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Politics : PRESIDENT GEORGE W. BUSH -- Ignore unavailable to you. Want to Upgrade?

To: AK2004 who wrote (529843)	1/26/2004 1:45:14 PM
From: Neocon	Read Replies (1) \| Respond to of 769670

I am sure there is a downside to the Canadian practice, although I suppose it would be better interpreted as failure to adequately amortize the R&D costs, so I see no point in arguing when we have similar worries. I was suggesting looking primarily at the efficacy of medical intervention, mortality was just one piece of evidence, but it is true that general healthiness can affect the severity of illness or recuperative power. I still think that there are pretty clear gains through technology, drugs, and surgical advances. PPOs certainly allow for some choice, and even some HMOs have some flexibility, but sure, one trades complete autonomy for the overall terms of coverage. I am not sure what "best available care" is supposed to mean. When my wife changed her doctors to those closer to work, she was suddenly treated by downtown practitioners attached to George Washington University. Although we lived in an affluent town (at the time, Annapolis, MD), and her doctors had gone to good schools, the quality of care noticeably improved, because the practice was not as routine, and she had some unusual problems. She was, in one sense, getting "best available care" within one context, but not absolutely. And if her problems had been more routine, there would likely have been no deficiency, she just needed someone who could deal with something uncommon. I am happy to see that we agree that the problem is not primarily the insurance companies, but I am still not quite clear on what you think the problem is. In the last twenty years, I have seen pediatricians' offices organized to cut costs, for example, through the utilization of nurse practitioners for routine matters, and other expedients. I have seen more procedures moved to outpatient care, to conserve hospital costs. I have seen a move towards the sale of generics, to control costs. In general, it seems to me that some kind of pressure has been put on the medical industry to restrain costs, even while the use of MRIs and CATSCANS, among other things, have raised certain costs.........