Silicon Investor (SI) -- The First Internet Community

STOCKTALK

We've detected that you're using an ad content blocking browser plug-in or feature. Ads provide a critical source of revenue to the continued operation of Silicon Investor. We ask that you disable ad blocking while on Silicon Investor in the best interests of our community. If you are not using an ad blocker but are still receiving this message, make sure your browser's tracking protection is set to the 'standard' level.

Technology Stocks : Full Disclosure Trading -- Ignore unavailable to you. Want to Upgrade?

To: Sam Citron who wrote (577)	5/9/2002 2:42:14 PM
From: Jacob Snyder	Read Replies (2) \| Respond to of 13403

OT: productivity in healthcare: <<Productivity in the overall economy tends to soar during recessions as companies cut costs and lay off workers. If your point is that healthcare has been insulated from this general trend, I can see what you mean.>> No, that's not what I mean. I mean that prices for most goods and services in healthcare, are monopoly prices, because decison-making is not made by informed consumers. Rather, decisions are made by uninformed consumers, or by the producers (rather than consumers) of the healthcare. Such a pricing system leads to steadily increasing inefficiency. There is the well-documented phenomenon: when a new specialist moves into a community, that does not tend to decrease the price for the work done by that doctor. Rather, the total work done by all the doctors in that specialty increases, to match the increased supply. For instance, if you have an isolated rural community with one general surgeon, you will have X number of gall bladder surgeries done per year. If a second general surgeon moves into the area, then 2X gall bladder surgeries will be done (while the price of the surgery, and the income of each surgeon, will not go down). This is robust data, demonstrable for many specialties in many communities. In medical school, I was told that 90% of my diagnostic accuracy was due to my history-taking and physical exam, and only 10% due to all everything else. I have found that to be true, in practice. Yet, the "everything else" done by doctors, increases every year, seemingly without end. Every year, there are more imaging studies available in more places, more blood tests we can do. Further, the imbalance between specialists and primary care doctors, (far too many specialists) means that decisions get made by a committee of specialists (each of whom charges more than the generalist), whereas in previous years the decision would be made by a single generalist. IMO, this has improved diagnostic accuracy, but at a rate nowhere near the rate at which costs are increasing. The diminishing returns seen in diagnosing, is also seen in treatment. Example: If a patient has a heart attack (and survives), they leave the hospital with a bagfull of pills they are supposed to take every day. Every year, the number of pills given for that and many other conditions, increases. Yet, the overwhelmingly important variables, in determining whether a patient gets another heart attack, is due to lifestyle: not smoking, eating well and exercising regularly, is far more important than all the pills. Every year, we give more and more pills, (while trying to change a patient's lifestyle is the least well rewarded activity for a doctor to do, and the least respected by peers). Everywhere I look in healthcare, I see diminishing returns, monopoly pricing, and an increasing reliance on the most expensive method to solve any problem.