on and ordered an immediate admittance. An issue is that even with Internet lookups, most patients do not have the ability to work with a doctor to ensure the best care. That leaves the level of care to the doctor and staff which is not always a good thing.


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## no really (Aug 7, 2013)

Nevada said:


> It's Medicare Advantage. In my case, I opt for UnitedHealthcare to administer my Medicare through a private HMO plan. There is no premium beyond maintaining Medicare Part B premiums. In fact it costs less than straight Medicare because prescription coverage is included without a Part D premium.
> 
> Before I was on Medicare I had a UnitedHealthcare HMO through the Nevada state exchange (Obamacare). It wasn't quite as generous as Senior Dimensions, but the plan was priced at about $550/month. Medicare pays more like $1000/month in premiums to Medicare Advantage providers, so there's more money available to take care of us.
> 
> ...


The cheaper prices for cities is a problem IMO, if there is a mandate to buy a product the value and usability of said product should be equal. Government should not force a portion of the population to pay the same or more for an inferior product. This is why we need to get the insurance companies out of the system.


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## emdeengee (Apr 20, 2010)

Nurse Practitioners were introduced in 2013 where I live in the far north and they have made a huge impact on the care available in rural and wilderness areas. We do have travelling doctors that move from place to place but the nursing stations in all the remote areas are just that - nursing stations. Anything very serious involves medi-vac extraction and elective treatments and complex testing can only be done in the three hospitals in the territory. 

Up until 2013 the full burden of care fell on to the shoulders of the registered nurses who were on duty 24 hours a day. Some of the nursing stations only had one nurse. It is not easy to find people willing to live in remote areas (especially not doctors) even though the income is very good and the lifestyle can be wonderful if you are so inclined.

The introduction of Nurse Practitioners has meant much expanded care given right on site and as a result of this the Nursing Stations have also become better equipped for these new medical procedures further expanding treatment available.

In the more southern regions the rural life is being decimated because there is no work and the young are moving to the cities. There are thousands of beautiful towns that offer inexpensive housing and a peaceful lifestyle which would really suit many of the retiring population but the doctors, dentists and other medical practitioners have also moved to the cities as the rural population has decreased. Without medical care or care that is hours away it is not practical for people to stay or move into these areas. Nursing stations staffed by nurse practitioners would bring these towns back to life.

In towns where NP have been introduced not only has the population increased but a need for other services has meant new businesses - everything from grocery stores to hairdressers/barbers to banks to hotels and recreation facilities. If you introduce healthcare to any area it grows the whole area not just because the older folks need care but most people would never live far away from care if they have children.


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## Nevada (Sep 9, 2004)

no really said:


> The cheaper prices for cities is a problem IMO, if there is a mandate to buy a product the value and usability of said product should be equal. Government should not force a portion of the population to pay the same or more for an inferior product. This is why we need to get the insurance companies out of the system.


The problem with doing that is that it really costs more to deliver medical services in rural areas. For example, a friend in Elko had a heart attack a while back. The local hospital couldn't handle it, so he took a 250 mile air ambulance ride to Salt Lake. Somebody has to pay for that ambulance ride.

For services that are available, there's virtually no competition. There's only one hospital, so they have no competition at all. The only place you'll see competition is in medications, since there are several drug stores in town.

So it really does cost more to provide medical services in remote areas. Knowing that, what's the justification for charging the same as urban areas?


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## Nevada (Sep 9, 2004)

Lisa in WA said:


> It's also a big problem with veterinarians. People have access to online information and think they know more than doctors or vets.
> Problem is, htey don't have the education, knowledge and experience as a framework to even know what sources they believe are legitimate and what isn't.
> It's like reading online about flying and then trying to tell the pilot of a 747 how to do his job.
> It doesn't work that way.


Just to be clear, I don't believe that Dr. Oz created his constituency. I believe it's been there all the time, he's just telling them what they want to hear.

If I'm surprised by anything it's the size of Dr. Oz's following. I knew those people existed, but not in that great of numbers.


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## MoonRiver (Sep 2, 2007)

Nevada said:


> There is a HUGE following of people who believe that. Dr. Oz's audience is evidence of that. Basically, they believe the following.
> 
> 1. Doctors don't really understand diseases or how to treat them.
> 2. Prescription medications that doctors prescribe aren't good for you, and probably do more harm than good.
> ...


I think it is mostly true for most people.

I had high blood pressure that put me in ER twice. I saw a kidney specialist, 2 cardiologists, my regular doc (Internal Med), 2 Nurse practitioners, and another MD (plus the ER docs). Every single one wanted to prescribe more and more meds, even though I told them the meds were mostly ineffective. The only one that did work, several doctors tried to get me to stop taking.

Even after I explained what was triggering the high bp, they completely ignored what I had to say and still wanted to give me more drugs at higher doses. I knew that saturated fat was causing the problem, so on my own I cut back to less than 20 g/day.

Problem seems to be solved. I have stopped 2 of the 3 drugs the doctors had prescribed and take 1/3 less of the one remaining drug. BP seldom goes above 120/80.

I have very little use for doctors. They have been brainwashed by big pharma and big medical devices. Their 2 primary methods of treatment seem to be drugs and surgery. No thanks.

Biggest pet peeve is robotic surgery for prostate cancer. Many urologists have become extremely wealthy by scaring men into surgery with no discussion of less invasive options.

If I need a tetanus shot or a shot for poison ivy, they're great, but that is something a nurse practitioner should be doing. For simple medical problems, I go to the walk-in clinic and usually see a nurse practitioner. For health checkups and guidance, I pay out of pocket to my doc because she doesn't take insurance. Anything beyond that I'm forced to see a corporate owned doctor.


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## MoonRiver (Sep 2, 2007)

Nevada said:


> A better analogy might be someone watching Fox News and deciding he knows more about global warming than climate scientists know.


Good point. I agree with both: Doctors don't know what they are doing and I know that man made global warming is a hoax.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> It's also a big problem with veterinarians. People have access to online information and think they know more than doctors or vets.
> Problem is, htey don't have the education, knowledge and experience as a framework to even know what sources they believe are legitimate and what isn't.
> It's like reading online about flying and then trying to tell the pilot of a 747 how to do his job.
> It doesn't work that way.


Terrible analogy. A pilot takes off, flies, and lands a plane. We have evidence of his expertise.

We have no way to factually know how good a doctor is. Do doctor's cure disease or do they mask symptoms? Is cutting a piece of your body off considered a success? How about taking more and more insulin when diet is proven to cure t2 diabetes (in many people)?


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## Bearfootfarm (Jul 13, 2006)

Nevada said:


> Just to be clear, I don't believe that Dr. Oz created his constituency.


You're correct.
He plays to the lunatic fringe.
Most of what he says is BS and he feeds the hysteria.


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## no really (Aug 7, 2013)

Nevada said:


> The problem with doing that is that it really costs more to deliver medical services in rural areas. For example, a friend in Elko had a heart attack a while back. The local hospital couldn't handle it, so he took a 250 mile air ambulance ride to Salt Lake. Somebody has to pay for that ambulance ride.
> 
> For services that are available, there's virtually no competition. There's only one hospital, so they have no competition at all. The only place you'll see competition is in medications, since there are several drug stores in town.
> 
> So it really does cost more to provide medical services in remote areas. Knowing that, what's the justification for charging the same as urban areas?


It's mandated by law to have insurance, so the costs should be shared by all isn't that the whole point? Not one receiving better service and paying less, than the one receiving less service.


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## ChocolateMouse (Jul 31, 2013)

Incidentally, I just wanted to present another fact about paying for single-payer in America.

https://en.wikipedia.org/wiki/National_Health_Service_(England)
This is England's single-payer system.
It services 50 million people for about $140 billion USD a year.
It is funded (over 90%) through general taxes.
Private insurance still exists but is only used by 8% of the population, usually in addition to public services.
USA has 350 million people, or seven times that of England.
140 billion X 7 = 980 billion.
Or about 25 billion less than we currently spend on health in the US.

Cons; There are some complaints about health access in some areas of the country.
Pros; We have more funds available to put into the program even with what we spend right now, programs get more efficient as they scale up in size, and the worst care in England is still better than the worst care in most of our rural areas. Not to mention we could probably design a more efficient system. Aren't we supposed to be great at things or something?

Cons; Corruption is everywhere and their government tends to cut business taxes instead of raising their healthcare budget, leading to the above problem.
Pros; 70% of citizens approve of raising taxes to improve those services. Like us, if they can fight tax loopholes for rich people they could easily afford to make large improvements in their healthcare system.


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## mnn2501 (Apr 2, 2008)

MoonRiver said:


> Every single one wanted to prescribe more and more meds, even though I told them the meds were mostly ineffective. The only one that did work, several doctors tried to get me to stop taking.


I just fired my doctor (switched to a different doctor) because he kept changing my meds to the "latest and greatest" - because he got kickbacks from big-pharma. MY new doctor (actually an older Internist) listened to me and put me back on my old meds which worked just fine and which now have generics. My only fear is that he's older than I am and nearing retirement age and I'll end up having to change doctors again.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> Terrible analogy. A pilot takes off, flies, and lands a plane. We have evidence of his expertise.
> 
> We have no way to factually know how good a doctor is. Do doctor's cure disease or do they mask symptoms? Is cutting a piece of your body off considered a success? How about taking more and more insulin when diet is proven to cure t2 diabetes (in many people)?


You're wrong.
He may fly, land , and take off terribly. But he's still a pilot who has taken whatever steps and training needed to become a licensed commercial pilot. Same with the doctor. He graduates from undergrad school, med school, passes residency, medical boards, obtains licensure etc. Hes a doctor with proven expertise.
Just because you, who has zero basis to decide whether a doctor has expertise or not, think you do..doesn't make it so.

Diabetes can be reversed or managed with diet. But it isn't "cured". If the person goes back to eating junk again, the diabetes comes right back.


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## Nevada (Sep 9, 2004)

Bearfootfarm said:


> You're correct.
> He plays to the lunatic fringe.
> Most of what he says is BS and he feeds the hysteria.


Maybe so, but it's a huge fringe group.


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## Nevada (Sep 9, 2004)

Lisa in WA said:


> Diabetes can be reversed or managed with diet.


To that particular disorder, I was at a neighbor's house when Oz was on TV. He said that if a diabetic took the supplement, and it lowered blood sugar enough, that the diabetic wouldn't need to take insulin any longer. My neighbor turned to me and said, "You see, doctors don't know. If a diabetic takes the supplement then he wont need insulin."

I told her that Dr. Oz didn't exactly say that. I reminded her that he also said that the supplement would have to lower blood sugar enough, but I doubted that a type 1 diabetic would have that happen. Type 2, along with diet, maybe, but not a type 1 diabetic.

Again she corrected me, saying, "He just said that you can take the supplement and it would work just as well as insulin."

She was only hearing what she wanted to hear.


