New healthcare thread (part II)
- Thread starter crimsonaudio
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HELLO AGAIN, Guest! We are back, live! We're still doing some troubleshooting and maintenance to fix a few remaining issues but everything looks stable now (except front page which we're working on over next day or two) Thanks for your patience and support! MUCH appreciated! --Brett (BamaNation) if you see any problems - please post them in the Troubleshooting board!
Got a 2nd KENALOG 10 MG injection for my thumb and one for my left hand ring finger today.
Left thumb was crazy numb!
This is much easier than surgery!
BTW....my hand doctor mentioned the insurance stuff was getting really hard to deal with. Way too complicated than need be.
Not mine I don't think - but I guess others she has to deal with. Or maybe it could have been mine too.... 🤷â€Â♂ï¸Â
Left thumb was crazy numb!
This is much easier than surgery!
BTW....my hand doctor mentioned the insurance stuff was getting really hard to deal with. Way too complicated than need be.
Not mine I don't think - but I guess others she has to deal with. Or maybe it could have been mine too.... 🤷â€Â♂ï¸Â
Insurance companies are the real evil ones.Got a 2nd KENALOG 10 MG injection for my thumb and one for my left hand ring finger today.
Left thumb was crazy numb!
This is much easier than surgery!
BTW....my hand doctor mentioned the insurance stuff was getting really hard to deal with. Way too complicated than need be.
Not mine I don't think - but I guess others she has to deal with. Or maybe it could have been mine too.... 🤷â€Â♂ï¸Â
Her comment was only made when I opened the door asking her if she still enjoyed her job.
She said she really enjoyed her patients but dealing with insurance was frustrating. Paraphrasing....all I want to do is fix the problems. But they make it SOOO complicated.
It only took 5 minutes for the injections, some of which was diagnostics.
White House weighs creating ‘TrumpRx’ website to buy meds directly from pharma firms
The plan is reportedly part of President Donald Trump’s campaign to force top drugmakers to slash their U.S. prices in line with what they charge in other developed nations
www.independent.co.uk
The skeptic in me knows that our government is incapable of doing anything on time and on budget. I wouldn't be a bit surprised if this turned into the same disaster Obamacare did.
Last fall I was having bad back spasms. My ortho sent me to a pain clinic, and I got a nerve block injection. Haven't had much problem with my lower back since.Got a 2nd KENALOG 10 MG injection for my thumb and one for my left hand ring finger today.
Left thumb was crazy numb!
This is much easier than surgery!
BTW....my hand doctor mentioned the insurance stuff was getting really hard to deal with. Way too complicated than need be.
Not mine I don't think - but I guess others she has to deal with. Or maybe it could have been mine too.... 🤷â€Â♂ï¸Â
My neck is a different situation, but that's not yet to the point of requiring medical intervention.
CNN has a story today that is subscriber only that I somehow managed to sneak past to copy and paste. I will attach it here and return later with commentary since I have a lot of experience on this issue.
H1Bs
When the Trump administration announced last month that every new H-1B visa would come with a $100,000 fee, the objective seemed straightforward: encourage companies, particularly tech companies thatheavily on the program, to start hiring American workers and stop driving down American wages.
But the health care industry is raising concerns that the price hike on the H-1B visa will threaten the ability of hospitals in rural and underserved areas to bring in foreign workers and fulfill a shortage of specialists needed to serve the community.
“There’s no way we’re going to pay $100,000,” Carolynn Lundry, a residency program coordinator at St. Luke’s Hospital in the St. Louis suburb of Chesterfield, Missouri.
“We pool from international graduates, and if we’re going to take away the H-1Bs from that, it’s going to shrink our pool of choices,” said Lundry, who selects 16 internal medicine residents a year for St. Luke’s.
More than 64% of international medical graduates were practicing in medically underserved areas or health professional shortage areas, with more than 45% practicing in rural areas, according to a 2021 study published by the National Institutes of Health.
And the United States needs an additional 13,075 physicians just to fill shortages, according to a 2024 report from the Health Resources and Services Administration (HRSA). The HRSA forecasts that by 2037, the US will be short of 87,150 full-time equivalent (FTE) primary care physicians.
Groups push back against $100,000 fee
The White House said the new fee for H-1B visa applicants is part of President Donald Trump’s promise to prioritize American workers.
“President Trump promised to put American workers first, and this commonsense action does just that by discouraging companies from spamming the system and driving down wages,” White House spokesperson Taylor Rogers told CNN in a statement. “It also gives certainty to American businesses who actually want to bring high-skilled workers into our great country but have been trampled on by abuses of the system.”
