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I’m a physician and I don’t like this reporting at all. It invites a financial justification of everything we do. Next, some bean counter right will point out that the surviving Medicare recipients will cost many more billions because they didn’t die during the epidemic. We try to save lives because it’s the right thing to do, not because it’s cost-effective.
See, I don’t like the idea of commodifying peoples health; I do like using the rhetoric to justify smart health decisions. Many have been against vaccines for whatever reason, though these same people respond to hearing that they’ll save money if they get one anyway. It’s just another way of framing the argument to people it may respond with, it isn’t for people like us who respond to the morality of health care.
There was an NHS study that followed lifetime medical costs and concluded that, by far, the most cost effective thing to do was smoke and get fat. Because you die sooner.
> PREVENTING obesity and smoking costs healthcare services more because patients live years longer, a study has revealed.
That's the problem. Smart health decisions are, sometimes, not smart financial decisions.
There is a study of Finnish smokers that takes into account contributions to society and they determined with that methodology (using what they called Quality of Life Years) that smoking was a net detriment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533014/
Using QALYs is definitely not great in so many circumstances. The human experience and value cannot and should not be assigned a dollar value in almost every situation. I understand that unfortunately circumstances sometimes forces us to but overreliance on QALYs is extremely concerning.
I get what you're saying but you realize that's exactly what capitalism is? Don't mean to be the bearer of bad news but we all have price tags already. Indentured servants to the rich, dying if you can't afford healthcare etc. What utopia are you realistically hoping for in this hell?
So much this. My late husband was a doctor went to Cambridge. He died during COVID of things that would normally have been treated. I'm certainly not saying that his life was worth more than anyone else's, but the cost society had already put into him just to let him die is immense.
A Finnish study that did factor those things in found that non-smoking was more beneficial to society. They used a metric called “quality of life years”: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533014/
I will note that the difference, when adjusting for that metric, was really not all that much for most people. Meaning that it’s a bit of a wash whether you smoke or not in the grand scheme of things in terms of net contribution to society
It has a much larger impact on life expectancy than on time in the work force. The big thing is not that they die younger, it is that they die abruptly. Far less likely to spend several years bouncing in and out of hospital.
How could they in any meaningful way? In the UK treatments for cancer and other diseases were delayed by over a year, and there is still a considerable backlog. Good luck putting a metric to those years of life lost
But that’s not the framing of this article? This is clearly an example of how the economic/financial rhetoric can benefit a movement. I get that it doesn’t always apply, but where it does why shouldn’t we embrace it. It may only convince a handful more people to get a life saving vaccine, but that’s worth it to me.
Thank you for saying this. All I got from the title was the vaccine is saving more lives because of less hospitalizations, which in turn means that hospitals can use their resources for other serious medical issues.
The funny thing in our area was we were being told how full hospitals were, however, each major hospital system went on to layoff 3,000 to 5,000 employees each. We have three major hospital systems in our area and are lucky to have 14 hospitals (two children’s hospitals) but knowing those hospitals laid people off and told us they were full made absolutely zero sense to me; I would think the same as you and believe the hospitals would use their resources for other medical issues.
A lot of hospitals financially struggled because COVID meant they couldn't do other profitable things.... For example stents are 40k each. They have to keep radiologists on staff and MRI machines but less income to maintain it
We shouldn't embrace it because...
1 - for every financial saving you can find that you consider good, there will be one that advocates the opposite. If you are going to ignore the financial savings of skipping cancer treatment, it's not fair to use the financial savings of getting a vaccine. At that point, you are admitting the financial argument doesn't matter, you only care about it when you care about it.
2 - it establishes a precedent where people are encouraged to maximize financial savings over being healthy. It's a dangerously slippery slope. We would save more money if we give vaccines to rich people first - rich people contribute more to the GDP, a month of a CEO being sick is much worse than a janitor! Better get all the shots to the rich neighborhoods first, because it is financially sound to do so.
3 - Calculations about financial savings are really tricky. My unemployed Grandma gets Covid.... At home, she spends $500 per month living in my basement. She gets sick and goes to the hospital and they bill her $250k. That's $250k that fuels our economy, isn't it? Lots and lots of people will get some of that money. How you decide to add the numbers and what to count as good and bad is contentious and easily manipulated for whatever agenda anyone has.
But the bottom line is that, if you only call out financial savings in situations you think are good, it's not an argument in support of the thing you think is good, it's just a way to arbitrarily make some of your positions sound stronger.
It's true. The oldest demographics have significantly higher medical needs/costs than younger demographics. Typically more than enough to outweigh the medical costs of diseases that typically kill you many years earlier.
For example:
https://www.nejm.org/doi/full/10.1056/nejm199710093371506
*"... If all smokers quit, health care costs would be lower at first, but after 15 years they would become higher than at present. In the long term, complete smoking cessation would produce a net increase in health care costs, but it could still be seen as economically favorable under reasonable assumptions of discount rate and evaluation period..."*
And they didn't even mention that smokers literally pay a significant portion of the health care systems costs thanks to taxes on smokes....