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## Bearfootfarm (Jul 13, 2006)

Nevada said:


> Maybe so, but it's a* huge* fringe group.


Yes, they are many.
Numbers don't make them more sane or rational.

They are the ones who think eating DE will cure most everything, and that Roundup caused the tumors in Seralini's rats.
He's a snake oil salesman with a gullible audience.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> You're wrong.
> He may fly, land , and take off terribly. But he's still a pilot who has taken whatever steps and training needed to become a licensed commercial pilot. Same with the doctor. He graduates from undergrad school, med school, passes residency, medical boards, obtains licensure etc. Hes a doctor with proven expertise.
> Just because you, who has zero basis to decide whether a doctor has expertise or not, think you do..doesn't make it so.
> 
> Diabetes can be reversed or managed with diet. But it isn't "cured". If the person goes back to eating junk again, the diabetes comes right back.


Licensing simply means someone meets minimum qualifications and pays the state a fee.

Education does not make someone a good or great doctor. That would be like saying someone with a degree in PE is qualified to be an NFL player.

Most doctors are inflexible and think they know what is right. The yearly training they get is paid for by phara companies. They get regular visits from drug reps pushing the latest proprietary drugs.

And, yes, t2 diabetes can be cured. The absence of the disease means it was cured. Doctors rarely cure you of disease.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> Licensing simply means someone meets minimum qualifications and pays the state a fee.
> 
> Education does not make someone a good or great doctor. That would be like saying someone with a degree in PE is qualified to be an NFL player.
> 
> ...


It makes them a doctor. Someone with a PE degree might not have the talent to be an NFL player. If you jump through the hoops to become an MD, you have the talent. Sure, he/she might turn out to be the greatest doctor, but they've attained an education that a naturopath has never had to attain. 
No, it isnt cured. Check with the American Diabetes Association.

Do you have ANY links from reputable sources to back up your claims?


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## painterswife (Jun 7, 2004)

The American diabetes institution is still recommend high level of carbs and pushing insulin when you can cut the carbs and get off the insulin for most type 2 diabetic.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> It makes them a doctor. Someone with a PE degree might not have the talent to be an NFL player. If you jump through the hoops to become an MD, you have the talent. Sure, he/she might turn out to be the greatest doctor, but they've attained an education that a naturopath has never had to attain.
> No, it isnt cured. Check with the American Diabetes Association.
> 
> Do you have ANY links from reputable sources to back up your claims?


American Diabetes Association is bought and paid for. They are just now starting to recommend a diet (except still too high in grains and starches) followed by low carbers for the last 20 years. 

Take a look at Dr Jason Fung's website who cures his patients of T2 diabetes with a combination of diet and fasting. https://intensivedietarymanagement.com/fasting-cures-diabetes-t2d-4/


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## Nevada (Sep 9, 2004)

MoonRiver said:


> ake a look at Dr Jason Fung's website who cures his patients of T2 diabetes with a combination of diet and fasting.


And if a patient goes off the diet?


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## MoonRiver (Sep 2, 2007)

Nevada said:


> And if a patient goes off the diet?


I think it's largely dependent on how long they have been on the diet.

T2 is measurable. When a person no longer has A1c, FPG, or OGTT that meets requirements of diagnosis of type 2 diabetes, they no longer have the disease. Some like to argue over whether this is remission or cure, but that fact is the labs no longer indicate type 2.


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## Nevada (Sep 9, 2004)

MoonRiver said:


> I think it's largely dependent on how long they have been on the diet.
> 
> T2 is measurable. When a person no longer has A1c, FPG, or OGTT that meets requirements of diagnosis of type 2 diabetes, they no longer have the disease. Some like to argue over whether this is remission or cure, but that fact is the labs no longer indicate type 2.


I'm not at all sure that you understand the disease.

When a doctor starts a patient on metformin the patient generally takes it for the rest of his life. There's a reason for that. His body isn't going to go back to the way it was 10 or 20 years ago.


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## painterswife (Jun 7, 2004)

If the bad diet got them there in the first place then yes if they can go back to a bad diet they will they might have it again.


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## Irish Pixie (May 14, 2002)

Nevada said:


> I'm not at all sure that you understand the disease.
> 
> When a doctor starts a patient on metformin the patient generally takes it for the rest of his life. There's a reason for that. His body isn't going to go back to the way it was 10 or 20 years ago.


That's because of damage to beta cells in the islet of Langerhans in the pancreas, for the most part. They are the sensors of sugar in the blood and detect how much insulin to release.


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## painterswife (Jun 7, 2004)

Nevada said:


> I'm not at all sure that you understand the disease.
> 
> When a doctor starts a patient on metformin the patient generally takes it for the rest of his life. There's a reason for that. His body isn't going to go back to the way it was 10 or 20 years ago.


I correspond with several people that are no longer diabetic and who did take Metformin and do not now. There are very exciting things happening in the world of type 2 diabetes.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> I think it's largely dependent on how long they have been on the diet.
> 
> T2 is measurable. When a person no longer has A1c, FPG, or OGTT that meets requirements of diagnosis of type 2 diabetes, they no longer have the disease. Some like to argue over whether this is remission or cure, but that fact is the labs no longer indicate type 2.


I said reputable. Jason Fung is a nephrologist, not an endocrinologist. Show me links where the ADA is "bought and paid for" and show me how the Jason Fung is not selling his quackery to people for a profit.


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## Lisa in WA (Oct 11, 2004)

Nevada said:


> And if a patient goes off the diet?


Then they are right back where they started. By this argument, wouldn't someone on insulin be "cured" too? I mean, till they go off of it.


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## painterswife (Jun 7, 2004)

*Beta cells in Type 2*
People with Type 2, however, recover beta cell function all the time. A study done in Seattle found that beta cells subjected to high glucose levels (about 288 mg/dl in a test tube) lost function rapidly. But when switched to a low-glucose environment (about 15 mg/dl), most of them recovered normal insulin production.

The longer the cells had stayed in the sugary solution, the longer it took them to recover. The researchers said that the damage might be irreversible after too much time in the glucose bath. They couldn’t say how long that time would be.

https://www.diabetesselfmanagement.com/blog/can-beta-cells-be-healed/


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> American Diabetes Association is bought and paid for. They are just now starting to recommend a diet (except still too high in grains and starches) followed by low carbers for the last 20 years.


Yes and the heart association is controlled by big pharma, thats why they pointed out that coconut oil was not a magical health elixir. Good grief....


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## Lisa in WA (Oct 11, 2004)

painterswife said:


> *Beta cells in Type 2*
> People with Type 2, however, recover beta cell function all the time. A study done in Seattle found that beta cells subjected to high glucose levels (about 288 mg/dl in a test tube) lost function rapidly. But when switched to a low-glucose environment (about 15 mg/dl), most of them recovered normal insulin production.
> 
> The longer the cells had stayed in the sugary solution, the longer it took them to recover. The researchers said that the damage might be irreversible after too much time in the glucose bath. They couldn’t say how long that time would be.
> ...


this is written by a nurse.


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## painterswife (Jun 7, 2004)

Jason Fung is not a quack. His patient's test results show the proof that their AC1 numbers go to non diabetic numbers.


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## Lisa in WA (Oct 11, 2004)

painterswife said:


> Jason Fung is not a quack. His patient's test results show the proof that their AC1 numbers go to non diabetic numbers.


We will have to agree to disagree about him.


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## painterswife (Jun 7, 2004)

Lisa in WA said:


> this is written by a nurse.


http://www.mayo.edu/research/centers
*In a patient's own pancreas.* Mayo researchers are working to enhance a person's natural ability to regenerate beta cells using gene therapy


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## Lisa in WA (Oct 11, 2004)

painterswife said:


> http://www.mayo.edu/research/centers
> *In a patient's own pancreas.* Mayo researchers are working to enhance a person's natural ability to regenerate beta cells using gene therapy


Yes, Ive heard of this. It would be wonderful to actually have a cure, and not just a reversal.


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## painterswife (Jun 7, 2004)

Many diabetics should call it a cure if they can stop the drugs just by changing their diet. No diabetic range AC1 is a great thing.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> I said reputable. Jason Fung is a nephrologist, not an endocrinologist. Show me links where the ADA is "bought and paid for" and show me how the Jason Fung is not selling his quackery to people for a profit.


Dr. Fung runs a clinic for t2 diabetes in Toronto, CA and has documented proof of patients being cured of type 2 diabetes. Dr Fung is a modern day Doogie Howser having completed medical school at age 23. To say because he earned a specialization in nephrology he's not qualified is silly.

Like most great doctors, he realized what he learned in medical school wasn't working and spent hours and hours researching the literature looking for better options. He put them into practice and over the years has developed an extremely successful strategy.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> Yes and the heart association is controlled by big pharma, thats why they pointed out that coconut oil was not a magical health elixir. Good grief....


*American Heart Association Renders Itself Obsolete With 1960s Dietary Advice Long Since Refuted*


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> Dr. Fung runs a clinic for t2 diabetes in Toronto, CA and has documented proof of patients being cured of type 2 diabetes. Dr Fung is a modern day Doogie Howser having completed medical school at age 23. To say because he earned a specialization in nephrology he's not qualified is silly.
> 
> Like most great doctors, he realized what he learned in medical school wasn't working and spent hours and hours researching the literature looking for better options. He put them into practice and over the years has developed an extremely successful strategy.


You can tell your anecdotes all you like to deflect. It is not a cure if they go off the diet and the diabetes comes out of remission.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> *American Heart Association Renders Itself Obsolete With 1960s Dietary Advice Long Since Refuted*



Aaannndd, you're using the granddaddy quack Mercola as your source. 
Okey doke, you win. There is no point in arguing with someone who doesn't have the slightest inkling what a reputable source is.


----------



## painterswife (Jun 7, 2004)

Yes, we will have to disagree. I reserve the right to rub your nose in it each time a new study comes out backing up my assertions.


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## ed/La (Feb 26, 2009)

*https://www.forbes.com/sites/theapo...economically-freer-than-the-u-s/#66829a3b137e The Swiss and Singaporean models*

The two advanced economies with the most economically free health care systems—Switzerland and Singapore—have achieved universal health insurance while spending a fraction of what the U.S. spends. Switzerland’s public spending on health care is about half of America’s, and Singapore’s is about a fifth of ours. If we had either of those systems, we wouldn’t have a federal budget deficit


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## Lisa in WA (Oct 11, 2004)

painterswife said:


> Yes, we will have to disagree. I reserve the right to rub your nose in it each time a new study comes out backing up my assertions.


Did you even have an old study backing up your assertions?
You wont need to rub my nose in anything. If actual studies from reputable sources (nd not info from a blog or internet quack) show that diet can actually CURE diabetes (not just reverse it or put it in remission) then Ill be thrilled.