Some groups have pushed back against the $100,000 fee, which was previously at about $3,000. Last week, the US Chamber of Commerce became the latest group to sue the Trump administration over the fee.
“The new $100,000 visa fee will make it cost-prohibitive for U.S. employers, especially start-ups and small and midsize businesses, to utilize the H-1B program, which was created by Congress expressly to ensure that American businesses of all sizes can access the global talent they need to grow their operations here in the U.S.,” said Neil Bradley, executive vice president and chief policy officer of the chamber, which is one of the biggest pro-business lobbying groups in the nation.
The American Medical Association and more than 50 other health care-related societies have urged the Trump administration to declare international medical graduates exempt from the hefty fee.
“States with a higher percentage of H-1B physicians are often those with lower physician density,” they wrote in a letter to Kristi Noem, the secretary of the Department of Homeland Security. “The U.S. health care workforce relies upon physicians from other countries to provide high-quality and accessible patient care.”
In its latest guidance, US Citizenship and Immigration Services said the $100,000 fee only applies to new H-1B applicants living abroad — not existing H-1B visa holders living who need to renew their visa, and not those who hold other visa statuses and need to change their status to an H-1B.
For small rural hospitals like St. Luke’s, the shortage of physicians, along with the new fee, can be devastating for their staffing. St. Luke’s already has trouble attracting American graduates because it is not an academic residency, which is often more appealing to American graduates who want to compete for certain hospital positions after finishing their residency.
“We need so many physicians in this country, and there just aren’t enough American medical graduates to fill all of those positions. We have to draw from other places,” Lundry said.
These foreign applicants open up choices for Lundry to pick residents who have prior work experience and “astronomical” scores on American qualifying exams.
“Those people can be stellar stars,” she said.
Clinics under pressure to stay open
Dr. Chuck Thigpen, chief clinical and strategy officer at ATI Physical Therapy, wonders if he can maintain the job offers he made to international students graduating from US universities in January.
ATI has 450 open clinical roles across the United States, and 49 employees on the H-1B visa and 97 employees on the H-4 visa, which is a non-immigrant visa for spouses and unmarried children under 21 of the H-1B visa holders.
“There are way more jobs than we have even applicants applying for those jobs, so there’s not enough qualified therapists with licensure to fill our current workforce needs,” Thigpen said.
With these shortages and federal cuts to the health care industry, an exorbitant fee on hiring immigrants “sort of just piles on,” Thigpen said.
Thigpen says the real loss will be borne by Americans who really need the help.
“We’re already under severe pressure of just margin to keep clinics open and be sustainable,” he said. “So, if I now layer on an additional $100,000 per hire to bring in, I can’t do it. I just have to close clinics.”
Uncertain path for international graduates looking to the US
The H-1B fee has cast doubt on the future for international graduates.
Mykola, who fled the war in Ukraine in 2024, was a practicing doctor in Kyiv. (He asked that his full name not be included out of fear of backlash.)
He arrived in the United States through Uniting for Ukraine (U4U), a US government humanitarian parole program that allowed private US citizens to sponsor and help support Ukrainians who left because of the war. Mykola decided to prepare for exams to qualify to work as a doctor here.
As a parolee, he doesn’t qualify for the change-of-status process, according to Rakhel Milstein, an immigration lawyer and founder and CEO of Milstein Law Group. “He has to do a new H-1B petition, notifying the consulate. And those are exactly the people who are impacted,” Milstein said.
Mykola has spent thousands of dollars on qualifying exams, including textbooks, credential verification and application fees.
“I’m mainly applying to programs that are in underserved areas,” he told CNN, adding that he has seen how health care can be accessible in Ukraine and that he would like to help make it more accessible in the United States.
“I’m willing to help those underserved areas,” he said. “I know that for me, it’s not really a problem to serve there.”
Now, he waits for a residency program to accept his application and hopes to be sponsored for an H-1B visa so he can leave his parolee status behind. But with the new $100,000 fee, he wonders if those sponsorship offers will come.
H1Bs
When the Trump administration announced last month that every new H-1B visa would come with a $100,000 fee, the objective seemed straightforward: encourage companies, particularly tech companies thatheavily on the program, to start hiring American workers and stop driving down American wages.
But the health care industry is raising concerns that the price hike on the H-1B visa will threaten the ability of hospitals in rural and underserved areas to bring in foreign workers and fulfill a shortage of specialists needed to serve the community.
“There’s no way we’re going to pay $100,000,” Carolynn Lundry, a residency program coordinator at St. Luke’s Hospital in the St. Louis suburb of Chesterfield, Missouri.