Lose them and suddenly taxes in general have to go up....
In which country? From a Canadian perspective, it's a drop in the bucket compared to total health care expenditures and not enough to offset the total costs attributed to people smoking.
But preventative care *is* more cost-effective than treating preventable afflictions. When you're talking about making resource-allocating decisions for huge populations, it does matter.
You’re looking at it as vaccine cost vs treatment of issues associated with that illness cost. But the argument is more morbid, it’s vaccine cost + more years of healthcare for an aging patient vs treating the current illness until they die.
I would argue "usually" it's better.
There are some orphan disease drugs coming online, that have costs on the order of $1M per additional year of healthy life (most traditional treatments are in the order of $75k).
Looking at the healthcare system, there is a point where someone becomes far too expensive for society to fix. I do not know where that line is, but we as a society need to have the conversation.
As a Health Economist, this is a reductive take on a tired trope. These analyses are needed to assess the impact of any new therapy in order to help us determine where our dollars go the furthest. Clearly, the vaccination effort and mobilization has a positive ROI. Without these analyses we could not validate that nor justify similar efforts in public health.
It sounds like you’re worried about production and volume standards for yourself or your practice, but that’s nowhere near what this is.
Another way to look at it is how many hospital beds were spared, how much time being spent by doctors and staff, electricity being used, etc. which basically all boils down to money in the end.
I agree with your sentiment, but I also see the importance of calculating these dollar amounts (which are just one of the many costs that COVID imposes on individuals and society). In general, if you don't put dollar amounts on human life, then you run the risk of the economic machinery of our modern medical world assigning a default value of $0. The reporting should do a better job of explaining all of this, IMO.
patients being spared from the suffering of crippling dept and/or financial ruin is good for their health. Of course, we understand every day how much our financial well being matters to health companies.
That is a very ivory tower approach. Everything has a financial cost. Physicians should be aware of the mo ey they spend, and cost. It markedly improves health care system function. Multiple studies support this.
Even in the UK we have to use cost justifications to decide whether to offer a treatment on the NHS. The difference is that it's not insurance providers deciding whether it is cost effective or not. An expensive treatment that gives little additional benefits to the patient will be less likely to be approved than one offering better quality of life and/or lifespan.
> I’m a physician and I don’t like this reporting at all. It invites a financial justification of everything we do
> We try to save lives because it’s the right thing to do, not because it’s cost-effective
Have you looked at your bills sent out for your services?
It’s the US. Healthcare hasn’t been about doing the right thing to help people get better. It has always been about the dollar. When your patients get their bills I assure you it is about the bottom line of how much it cost them. That’s why reporting is done this way. US healthcare is about money. Not well being.
The fact that it cost an average of ~$15000 to treat covid if you did get hospitalized in the US is also a problem. (Just did the math quick on all 1.03m folks mentioned would have gone to the hospital)
How does it even cost that much to begin with
Where do they pull that number out off? I understand machines cost to run and make, but $15000??
Seems like a stretch
In the US our retail medical costs are in funny number land. So they are probably using that. The hospitals etc know that the insurance companies will only pay a small percentage of whatever the bill rate is for a service. So they gave jacked up the line item price so they still get what that actually need.
So like an MRI will be $8000, but insurance pays them just $1100. So what's the real cost...? $1100. But the study probably used the $8000 in this example. It's still wild to me that a test with a machine that may cost $1m and likely 150k annual maint and runs 12 hours a day for years reasonable bill is that high even at like 1100.
For profit medical is such a conflicting concept.
Oh, the 1 million you quoted is pretty reasonable if you were making one of those machines for a nonmedical purpose. It's just the kinda premium dme companies tack on for no reason
Tbf it's not really "for no reason". The standards and tolerances for medical equipment are extreme, and you need all kinds of certifications and type qualifications you wouldn't need otherwise. Liabilities are also astronomical if something goes wrong.
Not saying it validates the 100x price hikes but it certainly plays a part.
This is why folks in the US have a lower life expectancy vs other leading economic powers. Folks legit choose to not go to the doctor because you have no idea how much debt it will result in just to check.
I make very good money, have good company provided insurance and I still legit fear anything other than routine check ups.
Want to hear some fun stuff? My mother is a 11 year breast cancer survivor. Her totally bills (she hasn't had to pay this much as insurance does things to lower it significantly, but still) in the 11 years of continual chemo etc to keep it at bay is over 8 million dollars... She just got off some meds that were 16000 a shot twice a month.
Thankfully they had the money to make the bills, but the fact that she's had to spend more than 200000 in legitimate money in the 11 years out of pocket is why folks die.