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## painterswife (Jun 7, 2004)

Lisa in WA said:


> Did you even have an old study backing up your assertions?
> You wont need to rub my nose in anything. If actual studies from reputable sources (nd not info from a blog or internet quack) show that diet can actually CURE diabetes (not just reverse it or put it in remission) then Ill be thrilled.


Funny, I did not notice any studies posted by you. Guess I should have used a smiley face. My attempt at levity fell flat.


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## Bearfootfarm (Jul 13, 2006)

painterswife said:


> I reserve the right to rub your nose in it each time *a new study* comes out backing up my assertions.


You've shown one actual study about some lab results that is close to 17 years old, and one 4 year old source which pretty much amounts to someone's blog that says: 


> We always hear that diabetes is incurable, and so far it has been.


It also included this tidbit that did nothing to boost their credibility:



> The herbal medicine site _Green Med Info_ lists black cumin seeds, vitamin D, berberine, bitter melon, curcumin, chard extract, and more as helping beta cells grow and heal, although mostly in rodent studies.


Where are these "*new*" studies that *say* they have found a cure?


----------



## Shrek (May 1, 2002)

MoonRiver said:


> *More than 52,000 Canadians travelled abroad for health care last year, study finds*
> 
> "In 2014, 52,513 Canadians travelled beyond our borders to seek medical treatment, compared with 41,838 in 2013. The numbers suggest that the Canadian health care system could not comply with the needs and demands of a substantial number of Canadian patients, according to the study."
> So I ask again, if US adopts single payer, where will Canadians (and Americans) go to get treatment not readily available is US?


A family I know in Winnipeg buy U.S. health insurance , use a U.S doctor and travel to the states because in Manitoba their dogs get treated faster than they do.

They told me that they aren't the only ones in their area who prefer U.S healthcare and are willing to make the trip south to get treated.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> You can tell your anecdotes all you like to deflect. It is not a cure if they go off the diet and the diabetes comes out of remission.


I'm not saying it does. For those who lose weight and maintain a healthy life style, it probably does not come back. According to Dr Fung, T2 diabetes is a result of becoming insulin resistant. You become insulin resistant through diet, so returning to a diet that causes insulin resistance will likely cause a return of diabetes. Diet caused the type 2 diabetes in the 1st place and returning to that diet will cause it again.

The point is doctors receive little or no training in nutrition, yet diet can cause disease and diet and heal disease. When they do offer diet advice, it is often wrong and based on conventional, not scientific, knowledge.

When a doctor starts to give you a prescription, try asking what you can do instead of taking the prescription. I'm guessing maybe 1 out of 3 will attempt to work with you and the other 2 will give you a look that says you are stupid while telling you all the bad things that will happen if you don't take the drug.

How about when doctors prescribe a proton pump inhibitor to decrease the production of stomach acid when quite often the problem is not enough stomach acid? How about prescribing drugs such as Vioxx, which I actually had prescribed to me. I took it once and didn't like the side effects, so thankfully I stopped taking it before I had any heart damage. I now manage arthritis quite well with vitamin C and fish oil.

Why would a doctor prescribe Vioxx when there are several vitamins, minerals, and supplements that manage arthritis with little or no side effects? Good medicine or influence of big Pharma?


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## MoonRiver (Sep 2, 2007)

ed/La said:


> If we had either of those systems, we wouldn’t have a federal budget deficit


Part of the reason health care is more expensive in the US is because this is where much of the research takes place and we pay for the research the rest of the world benefits from. Why are drugs so much more expensive in US than in Canada and Mexico?


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## painterswife (Jun 7, 2004)

Bearfootfarm said:


> You've shown one actual study about some lab results that is close to 17 years old, and one 4 year old source which pretty much amounts to someone's blog that says:
> 
> 
> It also included this tidbit that did nothing to boost their credibility:
> ...


First show me where I said I provided a study in the first place.


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## mnn2501 (Apr 2, 2008)

painterswife said:


> The American diabetes institution is still recommend high level of carbs and pushing insulin when you can cut the carbs and get off the insulin for most type 2 diabetic.


As the husband of a type one diabetic and being borderline type 2 myself, I KNOW for a fact that they do NOT push a high level of carbs. 
Stop drinking the kool aid someones giving you.


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## painterswife (Jun 7, 2004)

mnn2501 said:


> As the husband of a type one diabetic and being borderline type 2 myself, I KNOW for a fact that they do NOT push a high level of carbs.
> Stop drinking the kool aid someones giving you.


*"How Much Carbohydrate?*
How much carbohydrate you eat is very individual. Finding the right amount of carbohydrate depends on many things including how active you are and what, if any, medicines you take. Some people are active and can eat more carbohydrate. Others may need to have less carbohydrate to keep their blood glucose in control.

Finding the balance for yourself is important so you can feel your best, do the things you enjoy, and lower your risk of diabetes complications.

*A place to start is at about 45-60 grams of carbohydrate at a meal.* You may need more or less carbohydrate at meals depending on how you manage your diabetes.

You and your health care team can figure out the right amount for you. Once you know how much carb to eat at a meal, choose your food and the portion size to match."

http://www.diabetes.org/food-and-fi...ding-carbohydrates/carbohydrate-counting.html


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## MoonRiver (Sep 2, 2007)

mnn2501 said:


> As the husband of a type one diabetic and being borderline type 2 myself, I KNOW for a fact that they do NOT push a high level of carbs.
> Stop drinking the kool aid someones giving you.


They recommend grains and starches, which are high carb. What is really important is insulin level. If eating grains and starches causes a large glucose spike, then they should be restricted.

Type 1 and type 2 diabetes are not the same disease. Type 1 diabetics can't make insulin and type 2 is a disease of insulin resistance. One would think doctors would be smart enough to know that lack of insulin and insulin resistance require different treatments.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> They recommend grains and starches, which are high carb. What is really important is insulin level. If eating grains and starches causes a large glucose spike, then they should be restricted.
> 
> Type 1 and type 2 diabetes are not the same disease. Type 1 diabetics can't make insulin and type 2 is a disease of insulin resistance. One would think doctors would be smart enough to know that lack of insulin and insulin resistance require different treatments.


Out of curiosity: assuming you are right, why is the ADA recommending carbs to people if it is detrimental to their health?


----------



## ed/La (Feb 26, 2009)

Dr. Peter B. Bach, director of Director of Memorial Sloan Kettering's Center for Health Policy and Outcomes, says that pharmaceutical companies charge high prices simply "because they can." Bach added. "We have no rational system in the U.S. for managing prices of drugs. One of America's largest provider of medications, the federal government-run Medicare cannot, by law, negotiate with pharmaceuticals.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> Out of curiosity: assuming you are right, why is the ADA recommending carbs to people if it is detrimental to their health?


Food industry.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> Food industry.


So you think that all of the endocrinologists in the world and institutions like the ADA are promoting carbs to placate the food industry? Even though they know that their advice is detrimental to patients?


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## mnn2501 (Apr 2, 2008)

Lisa in WA said:


> Out of curiosity: assuming you are right, why is the ADA recommending carbs to people if it is detrimental to their health?


You still need carbs, if all you eat is protein, you go into ketoacidosis and eventually it will kill you.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> So you think that all of the endocrinologists in the world and institutions like the ADA are promoting carbs to placate the food industry? Even though they know that their advice is detrimental to patients?


Who puts on the healthcare seminars the doctors attend to meet their continuing education requirements?
Who pays for medical research (besides the government)?
Who has an interest in certain drugs and foods being deemed healthy?

Follow the money.

Most endocrinologists do what they have been taught, right or wrong.


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## MoonRiver (Sep 2, 2007)

mnn2501 said:


> You still need carbs, if all you eat is protein, you go into ketoacidosis and eventually it will kill you.


Where did you get such an idea? 

And no one is advocating an all protein diet. In general, what is recommended is a high fat, moderate protein, low carb diet; but it really comes down to is keeping blood glucose and insulin low. Keep blood glucose and insulin low and over time a person becomes insulin sensitive again.

The idea behind insulin for t2 is since a person is insulin resistant, give them more insulin to make up for the resistance. That means that, all things being equal, over time the amount of insulin will need to be increased as insulin resistance increases.

Restricting carbs lowers glucose. Fasting and restricting carbs also lowers insulin resistance, so over time, a person becomes sensitive to insulin again. At that point, they are "cured". If they go back to eating a high carb diet, chances are over time they will become insulin resistant again.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> Who puts on the healthcare seminars the doctors attend to meet their continuing education requirements?
> Who pays for medical research (besides the government)?
> Who has an interest in certain drugs and foods being deemed healthy?
> 
> ...



How do you know this?
Additionally, are you saying that you know more about diabetes than a board certified endocrinologist, if so, how?


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## AmericanStand (Jul 29, 2014)

Yellowsnow said:


> No it doesn't, and it's not 400 million people huge.


 If you include the Active Duty , VA ,Tricare , Indian health care . Welfare health care and whatever other healthcare programs the government pays for it's huge. 
And if you think it's bad healthcare just propose doing away with it and listen to the screams.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> How do you know this?
> Additionally, are you saying that you know more about diabetes than a board certified endocrinologist, if so, how?


I'm saying I probably know more about successfully treating type 2 diabetes than some endocrinologists.

I've been seeking out doctors for health problems I have for over 40 years. The only health improvements I have achieved were a result of my own research and intuition. 

Doctors who buck the AMA are often threatened with disciplinary action.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> I'm saying I probably know more about successfully treating type 2 diabetes than some endocrinologists.
> 
> I've been seeking out doctors for health problems I have for over 40 years. The only health improvements I have achieved were a result of my own research and intuition.
> 
> Doctors who buck the AMA are often threatened with disciplinary action.



Where did you get your medical degree and do your residency?

I'm guessing University of Google?


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> I'm saying I probably know more about successfully treating type 2 diabetes than some endocrinologists.
> 
> I've been seeking out doctors for health problems I have for over 40 years. The only health improvements I have achieved were a result of my own research and intuition.
> 
> Doctors who buck the AMA are often threatened with disciplinary action.



I guess the only question I have left for you is this: when you've been conferring with doctors for your myriad health problems have you been formerly diagnosed with Dunning Kruger Effect Syndrome or have you managed to fly under the radar with it?

It's not really a diagnosis but since medically winging it here is okay, I figured I'd just go for it.

Not that I'm a doctor or anything but it seems pretty apparent here.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> I guess the only question I have left for you is this: when you've been conferring with doctors for your myriad health problems have you been formerly diagnosed with Dunning Kruger Effect Syndrome or have you managed to fly under the radar with it?
> 
> It's not really a diagnosis but since medically winging it here is okay, I figured I'd just go for it.
> 
> Not that I'm a doctor or anything but it seems pretty apparent here.


Why do we have an epidemic of neurological diseases like Alzheimers, ADHD, autism, etc? If doctors are as great as you imply, why do we still have heart disease, strokes, high blood pressure, diabetes, arthritis, etc? Most people follow doctor's orders and take the pills, so what gives?