“We pool from international graduates, and if we’re going to take away the H-1Bs from that, it’s going to shrink our pool of choices,” said Lundry, who selects 16 internal medicine residents a year for St. Luke’s.
More than 64% of international medical graduates were practicing in medically underserved areas or health professional shortage areas, with more than 45% practicing in rural areas, according to a 2021 study published by the National Institutes of Health.
And the United States needs an additional 13,075 physicians just to fill shortages, according to a 2024 report from the Health Resources and Services Administration (HRSA). The HRSA forecasts that by 2037, the US will be short of 87,150 full-time equivalent (FTE) primary care physicians.
Groups push back against $100,000 fee
The White House said the new fee for H-1B visa applicants is part of President Donald Trump’s promise to prioritize American workers.
“President Trump promised to put American workers first, and this commonsense action does just that by discouraging companies from spamming the system and driving down wages,” White House spokesperson Taylor Rogers told CNN in a statement. “It also gives certainty to American businesses who actually want to bring high-skilled workers into our great country but have been trampled on by abuses of the system.”
Some groups have pushed back against the $100,000 fee, which was previously at about $3,000. Last week, the US Chamber of Commerce became the latest group to sue the Trump administration over the fee.
“The new $100,000 visa fee will make it cost-prohibitive for U.S. employers, especially start-ups and small and midsize businesses, to utilize the H-1B program, which was created by Congress expressly to ensure that American businesses of all sizes can access the global talent they need to grow their operations here in the U.S.,” said Neil Bradley, executive vice president and chief policy officer of the chamber, which is one of the biggest pro-business lobbying groups in the nation.
The American Medical Association and more than 50 other health care-related societies have urged the Trump administration to declare international medical graduates exempt from the hefty fee.
“States with a higher percentage of H-1B physicians are often those with lower physician density,” they wrote in a letter to Kristi Noem, the secretary of the Department of Homeland Security. “The U.S. health care workforce relies upon physicians from other countries to provide high-quality and accessible patient care.”
In its latest guidance, US Citizenship and Immigration Services said the $100,000 fee only applies to new H-1B applicants living abroad — not existing H-1B visa holders living who need to renew their visa, and not those who hold other visa statuses and need to change their status to an H-1B.
For small rural hospitals like St. Luke’s, the shortage of physicians, along with the new fee, can be devastating for their staffing. St. Luke’s already has trouble attracting American graduates because it is not an academic residency, which is often more appealing to American graduates who want to compete for certain hospital positions after finishing their residency.
“We need so many physicians in this country, and there just aren’t enough American medical graduates to fill all of those positions. We have to draw from other places,” Lundry said.
These foreign applicants open up choices for Lundry to pick residents who have prior work experience and “astronomical” scores on American qualifying exams.
“Those people can be stellar stars,” she said.
Clinics under pressure to stay open
Dr. Chuck Thigpen, chief clinical and strategy officer at ATI Physical Therapy, wonders if he can maintain the job offers he made to international students graduating from US universities in January.
ATI has 450 open clinical roles across the United States, and 49 employees on the H-1B visa and 97 employees on the H-4 visa, which is a non-immigrant visa for spouses and unmarried children under 21 of the H-1B visa holders.
“There are way more jobs than we have even applicants applying for those jobs, so there’s not enough qualified therapists with licensure to fill our current workforce needs,” Thigpen said.
With these shortages and federal cuts to the health care industry, an exorbitant fee on hiring immigrants “sort of just piles on,” Thigpen said.
Thigpen says the real loss will be borne by Americans who really need the help.
“We’re already under severe pressure of just margin to keep clinics open and be sustainable,” he said. “So, if I now layer on an additional $100,000 per hire to bring in, I can’t do it. I just have to close clinics.”
Uncertain path for international graduates looking to the US
The H-1B fee has cast doubt on the future for international graduates.
Mykola, who fled the war in Ukraine in 2024, was a practicing doctor in Kyiv. (He asked that his full name not be included out of fear of backlash.)
He arrived in the United States through Uniting for Ukraine (U4U), a US government humanitarian parole program that allowed private US citizens to sponsor and help support Ukrainians who left because of the war. Mykola decided to prepare for exams to qualify to work as a doctor here.
As a parolee, he doesn’t qualify for the change-of-status process, according to Rakhel Milstein, an immigration lawyer and founder and CEO of Milstein Law Group. “He has to do a new H-1B petition, notifying the consulate. And those are exactly the people who are impacted,” Milstein said.
Mykola has spent thousands of dollars on qualifying exams, including textbooks, credential verification and application fees.
