The Glade 4.0

This link is a decent explanation of medical insurance payments from a docs point of view.

http://www.associatedcontent.com/article/2422852/10_things_your_insurance_company_wont.html?cat=3

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Memento Vivere

I have local knowledge.
That sandbar was not there yesterday!

I can imagine how frustrating it is for doctors. Socialized will be even worse I'd imagine if you go by the Medicare model. I'm going to piggyback this video on here too since it talks about a good model for medical procedures not covered by insurance: Lasik surgery

[youtube]3E29LD98ruo[/youtube]

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“Strong people are harder to kill than weak people, and more useful in general”. - Mark Rippetoe

Dash,

That is a great link you have.

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Memento Vivere

I have local knowledge.
That sandbar was not there yesterday!

In the US you can't "shop for price" when it comes to medical care even if we manage to remove the moral hazard involved with it. Why? Malpractice cases. If there's even the slightest risk of a serious problem the doctor MUST order a legion of super-expensive tests to cover his own ***. If he doesn't, and you are the <1% that has the serious illness, you can sue him for millions. You are not allowed to make an agreement with the doctor that you'll accept treatment for the "most likely" diagnosis and accept the risk. If you refuse to pay for (or have insurance pay for) the $5000 MRI, he's not going to diagnose you, and he's not going to prescribe anything for you.

You can't price-shop because you aren't the customer. You're just the consumer.

That's why.

Malpractice is an issue, but not the primary.

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

What your talking about there is torte reform to reduce some of the pressure currently on doctors, which is certainly something I'd like to see done too.

That said, however you look at it prices would be driven down when people have more choices and need to consider the costs involved personally rather than have a 3rd party pay.

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“Strong people are harder to kill than weak people, and more useful in general”. - Mark Rippetoe

Tort reform in Texas significantly helped. The cost of malpractice insurance dropped to 1/3 of what it had been before. The cost before was so high that it was more than a doctor in some specialties could make in a year. There were large areas of the state which had no neurosurgeons, for instance.

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Memento Vivere

I have local knowledge.
That sandbar was not there yesterday!

Especially when one considers that it's a 3rd party that they rarely even choose. When your employer subsidizes your insurance vendor, competitors can't even, well, compete.

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"Aaaah! Emotions are weird!" - Amdee
"... Mirrorshades prevent the forces of normalcy from realizing that one is crazed and possibly dangerous. They are the symbol of the sun-staring visionary, the biker, the rocker, the policeman, and similar outlaws." - Bruce Sterling, preface to Mirrorshades

Doesn't the Lasik example discussed in Dash' video prove that it would work? Why is malpractice not an issue there?

Lack of regulation. It's preposterously hard to prove fault, as I understand it, and there aren't special rules that basically presume guilt and make the doctor prove he *didn't* commit malpractice.

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"Aaaah! Emotions are weird!" - Amdee
"... Mirrorshades prevent the forces of normalcy from realizing that one is crazed and possibly dangerous. They are the symbol of the sun-staring visionary, the biker, the rocker, the policeman, and similar outlaws." - Bruce Sterling, preface to Mirrorshades

First off, civil malpractice cases don't have a high burden of proof like criminal cases. Also you've got the problem that a jury of "common men" is always going to be heavily biased towards the suffering plaintiff (who is probably dealing with a lot of pain from a medical problem, even if it's not the doctor's fault) and against the super-rich doctor who we all "know" can easily spare the money.

Second, LASIK isn't a "required" treatment for anyone to preserve their life or health. That means it's up to you who you do the surgery on, and you can pre-screen patients. If you get a bad feeling, you don't have to risk it. For "typical" medical care, you can't do that. You have to treat them when they walk in, you have no choice.

There's a reason the most popular/lucrative medical field is dermatology and the least popular is obstetrics. Nobody wants to **** deliver babies anymore, if there's a birth defect or complications they're all coming after your money, and there's a good chance they'll get it even if you didn't do anything wrong.

Yes, because dermatology as a field keeps the number of residencies prohibitively small to protect their income.

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

Civil Malpractice suits are barely a drop in the bucket of our overall medical cost issues. Tort reform is largely a means of turning consequences for horrible crap into just another cost of doing business. Yes, doctors pay huge insurance premiums for malpractice insurance companies. But that doesn't mean tort reform would do anything to really help the overall medical cost issue we have in this country.

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It feels like all the people who want limited government really just want government limited to Republicans.
---The Daily Show

Monte, I notice you are missing some links to back up your assertions.

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Back this up, please. You make some pretty solid statements here. My understanding is different, so if I'm wrong I'd like to know.

"Cost of doing business" is exactly what malpractice is now. What do you think a doctor does after he loses a malpractice suit? His insurance pays for it, and he goes right back to practicing. The problem is doctors don't lose their licenses unless they did something truly horrible. A doctor that hurts someone should lose their license or go to prison, the suing for millions is ridiculous and just **** up everyone elses medical care.

Maybe if civil trials for malpractice carried the same demand that criminal trials do.

Way too often a jury sides with the "hurt" person against the "rich" doctor.

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

This is actually mostly correct, directly.


Where the cost comes from is defensive medicine. The lawsuits themselves aren't a huge proportion of healthcare spending. Insurance is, but still nothing compared to some of the wasteful spending on, say, a X-ray prior to a CT for some particular diagnosis. Just jump to the CT.

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

DFK!, I notice you are missing some links to back up your assertions.

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Nothing I can access is likely to be accessible by you without personal expenditure.

What would you have me do? I'd be happy to cite sources beyond my own knowledge and experience. I just don't think you'll be able to access them unless you have access to some sort of journal database as I do.

I'll be happy to help meet your sourcing needs, with feedback on how to best do it.



Also, much as the huge malpractice costs are in large part a myth of the right, uncompensated care is a myth of the left. Uncompensated care, IIRC, is about 2-2.4% of overall health services expenditures in the US. That's less than retail chains lose to theft.

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

Here are some publicly viewable sources, but not researched and peer-reviewed, which is what I would get for you otherwise:







I have other state-specific sources if you'd like.

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

Thank you. I find this to be sufficient corroboration to your claim for my purposes. I appreciate the effort you have undergone to assist in establishing the veracity of your position.

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No problem. Always happy to source when requested, and possible.

Really, the biggest cause for healthcare inflation, IMO, is technology.

Increasing technology equals increasing costs, unlike in many other fields.

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“The duty of a patriot is to protect his country from its government.” - Thomas Paine

I feel like I am in Zork.

Verbose off.

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"...but there exists also in the human heart a depraved taste for equality, which impels the weak to attempt to lower the powerful to their own level and reduces men to prefer equality in slavery to inequality with freedom." - De Tocqueville

Define "hurts someone". People are people and make mistakes. Not only that, but learning from mistakes is one of the main things that makes people better at what they do. No one is going to want to go into medicine if perfection is the standard and a mistake lands you in prison or jobless with huge student loans to repay.

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"Hysterical children shrieking about right-wing anything need to go sit in the corner and be quiet while the adults are talking."