When you read the side effects of most drugs, the cure is as bad as the medicine. But that's OK, because they have drugs for the side effects.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> Why do we have an epidemic of neurological diseases like Alzheimers, ADHD, autism, etc? If doctors are as great as you imply, why do we still have heart disease, strokes, high blood pressure, diabetes, arthritis, etc? Most people follow doctor's orders and take the pills, so what gives?
> 
> When you read the side effects of most drugs, the cure is as bad as the medicine. But that's OK, because they have drugs for the side effects.


I guess you'd better get on the 'puter and get a' researchin'!


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> Where did you get your medical degree and do your residency?
> 
> I'm guessing University of Google?


Anyone with slightly above average intelligence can read the same studies doctors supposedly read. Plus people who are sick and not helped by doctors are often highly motivated to do the research. I am. 

I started on a Ph D a few years back, and was surprised at the lack of motivation of most students. I wanted to learn as much as I could and they just wanted to complete the class - get their ticket punched. I bet it's the same in medical school.

I quit after 1 semester when I realized I could learn more, faster, on my own. When I worked in IT, I earned certifications (network engineer and instructor) from several vendors through self study. In my opinion, university training is about the most ineffective and inefficient way to learn anything.


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## painterswife (Jun 7, 2004)

What is the problem with someone trying to treat their illness with diet? Yes, you can treat diabetes with drugs but it will never get better. The doctor will tell you it is a progressive disease. The more drugs you take the more you hurt your body and the more your disease progresses. It just gets worse. So instead you change your diet. You might just get better, you get off drugs. How is that a bad thing?


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## Bearfootfarm (Jul 13, 2006)

> MoonRiver said: ↑
> Why do we have an epidemic of neurological diseases like Alzheimers, ADHD, autism, etc?


We don't.
We have an epidemic of people doing self diagnosis.


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## wr (Aug 10, 2003)

Shrek said:


> A family I know in Winnipeg buy U.S. health insurance , use a U.S doctor and travel to the states because in Manitoba their dogs get treated faster than they do.
> 
> They told me that they aren't the only ones in their area who prefer U.S healthcare and are willing to make the trip south to get treated.


It's my understanding that things go well for Canadians who buy US insurance unless things get serious and then they receive the absolute minimal treatment and a quick flight back to Canada. 

A good friend recently received such after a very serious accident in the US. He spent less than a week in a Utah hospital was stabilized as quick as possible, one surgery for internal bleeding and another to amputate his arm. Four days later, he was airlifted to a hospital in Calgary for further surgeries, burn treatment, skin grafting, etc. Ironically, no prior arrangements were made for his arrival and it was not handled as a hospital transfer so he had to be admitted in Calgary via ER. 

Another friend discovered that a serious gall bladder incident requiring surgery got an IV line, a few quick tests, T-3's and a flight home.


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## MoonRiver (Sep 2, 2007)

Bearfootfarm said:


> We don't.
> We have an epidemic of people doing self diagnosis.


"The rate of people dying from Alzheimer's disease in the United States rose by 55% over a 15-year period, new data from the Centers for Disease Control and Prevention shows.
The number of those patients dying at home from the neurodegenerative condition also rose, from 14% to 25% over the same time period studied, 2009-2014." CNN
​


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## painterswife (Jun 7, 2004)

Bearfootfarm said:


> We don't.
> We have an epidemic of people doing self diagnosis.


Yes there are. That however is not topic we're discussing. We are discussing how diet can change what you're diagnosed with. I am one of those people. I was diagnosed with high blood pressure 2 years ago. Major drugs. I could have stayed on those drugs but I didn't. I did my research and I changed my diet. I am now drug free and I no longer have high blood pressure. 

I know a diet can't solve everything but it can change a lot of things.


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## Nevada (Sep 9, 2004)

Lisa in WA said:


> Where did you get your medical degree and do your residency?
> 
> I'm guessing University of Google?


I would have guessed Trump University...


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## Lisa in WA (Oct 11, 2004)

Nevada said:


> I would have guessed Trump University...



Even more likely.


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## Bearfootfarm (Jul 13, 2006)

MoonRiver said:


> "The rate of people dying from Alzheimer's disease in the United States rose by 55% over a 15-year period, new data from the Centers for Disease Control and Prevention shows.
> The number of those patients dying at home from the neurodegenerative condition also rose, from 14% to 25% over the same time period studied, 2009-2014."


Before they just died of "natural causes".
Don't confuse an increase in *labeling* a condition with an actual increase in the frequency of a condition itself.

When I was young, no one had "ADD" or "ADHD".
They were just brats and troublemakers.
Now they get the labels and the prescriptions, and become statistics.


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## ChocolateMouse (Jul 31, 2013)

" That however is not topic we're discussing. We are discussing how diet can change what you're diagnosed with."

I'm fairly certain the topic of the thread was how to lower healthcare costs and if using RNPs would help with that, actually..... Maybe ya'll can make your own debate-about-diabetes thread?

Incidentally, my own regular care is provided by a RNP. I get all my prescriptions through her and the like. She does my annuals and puts my in touch with specialists at larger facilities if I need additional work. It's nice. She's nice. I like her.


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## Bellyman (Jul 6, 2013)

I am curious, is ANYONE reading or posting in this thread an actual physician or nurse practitioner?


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## Bearfootfarm (Jul 13, 2006)

painterswife said:


> That however is not topic we're discussing.


It is if I bring it up.



painterswife said:


> I was diagnosed with high blood pressure 2 years ago. Major drugs. I could have stayed on those drugs but I didn't. I did my research and I changed my diet. I am now drug free and I no longer have high blood pressure.
> 
> *I know a diet can't solve everything but it can change a lot of things.*


Diet can "change" things.
It doesn't "*cure*" things.
Diets generally aren't the root cause of the problem since some individuals can have the same diets as a diabetic but not have diabetes.

You've *controlled* your blood pressure by controlling your diet.
That's not unusual at all.
You haven't "cured" the problem that made your diet affect you in that manner.


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## ChocolateMouse (Jul 31, 2013)

Bellyman, I'm not but I could get a guy in here who does research diabetes if you want.  Worked in a diabetic retinopathy lab trying to work out pieces of a cure. Cool stuff.


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## MoonRiver (Sep 2, 2007)

Bearfootfarm said:


> It is if I bring it up.
> 
> Diet can "change" things.
> It doesn't "*cure*" things.
> ...


The absence of symptoms or lack of measurable indicators in lab tests is good enough for me. I had it, now I don't.

There are a lot of reasons we get sick and some of the additives put into food is just one of them. When our western diet is exported to developing countries, they soon develop the same diseases we suffer from.


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## Bearfootfarm (Jul 13, 2006)

MoonRiver said:


> The absence of symptoms or lack of measurable indicators in lab tests is good enough for me. I had it, now I don't.


That's still not a "cure".
That's your anecdote.



MoonRiver said:


> There are a lot of reasons we get sick and some of the additives put into food is just one of them. When our western diet is exported to developing countries, they soon develop the same diseases we suffer from.


That's the internet hype.
It's not necessarily factual.
Humans everywhere tend to suffer from the "same diseases" since we are all the same species.


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## AmericanStand (Jul 29, 2014)

Tend means the same as "Can" in the above context.


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## MoonRiver (Sep 2, 2007)

Bearfootfarm said:


> That's still not a "cure".
> That's your anecdote.


Simple logic:
If doctor's use lab test results to indicate disease, then the absence of these results has to mean no disease.



> That's the internet hype.
> It's not necessarily factual.
> Humans everywhere tend to suffer from the "same diseases" since we are all the same species.


Then why do they not get diseases (in large numbers) like heart disease, type 2 diabetes, high blood pressure, etc until after they have adopted a western diet? Why is it that cultures that still eat a traditional diet don't have these diseases in large numbers?

Think about where we came from. Signaling within our biological systems are based on light, water, natural emf, temperature, and food. Mess with any one and you have modern disease. Mess with them all and you have the US.


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## Bellyman (Jul 6, 2013)

Bellyman said:


> I am curious, is ANYONE reading or posting in this thread an actual physician or nurse practitioner?


Didn't think so...

It gets to be a "he said, she said" peeing contest after a while. Does every thread have to go down this road? Uugh!!


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## Lisa in WA (Oct 11, 2004)

Bellyman said:


> I am curious, is ANYONE reading or posting in this thread an actual physician or nurse practitioner?



Doctors? We don't need no stinkin' doctors.

Moon River knows more about medicine than a doctor does. He told us so.


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## Bellyman (Jul 6, 2013)

Lisa in WA said:


> Doctors? We don't need no stinkin' doctors.
> 
> Moon River knows more about medicine than a doctor does. He told us so.


Modern medicine can be a wonderful thing. Doctors are really good at some things, absolutely amazing at some things. Nutrition does not tend to be their strong point, though, as most get very little training in that area. 

I don't say that to belittle doctors or NP's in any way. (Hey, I don't get upset that my dog's vet doesn't know how to fix my car. He's not studied and trained for that.) There are some amazing docs and NP's out there. But on the other hand, there is a lot of what makes people healthy that has much more to do with how a person lives on the days they don't go to the doctor than what the drug of the day happens to be. What's that saying, something about let your food be your medicine and your medicine be your food... Old wives' tale? I think there is something to it.

What you eat matters. What you don't eat matters. What you're brought up eating (culture) matters as it develops habits that people carry with them. There really are pockets of people who are healthier and have more longevity and studies, real studies, do bear out some differences in how people eat are significant factors. You can ignore that if you want to. I'd rather pay attention.


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## painterswife (Jun 7, 2004)

Lisa in WA said:


> Doctors? We don't need no stinkin' doctors.
> 
> Moon River knows more about medicine than a doctor does. He told us so.


Well a few have offered results from doctors. Measurable results with the test that is used to indicate the disease in the first place.


----------



## Lisa in WA (Oct 11, 2004)

Bellyman said:


> Modern medicine can be a wonderful thing. Doctors are really good at some things, absolutely amazing at some things. Nutrition does not tend to be their strong point, though, as most get very little training in that area.
> 
> I don't say that to belittle doctors or NP's in any way. (Hey, I don't get upset that my dog's vet doesn't know how to fix my car. He's not studied and trained for that.) There are some amazing docs and NP's out there. But on the other hand, there is a lot of what makes people healthy that has much more to do with how a person lives on the days they don't go to the doctor than what the drug of the day happens to be. What's that saying, something about let your food be your medicine and your medicine be your food... Old wives' tale? I think there is something to it.
> 
> What you eat matters. What you don't eat matters. What you're brought up eating (culture) matters as it develops habits that people carry with them. There really are pockets of people who are healthier and have more longevity and studies, real studies, do bear out some differences in how people eat are significant factors. You can ignore that if you want to. I'd rather pay attention.


How much nutrition training does a doctor get?
How much do you have in comparison? 
How much do the various internet gurus that people listen to, have?