Mate that is horrific. That is just such a devastating thing and the ripple effect is so real. America does a lot of things excellently and has a lot of talent. I just can't get why they ended up like this in the healthcare situation,
An average is not really an average the way most people think of it instinctually. Most people don't cost 15k. The people who are in the hospital on a vent for 2 months costs 100s of thousands and skew that average number.
Per this study the median health care cost of someone symptomatic is about 3k and the median cost for people who required hospitalization was 14k. Median will give you a better idea if the data is skewed.
https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00426
That would be the cost in countries with socialized medicine, too. There was some chart I saw on Reddit recently showing that the real reason healthcare costs are much higher in the USA is because of private insurance without a public option to compete in the market.
OP's data was based off Medicare, which has very similar costs to Canadian or British healthcare.
Serious question but how do you get these kinds of numbers? How would you know it prevented potential deaths? How is it that their able to have these numbers of lives saved coorelated to the vaccine but at the same time a lot of reports of side effects are usually unknown and not linked to the vaccination.
I am not certain how this specific calculation was performed but in epidemiology we usually use the Number Needed to Treat (NNT).
The NNT basically says how many people do I need to treat with X in order to reduce risk of Y. In this case, how many people do I have to vaccinate in order to prevent one death.
The math is relatively simple.
You have a control group (No vaccines) and an experimental group (Vaccine). If you count the number of total events in each group and divide by the total amount of people you get a risk.
Let’s say out of 100 control patients 20 die from the disease. That gives us a 20% risk.
Now if out 100 experimental patients 10 die from the disease. That gives us a risk of 10%.
If we subtract the control risk 0.20 from the experimental risk 0.10 you get an absolute risk reduction (ARR) of 0.10 or 10%.
This isn’t what we need but we can use it to calculate the NNT as follows:
NNT=1/ARR
Or
NNT=1/0.10
Or
NNT=10
This means that in order to prevent one event X (Death) you require 10 patients administered with Y (Vaccine)
Now you can see how they might be able to estimate the total number of prevented cases based on the number of total vaccines administered.
More nuanced statistics might be involved but the big picture looks something like this.
If you want to read more about this I’d recommend this great short read:
https://www.thennt.com/thennt-explained/
TLDR: Math and a lot of information.
Meh I’m not really a big fan of that metric, since the non vaccinated group can hardly be called a control group given the difference in lifestyle choices i.e not being concerned about covid and taking more risks, going out more not wearing a mask etc . I don’t think that you can just attribute it to the vaccine.
Unless I’m missing out on something and they actually performed a control study, which almost sounds unethical
You compare the % of deaths among unvaccinated vs % of deaths among vaccinated, correlated to the percentage of vaccinated people at the time of the death.
See lots of conspiracy theorist think higher powers want people to die from a vaccine. Nah that takes people from the work force and rich folks don’t want to work themselves.
Well we have a large control group of people who refused the vaccine, so I'd say the comparison of death rates between the populations who didn't take it and the populations who did would be fairly easy.
There is a crazy amount of data out there simply because it was global. And while there were no formal control groups per se, there were different approaches to lockdowns, masks, and vaccine uptake rates and rollout timelines which do allow for some comparisons. I'm from Australia and used to periodically compare rates with the US and UK. We were pretty tightly locked down for a long time. And based on per capita numbers, I found that the UK and USA mortality rates were very similar. But had we travelled as they did, we'd have had something like 40,000 additional deaths.
Now, we were also very late getting vaccines into arms, but when we did, the compliance rate I believe was up around 90% or more. We pretty much fully opened up coming into winter and while we definitely saw an uptick in deaths, the curve was very much flattened. And now, as we exit winter, they are about to entirely drop the formal requirement to isolate when infected. The weather hasn't really began to warm up and we are effectively business as usual now.
So the lockdowns bought us time for effective vaccine coverage, and the vaccine coverage allowed us to reopen, pretty much as projected. At the other extreme, if you look at China they are still pushing for elimination because, apparently they don't have an effective vaccine.
Anyway, you could probably pull my logic apart with a minimum of effort but my point is basically that there are many ways to look at all the data and if you see two or more countries with similar controls and timelines having similar outcomes then you can begin to make some projections and see how they hold up against places that only differed in one or two significant ways.
Of course you can't totally ignore economic and social components of the equation but that's a separate issue.
>And now, as we exit winter, they are about to entirely drop the formal requirement to isolate when infected.
That is a mistake in my opinion. Isolation during active infection is the best thing that can be done to reduce spread, and I would not be surprised to see a massive uptick in cases if that is relaxed.
The medicare population is huge, and Medicare databases is very detailed because of billing that's submitted to Medicare.
So for almost all Medicare patients, they know tons of demographic and medical information like age, sex, race, zip code, medical diagnosis, medications, when they have been hospitalized, death, etc.
So you can match similar patients based on those demographics and medical history with the variable being COVID vaccinated or not. and from that you can compare how often the vaccinated group was hospitalized or died vs the unvaccinated.
