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

To: i-node who wrote (12709)	12/24/2009 6:43:45 PM
From: Lane3	2 Recommendations Read Replies (1) \| Respond to of 42652

When an attorney renders his opinion as to whether you should settle or move forward with litigation, it is the same principle. That's apples and oranges. It's true that doctors and lawyers are both professionals and are in an excellent position to advise you whether you would benefit from what they have to offer. But in your example of the lawyer or the CPA, they are advising a client who will pay for the service. The client wears two hats. One is whether he thinks he will benefit from the procedure and the other is whether he's willing to pay the professional's price to get it. Maybe he'd rather take a vacation in Maui or leave the money to his kids. He takes the professionals' advice and makes his decision. In the case of the doctor, the client isn't usually the payer. So there's nobody in the room who can assess whether this procedure is worth more than a vacation in Maui or a procedure for a different patient covered by the same pot of money or maybe a different procedure from a different provider or maybe just eating more fruit. Thus you have apples and oranges. I'm really just saying the government is the last entity on earth I want to see making these decisions. Indeed, which is one reason I'm so against government health "insurance." But the fact is, and we've discussed this on the thread before, the payer has to be a key player in this. The insurance company, private or public, will decide where to get the best bang for the buck and try to keep costs down within reason. In the doctor/patient relationship, cost is not a consideration because neither the doctor nor the patient is paying. From the patient's perspective it's whether he will benefit, even marginally. From the doctor's perspective it's whether the patient will benefit, even marginally, whether he can find a code for it, and whether he'll make a profit. So if the patient gets a marginal benefit, the doctor makes a profit, and the procedure is "covered," the doctor and patient decide to proceed. It doesn't matter to them if it costs a million dollars. If the patient were paying, he might find it worth only a thousand dollars. That he's a thousand dollars better off and the insurance company pays a million dollars is of no consequence to him. Now, none of that matters if you don't care about the country's health costs or if you don't pay taxes. I know you understand this. You're letting your animus toward the government decision makers get in the way. You know that the conservative solution to cost escalation is to make the patient the payer via HSAs and catastrophic insurance. You know that the experts want to move away from fee for service as a way to save money. Even with insurance company rationing, fee for service is a cost escalator because there is no incentive on the part of doctors or patients to control costs. Statins and stents for everyone courtesy of big pharma and the cath lab factory. Yet you ignore all that and instead promote doctors making the decisions? Who are you and what have you done with i-node?