No one here has denied that diet can make a difference. What has been denied is that diet is a CURE for diabetes.


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## no really (Aug 7, 2013)

In recent years, it has become increasingly clear that diet plays a starring role in preventing and treating certain chronic diseases. And physicians are often on the frontlines of counseling patients about how their diets and other lifestyle habits can affect their health and weight – a reality that has gained added importance given the obesity epidemic. And yet, it turns out that only 29 percent of U.S. medical schools offer med students the recommended 25 hours of nutrition education, according to a 2015 report in the Journal of Biomedical Education.


http://health.usnews.com/wellness/food/articles/2016-12-07/how-much-do-doctors-learn-about-nutrition


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> Doctors? We don't need no stinkin' doctors.
> 
> Moon River knows more about medicine than a doctor does. He told us so.


Don't make stuff up.


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## MoonRiver (Sep 2, 2007)

It's not doctors that do most research, but Ph D's in bios


Lisa in WA said:


> How much nutrition training does a doctor get?
> How much do you have in comparison?
> How much do the various internet gurus that people listen to, have?
> 
> No one here has denied that diet can make a difference. What has been denied is that diet is a CURE for diabetes.


Much current information comes from research done by PhD's with degrees and advanced training in bioscience, neuroscience, etc. Information comes from universities, not hospitals and doctor's offices. The internet gurus I listen to are primary researchers who have PhD's with advanced training and Md's who have done indepth sreview of the research literature.


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## Jolly (Jan 8, 2004)

Bellyman said:


> I am curious, is ANYONE reading or posting in this thread an actual physician or nurse practitioner?


I'm not a physician or a NP. I did (and still do PRN) clinical lab work for 36 years. I taught at the university level as an adjunct in an Allied Health department for 10 years.

But in a discussion with many of these folks, that does not matter. Everybody has their own opinion and pretty much nothing will change. 

I've already stated that NP's are not physicians. They do not have the depth of knowledge that even a family practice guys has. They do have their place in healthcare, but do not expect them to be good diagnosticians. They are good at care plans and following up on patients.


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## Bellyman (Jul 6, 2013)

Jolly said:


> I'm not a physician or a NP. I did (and still do PRN) clinical lab work for 36 years. I taught at the university level as an adjunct in an Allied Health department for 10 years.
> 
> But in a discussion with many of these folks, that does not matter. Everybody has their own opinion and pretty much nothing will change.
> 
> I've already stated that NP's are not physicians. They do not have the depth of knowledge that even a family practice guys has. They do have their place in healthcare, but do not expect them to be good diagnosticians. They are good at care plans and following up on patients.


I only know one NP personally. He works for a heart group, which is definitely a specialty area as opposed to just general practice. He's a very bright person and he takes his work very seriously. No, he's not a cardiologist, but I suspect he probably knows more about cardiology than most general practitioners. I've spent hours in his office (not because of my own heart, because of a family member) and I couldn't throw a question at him that he didn't have a reasoned answer for. On one occasion, he explained something that took probably 10 minutes to explain followed by, "that's a whole semester's worth of education right there." And we were getting pretty deep. He's the type that enjoys that kind of thing which shows a definite passion for what he does. I like him. And I have a lot of respect for what he has to say.

I would imagine that the world of NP's are a lot like the world of MD's. There are good ones, really good ones, mediocre ones, and ones there just for the paycheck. I think I've met just able all of those in person at one time or another. A few, like the guy I mention above are exceptional. A few, I wish they'd find another line of work before they kill someone. (One of them, an MD, I think I pretty much did watch kill someone, took a year to do it... I'll just say there is a lawsuit pending...)


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## Lisa in WA (Oct 11, 2004)

Jolly said:


> I'm not a physician or a NP. I did (and still do PRN) clinical lab work for 36 years. I taught at the university level as an adjunct in an Allied Health department for 10 years.
> 
> But in a discussion with many of these folks, that does not matter. Everybody has their own opinion and pretty much nothing will change.
> 
> I've already stated that NP's are not physicians. They do not have the depth of knowledge that even a family practice guys has. They do have their place in healthcare, but do not expect them to be good diagnosticians. They are good at care plans and following up on patients.


What do you think about nurse practitioners versus physician's assistants?

In my own anecdotal experience I've had some really great NP's whom I felt were more thorough than the MDs in the practice. They were generally older people who'd been RN's for many years and then went back to school to become NPs. Now it seems there are a lot of very young NPs without the same experience level. I've been told that now nursing students can go straight through school to become an NP without working as an RN in between degrees.

Overall, ive had better luck with NP's than PA's.


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## Lisa in WA (Oct 11, 2004)

no really said:


> In recent years, it has become increasingly clear that diet plays a starring role in preventing and treating certain chronic diseases. And physicians are often on the frontlines of counseling patients about how their diets and other lifestyle habits can affect their health and weight – a reality that has gained added importance given the obesity epidemic. And yet, it turns out that only 29 percent of U.S. medical schools offer med students the recommended 25 hours of nutrition education, according to a 2015 report in the Journal of Biomedical Education.
> 
> 
> http://health.usnews.com/wellness/food/articles/2016-12-07/how-much-do-doctors-learn-about-nutrition


I'm not disputing that diet is very important. My dispute is about whether or not diet provides a cure rather than a remission or reversal in diabetes. (And whether a lay person like me and presumably most people posting here have the educational background and framework to sort through google sites and proclaim themselves more educated than a board certified physician in their specialty). 
Given that, I'd be curious to know how much nutrition education an endocrinologist receives and what the percentage is of endocrinologists referring diabetic patients to to dietitians is (since your article suggest this).
Admittedly, I know only about 5 people with type 2 diabetes but they all were referred to a dietician when diagnosed and fairly extensive diet counseling.

From what I can tell, people here are also quarreling with the advice given by dietitians too.
http://www.eatright.org/resource/he...rbohydrates-part-of-a-healthful-diabetes-diet


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> Don't make stuff up.





MoonRiver said:


> I'm saying I probably know more about successfully treating type 2 diabetes than some endocrinologists.


I don't have to make anything up.


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## ed/La (Feb 26, 2009)

I think he is saying diet can kill insulin producing pancreas b-cells. After a certain age (low 20s) your body stops producing pancreas b-cells. They are gone forever. Changing your diet can reduce the amount of insulin needed. So if I listened correctly, diet does not cure diabetes.


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## painterswife (Jun 7, 2004)

https://www.sciencedaily.com/releases/2015/09/150921182105.htm

"In an innovative study in mice, Laura Alonso, MD, associate professor of medicine and the George F. and Sybil H. Fuller Foundation Term Chair in Diabetes, and Rohit Sharma, PhD, a postdoctoral associate, discovered how the pancreas knows that more insulin-producing beta cells are needed. When there's an increase in insulin demand, there's a corresponding increase in insulin production in the endoplasmic reticulum (ER) of the beta cell, which causes some stress to the ER system. "Although it was previously known that too much ER stress is bad for beta cells, causing them to die, our study found that a modest amount of stress is actually good for them, *because it provides pressure to increase beta cell number *to produce more insulin and keep blood sugar regulated," Alonso said."


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## Irish Pixie (May 14, 2002)

There are more diagnos


Lisa in WA said:


> I'm not disputing that diet is very important. My dispute is about whether or not diet provides a cure rather than a remission or reversal in diabetes. (And whether a lay person like me and presumably most people posting here have the educational background and framework to sort through google sites and proclaim themselves more educated than a board certified physician in their specialty).
> Given that, I'd be curious to know how much nutrition education an endocrinologist receives and what the percentage is of endocrinologists referring diabetic patients to to dietitians is (since your article suggest this).
> Admittedly, I know only about 5 people with type 2 diabetes but they all were referred to a dietician when diagnosed and fairly extensive diet counseling.
> 
> ...


I don't think that anyone has disputed that diet plays an important role in any disease process. I'm fine with stating that diet treats, manages, even reverses, but it does not cure diabetes.


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## painterswife (Jun 7, 2004)

https://www.ncbi.nlm.nih.gov/pubmed...diet-may-help-regenerate-a-diabetic-pancreas/

"
*Fasting diet may help regenerate a diabetic pancreas*
Fri, 24 Feb 2017 12:33:00 EST



"The pancreas can be triggered to regenerate itself through a type of fasting diet, say US researchers," BBC News reports.

Research in mice found a low-calorie diet may help in cases of type 1 and type 2 diabetes.

The pancreas is an organ that uses specialised cells known as beta cells to produce the hormone insulin, which the body uses to break down sugars in the blood (glucose)."


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## no really (Aug 7, 2013)

painterswife said:


> https://www.ncbi.nlm.nih.gov/pubmed...diet-may-help-regenerate-a-diabetic-pancreas/
> 
> "
> *Fasting diet may help regenerate a diabetic pancreas*
> ...


Interesting study, hopefully they will continue the research.


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## ed/La (Feb 26, 2009)

Reversing Type 2 diabetes starts with ignoring the guidelines | Sarah Hallberg | TEDxPurdueU


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## no really (Aug 7, 2013)

Lisa in WA said:


> I'm not disputing that diet is very important. My dispute is about whether or not diet provides a cure rather than a remission or reversal in diabetes. (And whether a lay person like me and presumably most people posting here have the educational background and framework to sort through google sites and proclaim themselves more educated than a board certified physician in their specialty).
> Given that, I'd be curious to know how much nutrition education an endocrinologist receives and what the percentage is of endocrinologists referring diabetic patients to to dietitians is (since your article suggest this).
> Admittedly, I know only about 5 people with type 2 diabetes but they all were referred to a dietician when diagnosed and fairly extensive diet counseling.
> 
> ...


I am curious about the level of education endocrinologist receive but have been unable to find much info other than they refer patients to dietitians. And yes I have disagreed with doctors before, probably will again. It is part of being active in my treatment.


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## painterswife (Jun 7, 2004)

The


no really said:


> Interesting study, hopefully they will continue the research.


 There is an amazing amount of research being done right now into type 2 diabetes. It ties in with cancer and heart disease. There are doctors in Sweden, Australia that are leading the forefront in this research. Just like we were taught that all fat is bad for you, they are now proving that wrong. I see major changes coming to treatment and cures in the next 5 years.


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## Irish Pixie (May 14, 2002)

no really said:


> I am curious about the level of education endocrinologist receive but have been unable to find much info other than they refer patients to dietitians. And yes I have disagreed with doctors before, probably will again. It is part of being active in my treatment.


Everyone should disagree with a Dr. that is trying to do something that either they don't understand, or that they know is contraindicated in that disease. I can't even remember all the times I've said no to Drs, NPs, and PAs when they've want to do or prescribe something I knew would exacerbate my condition. Most take it well. 

Endocrinologists are specialists in the field of endocrine glands and hormones. Many states require a physician to be board certified to specialize, so they are further educated in their field than general or family practice doctors.