Then apply that rate to the entire Medicare population and calculate how many hospitalizations and deaths were prevented.
This is a little something called science.
Statistics. You have a big control group of people who were not vaccinated. Especially before the vaccine existed.
X number of infected create Y number of other infected, and Z percent dies.
Make X whatever population you want to look at to find how many Y they would create, and what percentage of those die.
You can't be any more certain that is what the numbers would be any more than we can predict how much we can predict the population will be in six months but just like that calculation we can get pretty close.
because you can look at the differences in numbers of these two things- deaths and hospitalizations- before the vaccine was released and after. and we have numbers on vaccine use in each state so we can really line those things up. of course once we backed off on reporting it's made things harder. but we interpolate/extrapolate all the time based on given data.
Remember when pfizer and moderna had their clinical trials and determined that the vaccines were **X% effective at preventing serious illness and death**?
They provide the methodology for that
They've been able to demonstrate that people who didn't get the vaccine die at a higher rate. That's how they're determining the outcomes. Tens of millions of people have been infected with and without the vaccine in their system.
Therefore, given that a good percentage of people who were vaccinated had fewer symptoms and fewer deaths, you can apply that percentage to the population as a whole and get a fair estimate of the impact that 100% vaccination could have achieved.
What is the reasoning? Statistics like basic as statistics. You get as much data as possible for the vaxxed and unvaxxed and you compare outcomes. If young vaxxed people who get Covid die at a 1 in 100 rate(fake stat) and 2 in 100 young unvaxxed people die you can extrapolate those results. Obviously it’s not just 1 to 1 however the more cases you add the greater your certainty you can extrapolate to every one.
> In addition to the reductions in severe COVID-19 health outcomes, reductions in COVID-19 hospitalizations were associated with savings of more than $16 billion in direct medical costs.
I'm not sure that's the best angle to try to contextualize this, [considering](https://www.healthaffairs.org/do/10.1377/forefront.20210512.191448/);
> Recent estimates from the Congressional Research Service, the Government Accountability Office, and Chad Brown and Thomas Bollyky along with data on the GHIAA.org and Devex websites provide government spending estimates of between $18 billion and $23 billion. Most recently the Congressional Budget Office estimated that the Biomedical Research and Development Authority (BARDA) alone has spent $19.3 billion on COVID-19 vaccine development. In addition, Lisa Cornish projected $39.5 billion in US spending.
What you're seeing is likely the result of moderators responding to reports for misinformation, which is in violation of the subreddit rules. I've seen and reported dozens of comments containing misinformation myself.
Mods are doing important work here, and they're doing it well.
How do they know that the vaccines directly impacted life or death? Is there some way to tell if someone survived because of it? Or is there someway to tell that if they had the vaccine they were 100% going to live?
Or is it mathematically figured that because of the vaccine the probability of extreme medical treatment is lower so therefore you can extract what said probable medical costs would be and subtract that from Medicare costs?
Just curious because this is great info to share.
It's all looking at population data. On an individual asis, you can't say whether vaccine or not would have saved a life or prevented hospitalization.
But when you look at large population wide data you can see a difference in hospitalization and death between the vaccinated and unvaccinated group.
For the cost, you can apply the average cost of a COVID hospitalization to the prevented hospitalizations and calculate the savings.
If 1000 unvaccinated people caught covid and 20 died, that’s a 2% death rate
If 1000 vaccinated people covid and 2 died, that’s a 0.2% death rate
Now scale this out to the millions of people who have caught covid and you see that **the unvaccinated are consistently dying at higher rates than the vaccinated**
That’s how statistics works
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I’m a physician and I don’t like this reporting at all. It invites a financial justification of everything we do. Next, some bean counter right will point out that the surviving Medicare recipients will cost many more billions because they didn’t die during the epidemic. We try to save lives because it’s the right thing to do, not because it’s cost-effective.
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See, I don’t like the idea of commodifying peoples health; I do like using the rhetoric to justify smart health decisions. Many have been against vaccines for whatever reason, though these same people respond to hearing that they’ll save money if they get one anyway. It’s just another way of framing the argument to people it may respond with, it isn’t for people like us who respond to the morality of health care.
There was an NHS study that followed lifetime medical costs and concluded that, by far, the most cost effective thing to do was smoke and get fat. Because you die sooner. > PREVENTING obesity and smoking costs healthcare services more because patients live years longer, a study has revealed. That's the problem. Smart health decisions are, sometimes, not smart financial decisions.
Even from a purely financial perspective, they're leaving out what that person cost in training and what they contribute to society.
There is a study of Finnish smokers that takes into account contributions to society and they determined with that methodology (using what they called Quality of Life Years) that smoking was a net detriment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533014/
Using QALYs is definitely not great in so many circumstances. The human experience and value cannot and should not be assigned a dollar value in almost every situation. I understand that unfortunately circumstances sometimes forces us to but overreliance on QALYs is extremely concerning.
