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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: i-node who wrote (7607)	7/17/2009 4:36:00 PM
From: Lane3	1 Recommendation Read Replies (1) \| Respond to of 42652

The idea you're going to make the physician responsible for the patient's total health is just silly. Yes, silly. Risible, even. OB/GYNs who see patients for prenatal visits can charge just a single fee that includes the delivery plus 5 or 6 prenatal visits. That probably works pretty well in that constrained scenario. But more broadly it's unimaginable. A sufficient network would have to be huge. No more individual or small group practices. Also, this network would have to have a set of coverage rules just like an insurance plan or an HMO so you'd know what you are going to get. It would have to specify how often you get certain tests, for example, just like Medicare does. Otherwise it's in the practice's interest to do fewer because any money saved is profit. Conversely, the network would need protection from patients demanding more frequent tests. I don't know what these folks are thinking. Sure, fee for service can be wasteful. But you have to think through the implications of proposed solutions with just as critical an eye as that applied to the problem you're trying to solve. I don't see how the net long-term result of this proposal could be anything other than a few Kaiser-like entities comprising the entire market. I so despair over the dominance of magical thinking. I use the term, "thinking," loosely.