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## no really (Aug 7, 2013)

Irish Pixie said:


> Everyone should disagree with a Dr. that is trying to do something that either they don't understand, or that they know is contraindicated in that disease. I can't even remember all the times I've said no to Drs, NPs, and PAs when they've want to do or prescribe something I knew would exacerbate my condition. Most take it well.
> 
> Endocrinologists are specialists in the field of endocrine glands and hormones. Many states require a physician to be board certified to specialize, so they are further educated in their field than general or family practice doctors.


Certainly the specialists have advanced training and certifications but I do question the lack of nutritional education being taught. It is extremely important.


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## no really (Aug 7, 2013)

painterswife said:


> The
> 
> There is an amazing amount of research being done right now into type 2 diabetes. It ties in with cancer and heart disease. There are doctors in Sweden, Australia that are leading the forefront in this research. Just like we were taught that all fat is bad for you, they are now proving that wrong. I see major changes coming to treatment and cures in the next 5 years.


I have been following some of the new research. It's impressive to say the least.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> I don't have to make anything up.


This is what you said "Moon River knows more about medicine than a doctor does. He told us so."

This is what I said "I'm saying I probably know more about successfully treating type 2 diabetes than some endocrinologists."

They are not the same thing. I replied to a very specific question you asked. I did not proclaim I know more than doctors.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> This is what you said "Moon River knows more about medicine than a doctor does. He told us so."
> 
> This is what I said "I'm saying I probably know more about successfully treating type 2 diabetes than some endocrinologists."
> 
> They are not the same thing. I replied to a very specific question you asked. I did not proclaim I know more than doctors.


I'm sorry. Is an endocrinologist not a doctor? I believe that not only are they medical doctors but they are board certified in a specialty which you claim to know more about than some of them. "Some" is plural as is "doctors" ...so yeah, you did say that.


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## ChocolateMouse (Jul 31, 2013)

This topic has gotten real dumb. :/ Have fun with it.


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## Lisa in WA (Oct 11, 2004)

ChocolateMouse said:


> This topic has gotten real dumb. :/ Have fun with it.


It was so nice of you to drop in and contribute to the dumbness. 
Usually people who aren't interested just walk away without the drama of a swan song.


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## ChocolateMouse (Jul 31, 2013)

I've been watching this thread. I commented on it a long time ago. I did so because I was REALLY interested in the original topic not your debates about diabetes and off topic petty bickering! And then when I express disappointment in that it's; "Oooh! I know I have been arguing for like a WEEK on the internet throwing around petty insults and bickering about things mindlessly with people who won't listen to me, but YOU'RE the drama queen!"?

Please. You're doing nothing but petty childish bickering on the internet and wanna complain about ME being dramatic with even more petty insults? Great job. You sure showed me how to act with dignity and grace! Let's see, let's make sure I'm doing this right, OK? 

The appropriate response to someone expressing indirect disappointment on the internet is to confront them directly by quoting them with insults, right? Because that's what you just did. So that's how I should be treating you, right? Golden rule and all that.

So the right response to being insulted directly in a petty way like this must be to FLIP THE HECK OUT!!!! THIS IS HOW I SHOULD ACT RIGHT!!?!?!?!? YOU SET SUCH A GREAT EXAMPLE!!!!!!11! SUCH GRACE, YOU DUMB SWANLING!!!! OMG! I CAN'T EVEN. WHAT IS WRONG WITH YOU, YOU AWFUL HUMAN BEING!?!?!?!? YOU CAN"T HANDLE CONSTRUCTIVE CRITISISM!?! OMgomgomg!

Grow up honey bun and get over yourself. I might not be be perfect, but at least I don't think I am. I know when I'm being petty. Apparently you just can't help yourself.


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## Lisa in WA (Oct 11, 2004)

ChocolateMouse said:


> I've been watching this thread. I commented on it a long time ago. I did so because I was REALLY interested in the original topic not your debates about diabetes and off topic petty bickering! And then when I express disappointment in that it's; "Oooh! I know I have been arguing for like a WEEK on the internet throwing around petty insults and bickering about things mindlessly with people who won't listen to me, but YOU'RE the drama queen!"?
> 
> Please. You're doing nothing but petty childish bickering on the internet and wanna complain about ME being dramatic with even more petty insults? Great job. You sure showed me how to act with dignity and grace! Let's see, let's make sure I'm doing this right, OK?
> 
> ...



Good grief. All this screeching and on a holiday weekend.
I guess I was wrong about the swan song. But not the drama.

BTW: it's not my job to show you how to act with dignity and grace or when and where to do so. Make your own sammich.


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## ChocolateMouse (Jul 31, 2013)

AlL THiS sCREachINg On a HoliDaY WeekeNd! U shulD sEe a DoctOr!

Best part is, I'd love to see a doctor. But I'm probably not going to because rising healthcare costs, repealing Obamacrae, or the implementation of the new healthcare plan will take my coverage away.

Wouldn't it be nice to be able to talk about that instead of have trash fires of arguments on the internet?

TOO LATE! 

Btw; It's not my job to respond with dignity to people who don't act with dignity. I love sandwiches so no idea what that means.


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## painterswife (Jun 7, 2004)

I was having a good discussion with others. Sorry if I did not meet your criteria for staying on topic. The OP did not have a problem with the change.


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## ChocolateMouse (Jul 31, 2013)

Actually, you were fine. It's not your fault it devolved and I didn't see you being aggressive or insulting people. I guess if the OP wants to get into a petty fight with other people they're welcome to. If you wanna participate you're welcome to.
But I'm also welcome to also say that it's dumb and not what I was hoping the topic would be about or was originally made to be. And I'm not the only one who thinks it's dumb and ya'll just being petty.
I'm also welcome to act with the same level of maturity as the posters. ;P Since they think it's acceptable to act that way, I should be fine.
Maybe it just didn't meet my criteria for dignity or grace. The posters should do better!

Cause, like, expecting other people to act better than you is OK right?


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## Irish Pixie (May 14, 2002)

no really said:


> Certainly the specialists have advanced training and certifications but I do question the lack of nutritional education being taught. It is extremely important.


I'm sure all endocrinologists, and certainly all of those that that are board certified and work with diabetes patients, are fully qualified as to proper diet. They send patients to dietitians because they are the nutritional specialists, and they work in conjunction to fully treat their patient.


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## painterswife (Jun 7, 2004)

ChocolateMouse said:


> Actually, you were fine. It's not your fault it devolved and I didn't see you being aggressive or insulting people. I guess if the OP wants to get into a petty fight with other people they're welcome to. If you wanna participate you're welcome to.
> But I'm also welcome to also say that it's dumb and not what I was hoping the topic would be about or was originally made to be. And I'm not the only one who thinks it's dumb and ya'll just being petty.
> I'm also welcome to act with the same level of maturity as the posters. ;P Since they think it's acceptable to act that way, I should be fine.
> Maybe it just didn't meet my criteria for dignity or grace. The posters should do better!
> ...


Talk about thread stealing. You are doing a great job. Was that your goal.


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## no really (Aug 7, 2013)

Irish Pixie said:


> I'm sure all endocrinologists, and certainly all of those that that are board certified and work with diabetes patients, are fully qualified as to proper diet. They send patients to dietitians because they are the nutritional specialists, and they work in conjunction to fully treat their patient.


I would think they have a knowledge but most refer them to a nutritionist that has specialized in the field of diabetic nutrition. That has been what I've seen with a relatives experience.


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## ChocolateMouse (Jul 31, 2013)

You quoted me so I presume it's your desire.  Like, wow! This is the third time I've unwatched this thread and people just keep deliberately calling me out and pulling me back! You are SO good at ending a discussion and letting things go! Very capable at it. Let's keep chatting about how bad this topic is instead! Maybe I was wrong about you not being aggressive or trying to instigate? Such fun! I've got all day btw. I work from home.


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## Bearfootfarm (Jul 13, 2006)

ChocolateMouse said:


> So the right response to being insulted directly in a petty way like this must be to FLIP THE HECK OUT!!!! THIS IS HOW I SHOULD ACT RIGHT!!?!?!?!? YOU SET SUCH A GREAT EXAMPLE!!!!!!11! SUCH GRACE, YOU DUMB SWANLING!!!! OMG! I CAN'T EVEN. WHAT IS WRONG WITH YOU, YOU AWFUL HUMAN BEING!?!?!?!? YOU CAN"T HANDLE CONSTRUCTIVE CRITISISM!?! OMgomgomg!


Someone needs a nap.


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## ChocolateMouse (Jul 31, 2013)

Oh man, don't we all? Naps are pretty great. I love naps. Don't you?

Naps are a superior topic. We should talk about how good they are for you (or not).

I'm so popular. People keep quoting me!  My opinion must mean so much to you guys!


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## Bearfootfarm (Jul 13, 2006)

ChocolateMouse said:


> I'm also welcome to *act with the same level of maturity as the posters*.


When do you plan to start?


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## ChocolateMouse (Jul 31, 2013)

Awsnap. More ad hominem.  We could be, like, besties!


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## Jolly (Jan 8, 2004)

Endos are usually Internal Med docs (3 yr residency) that do a 2 year fellowship in endocrinology. Problem is, the money has been going down the last few years as reimbursements keep getting cut. It becomes financially advantageous to let your NP or your PA do the heavy lifting of diabetic education and nutrition counseling ( or refer the nutrition stuff), because you simply can't take the time to do it and keep the lights on.

More than of the endos that I know, will no longer take Medicare. You have to pay cash and file on your own.

As for PA's and NP's...Not a lot of difference. Both have Master's degrees. I think the NP's may be a bit more focused in one area, as that is how they train, whereas a PA receives a more general medical education. I think those differences iron out over the years. Personally, I'm not comfortable with either making an initial diagnosis. In medicine, when you hear hoof beats, think of horses, not zebras. That's fine and works well for these guys. But if you are a zebra...Not all docs are good diagnosticians. Some are heads and shoulders above the rest, so I think it's important to have a good doctor upon initial presentation of symptoms. For subsequent car, a lot of times you just don't have to have the M.D.

Obamacare recognizes three primary care givers - doctors, PA's and NP's.


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## MoonRiver (Sep 2, 2007)

Jolly said:


> Endos are usually Internal Med docs (3 yr residency) that do a 2 year fellowship in endocrinology. Problem is, the money has been going down the last few years as reimbursements keep getting cut. It becomes financially advantageous to let your NP or your PA do the heavy lifting of diabetic education and nutrition counseling ( or refer the nutrition stuff), because you simply can't take the time to do it and keep the lights on.
> 
> More than of the endos that I know, will no longer take Medicare. You have to pay cash and file on your own.
> 
> ...


The thing is I can usually see an NP the same day and if I want to see my regular doctor, it's more like 2 months. If I call with an urgent need they tell me to go to emergency room!