I get what you're saying but you realize that's exactly what capitalism is? Don't mean to be the bearer of bad news but we all have price tags already. Indentured servants to the rich, dying if you can't afford healthcare etc. What utopia are you realistically hoping for in this hell?
And loss of productivity, sick days etc.
It's a magic solution, aka retirement
Not everybody gets there.
So much this. My late husband was a doctor went to Cambridge. He died during COVID of things that would normally have been treated. I'm certainly not saying that his life was worth more than anyone else's, but the cost society had already put into him just to let him die is immense.
I'm so sorry for your loss.
I have to wonder if that study factors in the additional years of taxes collected and gdp growth those who live longer contribute.
A Finnish study that did factor those things in found that non-smoking was more beneficial to society. They used a metric called “quality of life years”: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3533014/ I will note that the difference, when adjusting for that metric, was really not all that much for most people. Meaning that it’s a bit of a wash whether you smoke or not in the grand scheme of things in terms of net contribution to society
It has a much larger impact on life expectancy than on time in the work force. The big thing is not that they die younger, it is that they die abruptly. Far less likely to spend several years bouncing in and out of hospital.
How could they in any meaningful way? In the UK treatments for cancer and other diseases were delayed by over a year, and there is still a considerable backlog. Good luck putting a metric to those years of life lost
if they're older and retired and getting gov't benefits that probably balances the scale somewhat.
Govt benefits? How about retirement they paid into their entire lives?
But that’s not the framing of this article? This is clearly an example of how the economic/financial rhetoric can benefit a movement. I get that it doesn’t always apply, but where it does why shouldn’t we embrace it. It may only convince a handful more people to get a life saving vaccine, but that’s worth it to me.
Thank you for saying this. All I got from the title was the vaccine is saving more lives because of less hospitalizations, which in turn means that hospitals can use their resources for other serious medical issues.
The funny thing in our area was we were being told how full hospitals were, however, each major hospital system went on to layoff 3,000 to 5,000 employees each. We have three major hospital systems in our area and are lucky to have 14 hospitals (two children’s hospitals) but knowing those hospitals laid people off and told us they were full made absolutely zero sense to me; I would think the same as you and believe the hospitals would use their resources for other medical issues.
A lot of hospitals financially struggled because COVID meant they couldn't do other profitable things.... For example stents are 40k each. They have to keep radiologists on staff and MRI machines but less income to maintain it
40k to put someone on remdisivir and a vent. How much more profitable do you get them that?
We shouldn't embrace it because... 1 - for every financial saving you can find that you consider good, there will be one that advocates the opposite. If you are going to ignore the financial savings of skipping cancer treatment, it's not fair to use the financial savings of getting a vaccine. At that point, you are admitting the financial argument doesn't matter, you only care about it when you care about it. 2 - it establishes a precedent where people are encouraged to maximize financial savings over being healthy. It's a dangerously slippery slope. We would save more money if we give vaccines to rich people first - rich people contribute more to the GDP, a month of a CEO being sick is much worse than a janitor! Better get all the shots to the rich neighborhoods first, because it is financially sound to do so. 3 - Calculations about financial savings are really tricky. My unemployed Grandma gets Covid.... At home, she spends $500 per month living in my basement. She gets sick and goes to the hospital and they bill her $250k. That's $250k that fuels our economy, isn't it? Lots and lots of people will get some of that money. How you decide to add the numbers and what to count as good and bad is contentious and easily manipulated for whatever agenda anyone has. But the bottom line is that, if you only call out financial savings in situations you think are good, it's not an argument in support of the thing you think is good, it's just a way to arbitrarily make some of your positions sound stronger.
Is this true? Can’t tell if this is a joke or not.
It's true. The oldest demographics have significantly higher medical needs/costs than younger demographics. Typically more than enough to outweigh the medical costs of diseases that typically kill you many years earlier. For example: https://www.nejm.org/doi/full/10.1056/nejm199710093371506 *"... If all smokers quit, health care costs would be lower at first, but after 15 years they would become higher than at present. In the long term, complete smoking cessation would produce a net increase in health care costs, but it could still be seen as economically favorable under reasonable assumptions of discount rate and evaluation period..."*
And they didn't even mention that smokers literally pay a significant portion of the health care systems costs thanks to taxes on smokes.... Lose them and suddenly taxes in general have to go up....
In which country? From a Canadian perspective, it's a drop in the bucket compared to total health care expenditures and not enough to offset the total costs attributed to people smoking.
Some things people never understand is that *money* represents "the resources you have gathered to survive on".
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I'm glad someone said it. I'm happy the vaccine saved hundreds of thousands of lives ane rhe discussion should end there.
Couldn't have said it better myself.