“I’m mainly applying to programs that are in underserved areas,” he told CNN, adding that he has seen how health care can be accessible in Ukraine and that he would like to help make it more accessible in the United States.
“I’m willing to help those underserved areas,” he said. “I know that for me, it’s not really a problem to serve there.”
Now, he waits for a residency program to accept his application and hopes to be sponsored for an H-1B visa so he can leave his parolee status behind. But with the new $100,000 fee, he wonders if those sponsorship offers will come.
OK, I've touched on this previously, but let me sort of try and lay out the building blocks of understanding here.
When the Covid pandemic hit the world in 2020, there was genuine fear that many healthcare workers would exit the profession - either by death from Covid (yes), retirement, going home and deciding you didn't want to return, inability to leave kids in someone's care, or something. Keep in mind that both nursing and laboratories - which you kinda have to have in a pandemic - were already short staffed. Covid caused a lot of people over 65 to go home and never return, early retirement, etc, especially if they had a comorbidity like diabetes, CHF, or whatever. In their efforts to retain sufficient personnel to not forever destroy the US healthcare system, the federal government decided to pay monies directly to hospitals to use for the pandemic. Throwing money at a problem - you can probably figure out where this one is going.
Nurses in some cases doubled salary overnight, particularly if they were ICU nurses. Hospitals, given mounds of money, opted (reasonably) to hire staff at inflated rates. Travel tech - which I began in March 2022 - became a lucrative way for medical technologists (such as myself) to suddenly go from making $1400 per week to $3000 per week (though it should be noted travel staff are required by law to "duplicate expenses", e.g. I have to pay state income tax both places, have a residence, etc; but a SMART person with money can make it work quite well). One technologist I know was making $6,000 per week in Portland (Oregon), and hospitals were competitively hiring at astronomical rates. For a number of the healthcare workers this became the new baseline of expectation. Hospitals were throwing $$$ at people because it wasn't theirs - it was free federal money!!!
(I actually turned down a guaranteed job offer in the summer of 2021 to do nothing but run Covid tests in rural Pennsylvania for $7,000 per week, 14-week contract. I was afraid to give up all I had accumulated - but given how much longer that went on, I probably could have pocketed over $250K before federal money was pulled on May 1, 2022. The guarantee was that even if testing suddenly ceased, I'd get the entire 98K - and they were going to put me up in their quarters).
And that leads us to the reality of H-1B healthcare workers, and I can speak to that in the laboratory.
When the Covid pandemic hit the world in 2020, there was genuine fear that many healthcare workers would exit the profession - either by death from Covid (yes), retirement, going home and deciding you didn't want to return, inability to leave kids in someone's care, or something. Keep in mind that both nursing and laboratories - which you kinda have to have in a pandemic - were already short staffed. Covid caused a lot of people over 65 to go home and never return, early retirement, etc, especially if they had a comorbidity like diabetes, CHF, or whatever. In their efforts to retain sufficient personnel to not forever destroy the US healthcare system, the federal government decided to pay monies directly to hospitals to use for the pandemic. Throwing money at a problem - you can probably figure out where this one is going.
Nurses in some cases doubled salary overnight, particularly if they were ICU nurses. Hospitals, given mounds of money, opted (reasonably) to hire staff at inflated rates. Travel tech - which I began in March 2022 - became a lucrative way for medical technologists (such as myself) to suddenly go from making $1400 per week to $3000 per week (though it should be noted travel staff are required by law to "duplicate expenses", e.g. I have to pay state income tax both places, have a residence, etc; but a SMART person with money can make it work quite well). One technologist I know was making $6,000 per week in Portland (Oregon), and hospitals were competitively hiring at astronomical rates. For a number of the healthcare workers this became the new baseline of expectation. Hospitals were throwing $$$ at people because it wasn't theirs - it was free federal money!!!
(I actually turned down a guaranteed job offer in the summer of 2021 to do nothing but run Covid tests in rural Pennsylvania for $7,000 per week, 14-week contract. I was afraid to give up all I had accumulated - but given how much longer that went on, I probably could have pocketed over $250K before federal money was pulled on May 1, 2022. The guarantee was that even if testing suddenly ceased, I'd get the entire 98K - and they were going to put me up in their quarters).
And that leads us to the reality of H-1B healthcare workers, and I can speak to that in the laboratory.
Virtually all of the H-1B technologists I've trained or worked with are VERY GOOD workers. All as far as I know have come from the Philippines. They are techs that in their home country made $2/day to run MANUAL tests and come here and are paid $20/hour ($160/day) to put samples on an instrument that does all the work - and know what they're doing.