My point was that if we want to lower the cost of healthcare, one thing that could be done is to increase the number of NP's (at a lower reimbursement rate than doctors). There was talk several years ago of Walmart and some of the pharmacies opening clinics in their stores. If we have more options, the free market should drive down prices.


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## ChocolateMouse (Jul 31, 2013)

There's also plenty of times where a nurse practitioner can help you out when what's happening is really obvious. When I started getting severe cycles that left me incapacitated (probably from the same genetics that cause uterine fibroids in my family) it was a RN who helped find the right medication for me, not a doctor. And it was relatively painless. Since that's a pretty easy fix for most folks, she just grabbed a list of medications that normally work and started in the middle. If I had a problem with a medication she'd check a list and find me a similar one until we found one that controlled my symptoms without severe side effects.


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## Bearfootfarm (Jul 13, 2006)

MoonRiver said:


> My point was that if we want to lower the cost of healthcare, one thing that could be done is to increase the number of NP's (at a lower reimbursement rate than doctors).


You can "lower the cost of healthcare" now if you want to settle for *minimal* testing and treatments.
If you want real healthcare, that's extra.

You can go to Wal-Mart and get a bandaid for your head, or go to a Dr and get an MRI to see if there's a concussion.

The choice is yours.


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## no really (Aug 7, 2013)

Bearfootfarm said:


> You can "lower the cost of healthcare" now if you want to settle for *minimal* testing and treatments.
> If you want real healthcare, that's extra.
> 
> You can go to Wal-Mart and get a bandaid for your head, or go to a Dr and get an MRI to see if there's a concussion.
> ...


If you want healthcare and not just insurance you'll go universal healthcare.


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## Bellyman (Jul 6, 2013)

no really said:


> Certainly the specialists have advanced training and certifications but I do question the lack of nutritional education being taught. It is extremely important.


I have no personal knowledge but do have a fairly close friend that's a medical doctor. He's been in a couple of different areas of medicine during his career but he has mentioned that he got "maybe an hour" (his words, not mine) of education on nutrition in med school. That was definitely not something that was focused upon heavily when he was there, and I would guess that he's in his late 40's or early 50's. I do not know if that has changed or not.

I hate to say it but what we currently have for healthcare is largely a product of what we've demanded. The typical patient doesn't really want to do much other than demand another pill. They don't want to eat healthy or exercise, just find another pill or two that will do the same thing as eating healthy and exercising. After all, they've seen the ad on TV every night for months, it MUST be the right pill for them, right? AARRGGHH!!!


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## no really (Aug 7, 2013)

Bellyman said:


> I have no personal knowledge but do have a fairly close friend that's a medical doctor. He's been in a couple of different areas of medicine during his career but he has mentioned that he got "maybe an hour" (his words, not mine) of education on nutrition in med school. That was definitely not something that was focused upon heavily when he was there, and I would guess that he's in his late 40's or early 50's. I do not know if that has changed or not.
> 
> I hate to say it but what we currently have for healthcare is largely a product of what we've demanded. The typical patient doesn't really want to do much other than demand another pill. They don't want to eat healthy or exercise, just find another pill or two that will do the same thing as eating healthy and exercising. After all, they've seen the ad on TV every night for months, it MUST be the right pill for them, right? AARRGGHH!!!


And than there are pills for the side effects of the first pill. I agree totally.


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## Jolly (Jan 8, 2004)

no really said:


> If you want healthcare and not just insurance you'll go universal healthcare.


Been there, done that.

There is only so much money, so much healthcare. When something is free or very low cost, the pigs crowd the trough. As such, the pigs suck up all the feed. The only way to distribute feed (healthcare) is to restrict and allocate what you have. If that's what you want, that's fine.

But, you will give up some stuff. I know it's different now, but several years ago we had more cat scanners in Louisiana...Heck, we had more cat scanners in NORTH LOUISIANA (the poor part of the state) than Canada. I know the turn-around-time on things like quantitative B-hCG testing was 2-3 hours, 24/7 in our town, whereas the head of the Canadian Health Service in Quebec told me their TAT was 2-3 *days*.

I do know the time between deciding a patient needs an elective procedure and then having the procedure done in the U.S. vs. Canada or England is a considerable difference in time. I don't think there's much difference in the quality of the work.

I also know the facilities in England tend to be older than the U.S. and private rooms are rare.

Lastly, concerning healthcare restrictions, care in the last 18 months or so of life will have to be curtailed. Pallative care will triumph over intervention. At a certain age, if you break a hip, adios. You will be made comfortable, but you will not receive a hip surgical repair. Decisions for mom or dad's healthcare will be made by medical committee, not by family. And the government will decide how many resources we need to commit to early preemies and NICU's. Or oncology care.

Do I have a solution? No, I don't. Possibly a two-tiered healthcare system, where poor people receive the most basic of care and people who are better off financially receive better care. But that ain't too far off from what we currently do.

I dunno....


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## no really (Aug 7, 2013)

Jolly said:


> Been there, done that.
> 
> There is only so much money, so much healthcare. When something is free or very low cost, the pigs crowd the trough. As such, the pigs suck up all the feed. The only way to distribute feed (healthcare) is to restrict and allocate what you have. If that's what you want, that's fine.
> 
> ...


Understand what you are saying but at this time the insurance companies make those same choices on who gets care. They don't automatically approve hip replacement on older patients, it's just not cost effective. Insurance is a for profit business. As to people who have to no insurance or high deductible policies they have to chose carefully what they can afford.

As to countries with universal care they beat us on longevity, infant mortality and costs. If they had sub par care it would be the opposite.


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## MoonRiver (Sep 2, 2007)

no really said:


> Understand what you are saying but at this time the insurance companies make those same choices on who gets care. They don't automatically approve hip replacement on older patients, it's just not cost effective. Insurance is a for profit business. As to people who have to no insurance or high deductible policies they have to chose carefully what they can afford.
> 
> As to countries with universal care they beat us on longevity, infant mortality and costs. If they had sub par care it would be the opposite.


I think when the studies are normalized for demographics, longevity and infant mortality balances out.

Wait 10 years until immigration has completely destroyed European healthcare and see how their mortality and infant mortality stacks up.

ObamaCare (death panels) dictated what choices we have. Insurance companies are now largely told what they must cover, so they are not the ones making these decisions.

Cruz has an amendment to the Senate bill that gives us some choice again. He wants insurance companies to be able to offer plans that don't conform to Obamacare/Obamacare lite, as long as they offer at least 1 policy that does conform. Brilliant idea because almost everyone will go for a cheaper policy given the choice.


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## no really (Aug 7, 2013)

MoonRiver said:


> I think when the studies are normalized for demographics, longevity and infant mortality balances out.
> 
> Can you give me some of these factors that would change the statistics?
> 
> ...


I read his proposal, not sure how it would help cost wise. Or that it has a chance passing.

Sorry about the mess in this post, on my phone


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## ChocolateMouse (Jul 31, 2013)

"ObamaCare (death panels) dictated what choices we have."
Oh my goodness. Really? Death panels? REALLY?

https://en.wikipedia.org/wiki/Death_panel
http://www.politifact.com/truth-o-meter/article/2009/dec/18/politifact-lie-year-death-panels/
http://money.cnn.com/2017/02/14/news/economy/obamacare-death-panels/index.html
http://www.npr.org/2017/01/10/50916...ruggled-with-fallout-from-a-kind-of-fake-news
http://www.cnn.com/2017/02/11/politics/death-panel-florida-gop-congressman/index.html
http://www.snopes.com/politics/medical/over75.asp

Shall we also be deeply concerned about pizzagate? My goodness! There literally is no such thing as a death panel! Factually, literally, actually.

For reference... My mother was on an obamacare-mandated plan with terminal cancer. Not only did they give her cancer treatment for 5 years including chemo, surgeries, pain med, anti-anxiety meds, the works, but they also offered her the option to continue treatment after that if she wanted (even though they said it wouldn't work they were willing to pay for it) and then covered the vast majority of her palliative care after the doctor tried literally every kind of cancer treatment available including an experimental trial medication.

Facts matter. There are no death panels in the US.
None.
If there are, please by all means, show me proof from a reliable source.
So far most people really like the ACA.* A lot. It just needs to cost less for the government. We can continue to lower healthcare cots without any more "death panels" than there were 15 years ago. It's not THAT crazy. We're a smart, capable country. We just have to know what does/doesn't work. And less red-tape and overhead goes a long way.

*(citation; https://www.usatoday.com/story/news...ty-americans-want-to-keep-obamacare/98854446/)


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## MoonRiver (Sep 2, 2007)

*U.S. Preventive Services Task Force (USPSTF)*


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## ChocolateMouse (Jul 31, 2013)

What about them? Are you trying to argue that they're a death panel? They've been around since the 80's.

https://en.wikipedia.org/wiki/United_States_Preventive_Services_Task_Force

"The *United States Preventive Services Task Force* (*USPSTF*) is "an independent panel of experts in primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services"...
...The USPSTF does not consider cost-effectiveness.[4] Recommendations are based solely upon evidence of medical benefit to the patient, no matter how expensive it is."
https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/uspstf/index.html
"Created in 1984, the U.S. Preventive Services Task Force (USPSTF or Task Force) is an independent group of national experts in prevention and evidence-based medicine that works to improve the health of all Americans by making evidence-based recommendations about clinical preventive services such as screenings, counseling services, or preventive medications."

I'd like to hear your case for this. Please, explain to me how an organization founded in the 80's whose mission statement is to establish effective treatment guidelines without regard to cost is somehow a "death panel", but only now that Obamacare is in place?


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## Jolly (Jan 8, 2004)

ChocolateMouse said:


> "ObamaCare (death panels) dictated what choices we have."
> Oh my goodness. Really? Death panels? REALLY?
> 
> https://en.wikipedia.org/wiki/Death_panel
> ...


Call them what you like, but after three days in a hospital, the case manager meets with the head nurse of the floor and the hospitalist, to decide whether to move a patient to LTAC, nursing home, or what to do with them, because with currentc Medicare reimbursement they are starting to cost the hospital money. And to be fair, it may not always be three days, it may be longer, considering the disease state. But the fact remains there is pressure to do something with them. It's a very small step from restriction of care to denial of care.

They don't call them Death Panels in Britain, but a rose by any other name would smell as sweet...This is what you have to do under single-payer, socialized medicine:

https://www.theatlantic.com/politic...ald-trump-offers-to-help-charlie-gard/532551/

Again, I just want folks to know that healthcare is a commodity and it is finite. How we use it, is the debate.


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## ed/La (Feb 26, 2009)

Perhaps we skip a war or two and put that money toward universal health care. When we are going to war they do not ask where the money is coming from, they just print it. If you have the money get supplemental insurance for better care. Most of the world has universal health care. It is just a matter of seeing what one would work best here.


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## Jolly (Jan 8, 2004)

Just as food for thought, 1 out of 5 Americans are on Medicaid:

https://www.medicaid.gov/medicaid/p...-enrollment-data/report-highlights/index.html

Of that, the government spends about $8000/person.