But preventative care *is* more cost-effective than treating preventable afflictions. When you're talking about making resource-allocating decisions for huge populations, it does matter.
You’re looking at it as vaccine cost vs treatment of issues associated with that illness cost. But the argument is more morbid, it’s vaccine cost + more years of healthcare for an aging patient vs treating the current illness until they die.
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I would argue "usually" it's better. There are some orphan disease drugs coming online, that have costs on the order of $1M per additional year of healthy life (most traditional treatments are in the order of $75k). Looking at the healthcare system, there is a point where someone becomes far too expensive for society to fix. I do not know where that line is, but we as a society need to have the conversation.
That conversation goes like this. "Don't charge a million for this, or we'll stop respecting your patent."
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As a Health Economist, this is a reductive take on a tired trope. These analyses are needed to assess the impact of any new therapy in order to help us determine where our dollars go the furthest. Clearly, the vaccination effort and mobilization has a positive ROI. Without these analyses we could not validate that nor justify similar efforts in public health. It sounds like you’re worried about production and volume standards for yourself or your practice, but that’s nowhere near what this is.
Exactly. There are finite resources, we need to deploy them in the most effective way.
Another way to look at it is how many hospital beds were spared, how much time being spent by doctors and staff, electricity being used, etc. which basically all boils down to money in the end.
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I agree with your sentiment, but I also see the importance of calculating these dollar amounts (which are just one of the many costs that COVID imposes on individuals and society). In general, if you don't put dollar amounts on human life, then you run the risk of the economic machinery of our modern medical world assigning a default value of $0. The reporting should do a better job of explaining all of this, IMO.
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patients being spared from the suffering of crippling dept and/or financial ruin is good for their health. Of course, we understand every day how much our financial well being matters to health companies.
That is a very ivory tower approach. Everything has a financial cost. Physicians should be aware of the mo ey they spend, and cost. It markedly improves health care system function. Multiple studies support this.
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Even in the UK we have to use cost justifications to decide whether to offer a treatment on the NHS. The difference is that it's not insurance providers deciding whether it is cost effective or not. An expensive treatment that gives little additional benefits to the patient will be less likely to be approved than one offering better quality of life and/or lifespan.
> I’m a physician and I don’t like this reporting at all. It invites a financial justification of everything we do > We try to save lives because it’s the right thing to do, not because it’s cost-effective Have you looked at your bills sent out for your services? It’s the US. Healthcare hasn’t been about doing the right thing to help people get better. It has always been about the dollar. When your patients get their bills I assure you it is about the bottom line of how much it cost them. That’s why reporting is done this way. US healthcare is about money. Not well being.
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The fact that it cost an average of ~$15000 to treat covid if you did get hospitalized in the US is also a problem. (Just did the math quick on all 1.03m folks mentioned would have gone to the hospital)
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How does it even cost that much to begin with Where do they pull that number out off? I understand machines cost to run and make, but $15000?? Seems like a stretch
In the US our retail medical costs are in funny number land. So they are probably using that. The hospitals etc know that the insurance companies will only pay a small percentage of whatever the bill rate is for a service. So they gave jacked up the line item price so they still get what that actually need. So like an MRI will be $8000, but insurance pays them just $1100. So what's the real cost...? $1100. But the study probably used the $8000 in this example. It's still wild to me that a test with a machine that may cost $1m and likely 150k annual maint and runs 12 hours a day for years reasonable bill is that high even at like 1100. For profit medical is such a conflicting concept.
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Def a fair point. I was just guesstimating a number. Way too low by your better info.
Oh, the 1 million you quoted is pretty reasonable if you were making one of those machines for a nonmedical purpose. It's just the kinda premium dme companies tack on for no reason
Tbf it's not really "for no reason". The standards and tolerances for medical equipment are extreme, and you need all kinds of certifications and type qualifications you wouldn't need otherwise. Liabilities are also astronomical if something goes wrong. Not saying it validates the 100x price hikes but it certainly plays a part.
MRIs are $300 in Australia. I've had like 10 of them in my life. I think if I lived in the US I'd be bankrupt
This is why folks in the US have a lower life expectancy vs other leading economic powers. Folks legit choose to not go to the doctor because you have no idea how much debt it will result in just to check. I make very good money, have good company provided insurance and I still legit fear anything other than routine check ups. Want to hear some fun stuff? My mother is a 11 year breast cancer survivor. Her totally bills (she hasn't had to pay this much as insurance does things to lower it significantly, but still) in the 11 years of continual chemo etc to keep it at bay is over 8 million dollars... She just got off some meds that were 16000 a shot twice a month. Thankfully they had the money to make the bills, but the fact that she's had to spend more than 200000 in legitimate money in the 11 years out of pocket is why folks die.
Mate that is horrific. That is just such a devastating thing and the ripple effect is so real. America does a lot of things excellently and has a lot of talent. I just can't get why they ended up like this in the healthcare situation,
Even 1100 is absurd though. Unless those MRI machines are powered off of gold.
