Interesting article regarding health economics

http://annals.org/aim/article-abstract/2716078/high-deductible-insurance-delay-care-macrovascular-complications-diabetes

 

Abstract

Background:Little is known about the long-term effects of high-deductible insurance on care for chronic medical conditions.

 

Objective:To determine whether a transition from low-deductible to high-deductible insurance is associated with delayed medical care for macrovascular complications of diabetes.

 

Design:Observational longitudinal comparison of matched groups.

 

Setting:A large national health insurer during 2003 to 2012.

 

Participants:The intervention group comprised 33 957 persons with diabetes who were continuously enrolled in low-deductible (≤$500) insurance plans during a baseline year followed by up to 4 years in high-deductible (≥$1000) plans. The control group included 294 942 persons with diabetes who were enrolled in low-deductible plans contemporaneously with matched intervention group members.

Intervention:Employer-mandated transition to a high-deductible plan.

 

Measurements:The number of months it took for persons in each study group to seek care for their first major macrovascular symptom, have their first major diagnostic test for macrovascular disease, and have their first major procedure-based treatment was determined. Between-group differences in time to reach a midpoint event rate were then calculated.

 

Results:No baseline differences were found between groups. During follow-up, the delay for the high-deductible group was 1.5 months (95% CI, 0.8 to 2.3 months) for seeking care for the first major symptom, 1.9 months (CI, 1.4 to 2.3 months) for the first diagnostic test, and 3.1 months (CI, 0.5 to 5.8 months) for the first procedure-based treatment.

 

Limitation:Health outcomes were not examined.

 

Conclusion:Among persons with diabetes, mandated enrollment in a high-deductible insurance plan was associated with delays in seeking care for the first major symptoms of macrovascular disease, the first diagnostic test, and the first procedure-based treatment.

Medical symbol that has been bothering me indeed as well.

For america the left symbol is better, because the medical healthcare there is a multibillion dollar industry thriving on earning money instead of curing patients.

Cash and value flows

So:

I always wondered if cash and value has similarity to a physical systems. For example, can you visualize cash and value to flow through certain countries, firms and persons? And is it a closed circuit? What part of money evaporates in the process, and what part goes down the drain? Where is most cash located, in the hands of firms, people or countries? How does the cash flow look like in an extremely-rightwing country look like in comparison to a much more leftwing country such as scandinavia? How do these flows look like in time? Are there maybe even conservation laws that you can find? What is the effect of different political decisions on the different value flows? Look at the image at what I mean. How do credit flows look like in comparison? What happens when countries are at war? How did the flows look like in the economic crisis?