MrRodgers
Posts: 10542
Joined: 7/30/2005
Status: offline
|
quote:
ORIGINAL: DesideriScuri
quote:
ORIGINAL: JeffBC
quote:
ORIGINAL: DesideriScuri
Procedure costs being high will increase the amount an insurer pays out, making your premiums high. Not saying that as if you didn't already know it. But, what is it about procedure costs that they keep going up? Therein lies the issue, imo, not who is paying the bill.
*nods* I almost talked to this point.
Given the corporatism going on in the US I'm utterly certain that a monolithic insurance system in the US will only serve to make a huge vacuum cleaner funnelling money into the hands of the medical industrial complex. How could it be otherwise? That is the story of the entire US economy and nothing can be done about it until the US citizens decide they are tired of buying yachts for rich folks. Accordingly, I see that as a separate issue... it's going to happen no matter what. That leaves me thinking that all things being equally evil, I'd rather not have people dying for lack of medical care. I still find that aesthetically unappealing. I'm not nearly conservative enough to say "let them die".
That is not a conservative position. No person with a conscience wants anyone dying in the street simply for the lack of money to pay for care. The conservative position supports letting the Market find the fix.
quote:
Insofar as why does this happen... why are procedure costs so high... that's one of those "gee duh" questions. It is the miracle of a free market economy at work. Said free market economy was bought and paid for by the corporations and they are now enjoying the profit on their investment. How you'd stop it would be trivially easy if it were the citizen's government rather than the corporations government. You'd just set prices at some level half-way-ish between US and Canada and ratchet them down annually every year. You want to sell medical services in the US? That's the price you'll get paid.
I agree the high costs are from a market economy. However, notice I did not say it was a free market economy. It is a quite distorted market. Separating the providers from the insurers will help to free the market to a large extent, imo. It isn't the only solution, but I do believe that would have tangible impact, making health care more affordable for anyone who wants care.
quote:
It's possible in my mind that we might need to look at tort reform also but I'd need to be convinced of that one.
From my second link:quote:
It is difficult to untangle precisely why prices are higher in the U.S., but two things are apparent: U.S. physicians get higher incomes than in other countries and the U.S. uses more expensive diagnostic procedures. More generally, with so many different kinds of insurance, no one organization has a strong incentive to cut out wasteful practices and ensure that all Americans get value for the very high levels of expenditure incurred when they are sick.
NewsHour: The U.S. system is known for over-testing and over-treating, everything from CT scans and MRIs, knee replacements to coronary bypasses. How severe is the over-testing and why is it occurring? Are there mechanisms in place to prevent this in other OECD countries?
Pearson: Our data suggests that the U.S. does do more tests than other OECD countries. The U.S. did 100 MRI tests and 265 CT tests for every 1000 people in 2010 -- more than twice the average in other OECD countries. It does more tonsillectomies and more knee replacements than any other OECD country. It also has more Caesarean sections and coronary bypass procedures than in most other countries.
These procedures and the use of expensive diagnostic tests are all subject to physician opinion on whether they are desirable or not. The fact that U.S. physicians decide that more procedures and tests are desirable compared to their peers in other countries could be due to a few different things, such as:
- A fear of litigation that sees physicians test for everything so that they cannot be blamed for not having covered all bases
- Payments that mean that physicians get paid more if they do more interventions, regardless of medical necessity.
- Because patients ask for more tests and services. It is often comforting to feel that medical problems are being diagnosed or treated, regardless of whether they are medically necessary. As these services are often paid for by insurance policies, the immediate cost of extra treatment for a patient is often zero or very low.
It is often argued that differences in testing could reflect differences in patients' needs between and within countries. However, research at the Dartmouth Institute has documented that there are large variations in medical practice across different regions in the United States which cannot be explained by differences in population structure or differences in illness. They found that the rate of coronary bypass was five times greater in certain hospital referral regions in the United States than others between 2003 and 2007. Similarly, regional variations in hip and knee replacement are substantial, with the rates four to five times higher in some regions compared with others in 2005-06.
Some OECD countries have seen their medical profession and health policy makers develop 'clinical guidelines' to promote a more rational use of MRI and CT exams. In the United Kingdom, since the creation of the Diagnostic Advisory Committee by the National Institute for Health and Clinical Excellence (NICE), a number of guidelines have been issued on the appropriate use of MRI and CT exams for different purposes
The reasoning behind capping litigation costs would be to 1. reduce the cost of malpractice insurance, and 2. reduce the number of diagnostic tests used (physicians attempt to cover their asses against malpractice suits by testing for everything even when it's not likely to have any significance).
Oddly enough, I had an orthopedic surgeon not recommend an MRI prior to arthroscopic surgery. The reason for the MRI, according to him, was to get an idea of what was going on to make it easier for him to find the problem. He didn't recommend it because, according to him, when he performs an arthroscope, he "looks at everything" when he gets in, so the MRI is unnecessary.
quote:
I do not, however, believe that we can justify "do nothing" on the basis of existing corporatism since that's simply systemic to everything. Were that the case why not simply just agree to do nothing unto the end of eternity?
Few people want to actually "do nothing" about the issue. But, simply doing something, anything, for the sake of not doing nothing, can make things worse. With the Corporatism we have, what Congress is motivated to do, will make things worse.
In reply:
*the current 'conservative' position is that if jobs can be sacrificed for a profit, if earnings remain off shore in tax avoidance, then surely if you are not a profit...you can just go ahead and die. The 'market' doesn't 'fix' anything, it exists for a profit or it doesn't exist.
*You are correct, we do not have a free market and in far more markets than health care and banking. Those in control and benefiting from it, will not allow true free markets to come back. As I am sure you know, there are 1000's of suppliers and competition that is bought up or run out of business, every year.
*Tort reform will be necessary (even though only 2% of the total health care market but in all western examples of this there is also a huge tax on incomes over $200,000 which can vary from country to country.
< Message edited by MrRodgers -- 3/4/2013 3:08:17 AM >
|
RE: Single Payer for Dummies - 
Profile
New Messages
No New Messages
Hot Topic w/ New Messages
Hot Topic w/o New Messages
Locked w/ New Messages
Locked w/o New Messages
Post New Thread