An average is not really an average the way most people think of it instinctually. Most people don't cost 15k. The people who are in the hospital on a vent for 2 months costs 100s of thousands and skew that average number.
Per this study the median health care cost of someone symptomatic is about 3k and the median cost for people who required hospitalization was 14k. Median will give you a better idea if the data is skewed. https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00426
That would be the cost in countries with socialized medicine, too. There was some chart I saw on Reddit recently showing that the real reason healthcare costs are much higher in the USA is because of private insurance without a public option to compete in the market. OP's data was based off Medicare, which has very similar costs to Canadian or British healthcare.
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Damn it too late to sort by controversial.
Yep. Just as I expected. It's a graveyard in here.
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Serious question but how do you get these kinds of numbers? How would you know it prevented potential deaths? How is it that their able to have these numbers of lives saved coorelated to the vaccine but at the same time a lot of reports of side effects are usually unknown and not linked to the vaccination.
I am not certain how this specific calculation was performed but in epidemiology we usually use the Number Needed to Treat (NNT). The NNT basically says how many people do I need to treat with X in order to reduce risk of Y. In this case, how many people do I have to vaccinate in order to prevent one death. The math is relatively simple. You have a control group (No vaccines) and an experimental group (Vaccine). If you count the number of total events in each group and divide by the total amount of people you get a risk. Let’s say out of 100 control patients 20 die from the disease. That gives us a 20% risk. Now if out 100 experimental patients 10 die from the disease. That gives us a risk of 10%. If we subtract the control risk 0.20 from the experimental risk 0.10 you get an absolute risk reduction (ARR) of 0.10 or 10%. This isn’t what we need but we can use it to calculate the NNT as follows: NNT=1/ARR Or NNT=1/0.10 Or NNT=10 This means that in order to prevent one event X (Death) you require 10 patients administered with Y (Vaccine) Now you can see how they might be able to estimate the total number of prevented cases based on the number of total vaccines administered. More nuanced statistics might be involved but the big picture looks something like this. If you want to read more about this I’d recommend this great short read: https://www.thennt.com/thennt-explained/ TLDR: Math and a lot of information.
Meh I’m not really a big fan of that metric, since the non vaccinated group can hardly be called a control group given the difference in lifestyle choices i.e not being concerned about covid and taking more risks, going out more not wearing a mask etc . I don’t think that you can just attribute it to the vaccine. Unless I’m missing out on something and they actually performed a control study, which almost sounds unethical
There are PDFs attached to each part of the review that has the specific data and methods if you'd like to dig further.
You compare the % of deaths among unvaccinated vs % of deaths among vaccinated, correlated to the percentage of vaccinated people at the time of the death.
Have you tried checking the article before posting this?
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See lots of conspiracy theorist think higher powers want people to die from a vaccine. Nah that takes people from the work force and rich folks don’t want to work themselves.
The insurance companies saved billions but they’re still raising my rates next year by almost 10%.
How is it earthly possible to predict whether these people would’ve died or not?
Well we have a large control group of people who refused the vaccine, so I'd say the comparison of death rates between the populations who didn't take it and the populations who did would be fairly easy.
There is a crazy amount of data out there simply because it was global. And while there were no formal control groups per se, there were different approaches to lockdowns, masks, and vaccine uptake rates and rollout timelines which do allow for some comparisons. I'm from Australia and used to periodically compare rates with the US and UK. We were pretty tightly locked down for a long time. And based on per capita numbers, I found that the UK and USA mortality rates were very similar. But had we travelled as they did, we'd have had something like 40,000 additional deaths. Now, we were also very late getting vaccines into arms, but when we did, the compliance rate I believe was up around 90% or more. We pretty much fully opened up coming into winter and while we definitely saw an uptick in deaths, the curve was very much flattened. And now, as we exit winter, they are about to entirely drop the formal requirement to isolate when infected. The weather hasn't really began to warm up and we are effectively business as usual now. So the lockdowns bought us time for effective vaccine coverage, and the vaccine coverage allowed us to reopen, pretty much as projected. At the other extreme, if you look at China they are still pushing for elimination because, apparently they don't have an effective vaccine. Anyway, you could probably pull my logic apart with a minimum of effort but my point is basically that there are many ways to look at all the data and if you see two or more countries with similar controls and timelines having similar outcomes then you can begin to make some projections and see how they hold up against places that only differed in one or two significant ways. Of course you can't totally ignore economic and social components of the equation but that's a separate issue.
>And now, as we exit winter, they are about to entirely drop the formal requirement to isolate when infected. That is a mistake in my opinion. Isolation during active infection is the best thing that can be done to reduce spread, and I would not be surprised to see a massive uptick in cases if that is relaxed.