Healthcare staffing is a crisis that is only getting worse by the day. In 2016, BLS estimated we would need 12,000 new medical technologist graduates JUST TO KEEP UP (and this before the pandemic). We were turning out less than 1/2 of that per year (5K) - and then the world shut down, the retirement phase advanced for thousands, and it is now at a critical shortage, not that this will produce higher salaries. The tipping point is expected next year, when we hit the halfway mark of the Boomer years and a bunch of the middle era Boomers hit 70 and full Social Security. That's been known since at least 2021.
So how do you keep healthcare costs from getting worse? Or how do you make money at this?
1) hire out of the country qualified persons (despite #2, they are qualified)
2) lower the standards for them to do the same job (again - great workers but this does happen)
3) bring them on THREE-YEAR contracts at $20/hour (avg current salary: $35/hour across USA)
4) thus, you replace workers making $35/hour with ones making $20/hour WHO YOU KNOW CANNOT GO ANYWHERE FOR THREE YEARS!!!
5) their sponsorship fees were around $3K, a small investment
Furthermore:
a) during the pandemic, even California relaxed their state licensure standards out of pure desperation
b) DeSantis and the Florida GOP set it up so that while a person like me has to take their state board and national certification, an H-1B DOES NOT have to do that.
I'm not arguing what is right or wrong here as far as the immigration part or the cutting costs part - except if you've watched any disaster movie, you know what's coming next.
During the pandemic, people (Americans) were somehow able to fake credentialing and get jobs in hospitals making $3K per week without ever having set foot in a laboratory other than to be drawn. Labs were desperate enough to just ask a few questions about their experience, they hired them, and the staffing agencies (this is like the NCAA football pay for play) either had to blind submit a pool of candidates OR LOSE THE MONEY to another agency. One staffing agency asked me a ten question test verbally that puzzled me - that's when I found out they had people getting jobs who had never worked in the lab.
To make this insanity even better...during the pandemic, even lousy lab techs were retained if they learned to fake it well enough, because the lab didn't want to train a new person or take time to interview.
Healthcare staffing is a crisis that is only getting worse by the day. In 2016, BLS estimated we would need 12,000 new medical technologist graduates JUST TO KEEP UP (and this before the pandemic). We were turning out less than 1/2 of that per year (5K) - and then the world shut down, the retirement phase advanced for thousands, and it is now at a critical shortage, not that this will produce higher salaries. The tipping point is expected next year, when we hit the halfway mark of the Boomer years and a bunch of the middle era Boomers hit 70 and full Social Security. That's been known since at least 2021.
So how do you keep healthcare costs from getting worse? Or how do you make money at this?
1) hire out of the country qualified persons (despite #2, they are qualified)
2) lower the standards for them to do the same job (again - great workers but this does happen)
3) bring them on THREE-YEAR contracts at $20/hour (avg current salary: $35/hour across USA)
4) thus, you replace workers making $35/hour with ones making $20/hour WHO YOU KNOW CANNOT GO ANYWHERE FOR THREE YEARS!!!
5) their sponsorship fees were around $3K, a small investment
Furthermore:
a) during the pandemic, even California relaxed their state licensure standards out of pure desperation
b) DeSantis and the Florida GOP set it up so that while a person like me has to take their state board and national certification, an H-1B DOES NOT have to do that.
I'm not arguing what is right or wrong here as far as the immigration part or the cutting costs part - except if you've watched any disaster movie, you know what's coming next.
During the pandemic, people (Americans) were somehow able to fake credentialing and get jobs in hospitals making $3K per week without ever having set foot in a laboratory other than to be drawn. Labs were desperate enough to just ask a few questions about their experience, they hired them, and the staffing agencies (this is like the NCAA football pay for play) either had to blind submit a pool of candidates OR LOSE THE MONEY to another agency. One staffing agency asked me a ten question test verbally that puzzled me - that's when I found out they had people getting jobs who had never worked in the lab.
To make this insanity even better...during the pandemic, even lousy lab techs were retained if they learned to fake it well enough, because the lab didn't want to train a new person or take time to interview.
The only real surpise here is that it took this long after Trump and RFKjr chummed the water.
www.nytimes.com
Texas Sues Tylenol Makers, Claiming They Hid Autism Risks
The lawsuit follows claims by President Trump that linked acetaminophen taken by pregnant women to autism, a connection that is unproven.
these people are dangerous moronsThe only real surpise here is that it took this long after Trump and RFKjr chummed the water.
Texas Sues Tylenol Makers, Claiming They Hid Autism Risks
The lawsuit follows claims by President Trump that linked acetaminophen taken by pregnant women to autism, a connection that is unproven.
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