1. The whole system needs overhaul. Doctors are being paid on a piecework basis (eg a fee for service) is one example. Doctors are human. They have their biases and other very understandable problems.
There are so many problems with this remark one hardly knows where to start. One could write volumes on it. I don't know how one breaks out the cost of doctor's biases vs. defensive medicine. But there is scant credible evidence that outcome-based medicine, LONG TERM, is going to reduce costs. One has to consider what it will do to the supply of physicians and 100 other factors, effects which could be substantial.
2. There are huge savings from modernizing computer systems reducing costly errors, redundancies, and inefficiencies.
Liberal talking points. Nothing more. The Obama government is paying 10s of thousands of dollars for physicians to move to EMR in their practices -- and as a guy who installs and supports those systems, I'm a beneficiary. But there is just no evidence that it really will save money after you consider the cost of installing and maintaining those systems.
A typical physician's office will spend from 20K to 50K on the system, then incur ongoing maintenance costs of 20% that amount annually, forever. In addition, they commonly have to have additional personnel to utilize the system.
The reason the government is having to spend this money is that physicians have, for the most part, not seen the ROI from these systems. One day, 20 years from now, things may be different, but that is far too long-term to make credible projections about.
There are probably thousands of other things that can be done to reduce costs and improve health care.
This is the bottom line. We can all see things that can be done. The waste & inefficiency in Medicare is staggering. But you can't make specific points about where money can be saved, and frankly, neither has anyone else. Even when you identify savings, getting the legislation in place to make the changes is an uphill battle.
we know pretty much what is wrong with our system and why it cost so much
This is a most bizarre comment. You (and the Ds) failed to mention the most easily identifiable waste (defensive medicine).
Are you prepared to eliminate non-emergency medical transportation services? These costs have among the highest rates of growth, and are rife with fraud (one state conducted an analysis and found over 50% of transactions were improperly documented or lacked documentation AT ALL). I've not heard it mentioned ONE TIME during this debate. Good luck getting THAT legislation through Congress.
The truth is there are no specifics. This is ALL about a goal of single payer and it has nothing, whatsoever, to do with controlling costs. As is evidenced by the numbers associated with every one of these proposals. |