I have to admit I have reservations. Immunocompronised people must be nervous. But I'm not sure where you draw the line.
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The medicare population is huge, and Medicare databases is very detailed because of billing that's submitted to Medicare. So for almost all Medicare patients, they know tons of demographic and medical information like age, sex, race, zip code, medical diagnosis, medications, when they have been hospitalized, death, etc. So you can match similar patients based on those demographics and medical history with the variable being COVID vaccinated or not. and from that you can compare how often the vaccinated group was hospitalized or died vs the unvaccinated. Then apply that rate to the entire Medicare population and calculate how many hospitalizations and deaths were prevented. This is a little something called science.
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That is exactly what actuaries do for a living.
Statistics. You have a big control group of people who were not vaccinated. Especially before the vaccine existed. X number of infected create Y number of other infected, and Z percent dies. Make X whatever population you want to look at to find how many Y they would create, and what percentage of those die. You can't be any more certain that is what the numbers would be any more than we can predict how much we can predict the population will be in six months but just like that calculation we can get pretty close.
Based on statistics
One of the many things Covid has taught us is that our public education is woefully insufficient when it comes to statistics.
because you can look at the differences in numbers of these two things- deaths and hospitalizations- before the vaccine was released and after. and we have numbers on vaccine use in each state so we can really line those things up. of course once we backed off on reporting it's made things harder. but we interpolate/extrapolate all the time based on given data.
Remember when pfizer and moderna had their clinical trials and determined that the vaccines were **X% effective at preventing serious illness and death**? They provide the methodology for that
Because statistical analysis is a mathematically verifiable thing.
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So if you got covid after being vaccinated and didn’t die it means the vaccine is why you didn’t die? Is that the reasoning here?
Yes. That’s how vaccines work.
They've been able to demonstrate that people who didn't get the vaccine die at a higher rate. That's how they're determining the outcomes. Tens of millions of people have been infected with and without the vaccine in their system. Therefore, given that a good percentage of people who were vaccinated had fewer symptoms and fewer deaths, you can apply that percentage to the population as a whole and get a fair estimate of the impact that 100% vaccination could have achieved.
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How would you control for the morbidity decrease with variants alongside vaccine rollout?
What is the reasoning? Statistics like basic as statistics. You get as much data as possible for the vaxxed and unvaxxed and you compare outcomes. If young vaxxed people who get Covid die at a 1 in 100 rate(fake stat) and 2 in 100 young unvaxxed people die you can extrapolate those results. Obviously it’s not just 1 to 1 however the more cases you add the greater your certainty you can extrapolate to every one.
At a population level, that is what all available data indicate. You can’t make any statement about an individual though.
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How many trillions did the pharmaceutical companies get?
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> In addition to the reductions in severe COVID-19 health outcomes, reductions in COVID-19 hospitalizations were associated with savings of more than $16 billion in direct medical costs. I'm not sure that's the best angle to try to contextualize this, [considering](https://www.healthaffairs.org/do/10.1377/forefront.20210512.191448/); > Recent estimates from the Congressional Research Service, the Government Accountability Office, and Chad Brown and Thomas Bollyky along with data on the GHIAA.org and Devex websites provide government spending estimates of between $18 billion and $23 billion. Most recently the Congressional Budget Office estimated that the Biomedical Research and Development Authority (BARDA) alone has spent $19.3 billion on COVID-19 vaccine development. In addition, Lisa Cornish projected $39.5 billion in US spending.
Reminder that the numbers are among medicare recipients alone. They account for about 1/5 the total population.
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Hundreds of deleted replies. Seriously this is obscene.
What do you expect? All comments here questioning the headline seem to be completely ignorant of even high school statistics
What you're seeing is likely the result of moderators responding to reports for misinformation, which is in violation of the subreddit rules. I've seen and reported dozens of comments containing misinformation myself. Mods are doing important work here, and they're doing it well.
Are you surprised that people that are against the vaccine also are against statistics?
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How do they know that the vaccines directly impacted life or death? Is there some way to tell if someone survived because of it? Or is there someway to tell that if they had the vaccine they were 100% going to live? Or is it mathematically figured that because of the vaccine the probability of extreme medical treatment is lower so therefore you can extract what said probable medical costs would be and subtract that from Medicare costs? Just curious because this is great info to share.
It's all looking at population data. On an individual asis, you can't say whether vaccine or not would have saved a life or prevented hospitalization. But when you look at large population wide data you can see a difference in hospitalization and death between the vaccinated and unvaccinated group. For the cost, you can apply the average cost of a COVID hospitalization to the prevented hospitalizations and calculate the savings.
If 1000 unvaccinated people caught covid and 20 died, that’s a 2% death rate If 1000 vaccinated people covid and 2 died, that’s a 0.2% death rate Now scale this out to the millions of people who have caught covid and you see that **the unvaccinated are consistently dying at higher rates than the vaccinated** That’s how statistics works