IGX

http://www.washingtonpost.com/blogs/ezr ... plain-why/

Health care should be like buying a washer?

Turdacious wrote:
Health care should be like buying a washer?

perhaps like a restaurant chain

http://www.newyorker.com/reporting/2012 ... ct_gawande

dead man walking wrote:

Turdacious wrote:
Health care should be like buying a washer?

perhaps like a restaurant chain

Or the auto industry.

Pinky wrote:

dead man walking wrote:

Turdacious wrote:
Health care should be like buying a washer?

perhaps like a restaurant chain

Or the auto industry.

Health care should be like health care in most every other developed nation in the world.

the free market is solving all these problems

give it time to work

problem is, much of the time docs don't know what works.

http://www.nytimes.com/2012/08/20/opini ... tices.html

protobuilder wrote:the free market is solving all these problems

give it time to work

There isn't a free market in healthcare

When my wife had ankle surgery last year, I drove her to the Doctor's office for followup.

In the Waiting Room, I overheard the receptionist telling a patient that Medicare covers only two visits per quarter for him to get his toenails trimmed.

Medical care could be improved in many places by a combo of initial internet consults and patients having a little skin in the game.

Don't even get me started on how many patients I send to the hospital in a $1500 ambulance ride for shit that I wouldn't even take ibuprofen for.

A new federal health analysis has found that 36 million adults in the United States have high blood pressure that is not being controlled even though 32 million of them get regular medical care and 30 million of them have health insurance.

This is not primarily a case of poor, uninsured people unable to get the care they need. It is shocking evidence of how our complicated, dysfunctional health care system can’t deliver recommended care to many patients who could benefit, because their doctors are asleep at the switch. As a result, patients go on to suffer medical harm and their care inflicts big costs on the health care system.

http://www.nytimes.com/2012/09/09/opini ... h_20120909

Ah the wonderful world of HIPAA.

Some of those translate better than others. They're dead on about improving cost transparency though in emergency cases that is not something the patient is in a position to evaluate, and it is not like if a surgeon discovers additional complications during surgery they can wake you up and ask you want you want to do.

The utter failure of healthcare to digitize their records and streamline administrative work is ridiculous. You can go into the top hospitals in the US and find people still using filing cabinets to manage patient records. Doesn't just waste money either. How many people have the experience of going to the hospital and telling five different doctors the same thing? Why not just write that all into one electronic record the doctor can reference BEFORE going in? Or when lack of one consolidated patient record in a hospital means one doctor misses something another doctor caught and there are negative patient outcomes as a result?

I'd Hit It wrote:Some of those translate better than others. They're dead on about improving cost transparency though in emergency cases that is not something the patient is in a position to evaluate, and it is not like if a surgeon discovers additional complications during surgery they can wake you up and ask you want you want to do.

This is not as easy as it sounds-- medical care is not a normal economic transaction.

And the birth control decision by HHS and the President undermines cost control.

dead man walking wrote:

dysfunctional health care system can’t deliver recommended care to many patients who could benefit, because their doctors are asleep at the switch. As a result, patients go on to suffer medical harm and their care inflicts big costs on the health care system.

This doesn't even take a Doctor. A nurse, an EMT, or even a machine in the supermarket can take a BP & identify high blood pressure. The same goes for EKG's & blood sugar testing.
And to identify obesity, all you need is a mirror or your beltline. You don't need an MD for most of this shit.
Most of this stuff is cheap & easy. Technology should be making it cheaper & easier.

Turdacious wrote:This is not as easy as it sounds-- medical care is not a normal economic transaction.

And the birth control decision by HHS and the President undermines cost control.

That is what I was trying to say about the cost control. It is not something that can always be predicted. I meant transparency for routine procedures and check-ups.

How does the birth control decision undermine cost control? Birth control and preventative care are significantly cheaper than welfare babies and surgeries for out-of-control ovarian cysts, fibroids, endometriosis, menstrual hemorrhaging, and cervical cancer.

I'd Hit It wrote:That is what I was trying to say about the cost control. It is not something that can always be predicted. I meant transparency for routine procedures and check-ups.

IMO Johno hit on it-- restructuring how medical care is done would help. The less that doctors do that doesn't require an MD the better. In an advanced medical care structure, like we have in the US, any change will be difficult. FWIW we already have cost control in place-- it's called a high deductible. It's regressive and doesn't effect Medicare and Medicaid patients much.

More importantly, as the Arrow paper I referenced suggests-- doctors don't want to be seen as profit maximizing (it undermines their effectiveness as an advocate for the patient).

I'd Hit It wrote:How does the birth control decision undermine cost control? Birth control and preventative care are significantly cheaper than welfare babies and surgeries for out-of-control ovarian cysts, fibroids, endometriosis, menstrual hemorrhaging, and cervical cancer.

It will:
increase consumption of more expensive forms of birth control
have little effect on use (women already buy and use it anyway)

The effect on insurance rates is the thing to watch.

Obamacare wasn't designed to pay for these kinds of costs.

The birth control decision takes a cost that women would normally pay anyway (and, yes, there is actually evidence of that) and shifts it to the population as a whole. There is no reason to believe it will result in a noticeable reduction in welfare babies, ovarian cysts, etc.

The administration was lying when it said that insurance companies would bear no additional cost (that might be passed on to the consumer) due to the mandate.

Pinky wrote:The administration was lying when it said that insurance companies would bear no additional cost (that might be passed on to the consumer) due to the mandate.

But it does put downward pressure on wages; induces businesses to replace full time work with part time work; and delays hiring decisions. See? Everyone's better off.

What do you think of fee-for-service? No fee-for-service, doctor does not feel compelled to implement unnecessary procedures.