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## Jolly (Jan 8, 2004)

ed/La said:


> Perhaps we skip a war or two and put that money toward universal health care. When we are going to war they do not ask where the money is coming from, they just print it. If you have the money get supplemental insurance for better care. Most of the world has universal health care. It is just a matter of seeing what one would work best here.


Since Louisiana had the only socialized hospital system in the United States, here's some interesting reading...

http://senate.la.gov/FiscalServices/Presentations/2015/SFC - LSU Hospitals FY16 Budget - Final.pdf


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## ChocolateMouse (Jul 31, 2013)

No denial here about the spending. We spend a lot on healthcare. But costs per person go down with single payer.

I also think RNP are a wise call in general. In many cases they can make good judgments about whether they can handle their patient's needs or send them to a specialist.


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## AmericanStand (Jul 29, 2014)

But don't insurance companies have people who decide if treatment would be warranted and paid for ?
So either way there are death panels it's just a matter of who's death panel ?


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## MoonRiver (Sep 2, 2007)

AmericanStand said:


> But don't insurance companies have people who decide if treatment would be warranted and paid for ?
> So either way there are death panels it's just a matter of who's death panel ?


If you don't like the coverage an insurance company offers, you are free to change insurance companies.

If the government controls insurance and what is and what isn't covered, you have no choice.


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## Bearfootfarm (Jul 13, 2006)

MoonRiver said:


> If you don't like the coverage an insurance company offers, you are *free to change insurance companies*.


Unless it's provided by your employer, which is how the majority get their insurance.


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## ChocolateMouse (Jul 31, 2013)

Or you have a pre-existing condition and they can deny you coverage if you try to switch.
Or if you're covered under the only insurance company you can afford.
Or if the other company has something like a lifetime or yearly cap that would cause you to go broke if you had a serious or chronic condition.


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## AmericanStand (Jul 29, 2014)

MoonRiver said:


> If you don't like the coverage an insurance company offers, you are free to change insurance companies.
> 
> If the government controls insurance and what is and what isn't covered, you have no choice.


 Either way you still face the Death Panels.


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## MoonRiver (Sep 2, 2007)

AmericanStand said:


> Either way you still face the Death Panels.


We're arguing semantics. An insurance policy can't stop you from getting treatment on your own. It only stops an insurance company from paying for treatment. To a degree, this gives you some control. You could purchase a supplemental policy in case something like this happened, you could maintain a health care fund, or maybe you could shop for a better policy.

A government system like in Britain, can deny treatment AND prevent you from obtaining it elsewhere, even if you have the money to pay for treatment yourself.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> We're arguing semantics. An insurance policy can't stop you from getting treatment on your own. It only stops an insurance company from paying for treatment. To a degree, this gives you some control. You could purchase a supplemental policy in case something like this happened, you could maintain a health care fund, or maybe you could shop for a better policy.
> 
> A government system like in Britain, can deny treatment AND prevent you from obtaining it elsewhere, even if you have the money to pay for treatment yourself.


I have not heard this. How in the world can they prevent a citizen from say, going on a vacation and having say...plastic surgery in Thailand? Do you have a link to this law?


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## ed/La (Feb 26, 2009)

I have not heard this. How in the world can they prevent a citizen from say, going on a vacation and having say...plastic surgery in Thailand? Do you have a link to this law?
I think this is what Moonriver is referring to. https://www.nytimes.com/2017/07/03/world/europe/uk-trump-pope-francis-charlie-gard.html 

The London hospital that is treating Charlie has asked permission to remove him from life support. His parents want to take him to the United States, where they believe an experimental treatment has a chance — however remote — of prolonging his life, even though the disease has no cure.






Three courts in Britain agreed with the hospital, as did the European Court of Human Rights, which last week rejected a last-ditch appeal by Charlie’s parents.


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## Lisa in WA (Oct 11, 2004)

ed/La said:


> I have not heard this. How in the world can they prevent a citizen from say, going on a vacation and having say...plastic surgery in Thailand? Do you have a link to this law?
> I think this is what Moonriver is referring to. https://www.nytimes.com/2017/07/03/world/europe/uk-trump-pope-francis-charlie-gard.html
> 
> The London hospital that is treating Charlie has asked permission to remove him from life support. His parents want to take him to the United States, where they believe an experimental treatment has a chance — however remote — of prolonging his life, even though the disease has no cure.
> ...



From what I've read, this is happening because the doctors and hospitals treating him think it will prolong and increase his suffering to no avail. Same thing that happens here occasionally when parents aren't perceived to be doing the right thing for their kids...faith healing, etc. The courts step in.
I've not seen anything stating it's because British citizens are not permitted to seek healthcare elsewhere.


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## ed/La (Feb 26, 2009)

Read it again. Three courts in Britain agreed with the hospital, as did the European Court of Human Rights, which last week rejected a last-ditch appeal by Charlie’s parents. The parents want to take the child to the U.S. for treatment. The courts said no.


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## Lisa in WA (Oct 11, 2004)

ed/La said:


> Read it again. Three courts in Britain agreed with the hospital, as did the European Court of Human Rights, which last week rejected a last-ditch appeal by Charlie’s parents. The parents want to take the child to the U.S. for treatment. The courts said no.


Ive read it plenty.
Citizens of the U.K. Are free to pursue health care wherever they choose if they care to pay.
Charley Gard is being kept from seeking care elsewhere because of concern over suffering. If you have different information from reliable sources please post links.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> Ive read it plenty.
> Citizens of the U.K. Are free to pursue health care wherever they choose if they care to pay.
> Charley Gard is being kept from seeking care elsewhere because of concern over suffering. If you have different information from reliable sources please post links.


What prompted the post was a discussion of death panels. If what Britain has done is not a death panel, I don't know what one is. 

In US, many cancer patients go outside the US for treatments not available within US. What if our government had same policy as Britain and a doctor or hospital could say "no, you can't be released to seek treatment outside US. We know what's best. That treatment wouldn't help. You have to stay in our hospital until you die?"


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## mmoetc (Oct 9, 2012)

In US, many cancer patients go outside the US for treatments not available within US. What if our government had same policy as Britain and a doctor or hospital could say "no, you can't be released to seek treatment outside US. We know what's best. That treatment wouldn't help. You have to stay in our hospital until you die?"[/QUOTE]

But that's not what the British and EU courts ruled on. The ruling centers around the legal status of the child as a seperate person and the parent's rights to make decisions for her. If the child were an adult and capable of making such a decision that decision to seek treatment elsewhere would be honored. It's an interesting case dealing with how different jurisdictions handle the legal status of minors but has little to do with "death panels".


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## MoonRiver (Sep 2, 2007)

mmoetc said:


> But that's not what the British and EU courts ruled on. The ruling centers around the legal status of the child as a seperate person and the parent's rights to make decisions for her. If the child were an adult and capable of making such a decision that decision to seek treatment elsewhere would be honored. It's an interesting case dealing with how different jurisdictions handle the legal status of minors but has little to do with "death panels".


It has everything to do with death panels. The court ruled the hospital can pull the plug on baby Charlie.


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## mmoetc (Oct 9, 2012)

MoonRiver said:


> It has everything to do with death panels. The court ruled the hospital can pull the plug on baby Charlie.


Have it your way. It's a bit more complicated than that but I won't argue.


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## Lisa in WA (Oct 11, 2004)

ed/La said:


> No one is disputing rich people's right to seek medical attention where ever they want. .


The post quoted below by MoonRiver was the post I was responding to originally before you decided to leap into the imaginary fray. So here you can see, you're wrong. Someone WAS in fact saying that.



MoonRiver said:


> A government system like in Britain, can deny treatment AND prevent you from obtaining it elsewhere, even if you have the money to pay for treatment yourself.


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## MoonRiver (Sep 2, 2007)

Lisa in WA said:


> The post quoted below by MoonRiver was the post I was responding to originally before you decided to leap into the imaginary fray. So here you can see, you're wrong. Someone WAS in fact saying that.


You are mistaken. ed/La and I seem to be in agreement.


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## Lisa in WA (Oct 11, 2004)

MoonRiver said:


> You are mistaken. ed/La and I seem to be in agreement.


 all right, cowboy. You win.


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## EmyJ (Aug 3, 2017)

MoonRiver said:


> The walk-in clinic I go to for minor health problems, like a bad cut or poison ivy, uses nurse practitioners. I believe the way this particular clinic works is it is in a group of 4 clinics and there is a supervising doctor.
> 
> *Nurse practitioners* are advanced registered nurses educated and trained to provide health promotion and maintenance through the diagnosis and treatment of acute illness and chronic condition. According to the International Council of Nurses, an advanced practice registered nurse (APRN) is "a registered nurse who has acquired the expert knowledge base, complex decision-making skills and clinical competencies for expanded practice, the characteristics of which are shaped by the context and/or country in which s/he is credentialed to practice. A master's degree is recommended for entry level."[1] wikipedia​Nurse practitioners in these states have full practice authority. That means they can diagnose, prescribe, and treat patients without physician oversight. other states require some level of oversight.
> Alaska, Arizona, Colorado, Connecticut, District of Columbia, Hawaii, Idaho, Iowa, Maine, Maryland, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, Vermont, Washington, Wyoming.​There are currently about 200,000 NP in US. Let's say we increased the number to 300,000 in 5 years. Do you think it would lower the cost of healthcare?
> ...


The patient Protection and Affordable care Act was intended to focus on the increasing growth in healthcare spending. This is a real threat to the economic future of United States and Canada.
Let me quote from http://repository.upenn.edu:
"_Nurse practitioners have the potential to lower costs by assuming provider roles within the healthcare workforce to deliver care of equal or better quality at lower costs than comparable services by other providers_."
It further points to the fact that payer, societal, hospital and employer stakeholders perspectives support nurse practitioners over physicians for cost-effective care in primary and acute care settings.
I totally agree with the suggestion that nurse practitioners provide equal or in fact superior quality of care as compared to physicians. Quality matters.
Clinical output is almost same for patients who receive care from nurse practitioners (not to mention the patient satisfaction).
A study conducted says that over the next 10 years, over 118,000 nurses will reach the age of retirement and over 150,000 new physicians will be needed to meet the demands of aging baby boomers.
Many health care training institute state that the nurse practitioners are qualified to take the place of doctors. They begin as registered nurses, log a number of clinical hours before going back to school for obtaining a masters or doctorate as a nurse practitioner.


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## haley1 (Aug 15, 2012)

If the people of the USA want to reduce costs they need to get in shape and quit eating junk, no more wheat/corn/soy. 
That will reduce chronic health problems and bring costs down. People need to take care of themselves!
Problems with our system if you go see Dr. For 3"minutes and they push the drugs which then cause other problems and then they give you another drug for that and the cycle continues.
How many drugs actually cure??????? They just suppress symptoms.


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