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

To: skinowski who wrote (24627)	9/1/2012 11:16:03 AM
From: Lane3	Read Replies (1) \| Respond to of 42652

You agree that market prices would no longer work since we are too far away from them by now. So, whatcha gonna do instead? You set up some unit that represents the salient value you're trying to compensate. Then you determine how many units are in the service you're compensating. We do that all the time to measure relative value. For example, there are people who analyze whether various jobs are compensated fairly. You see in the news every once in a while the observation that teachers are underpaid or that athletes are overpaid. That judgement is based on looking at the underlying units of value in an objective way. In the real world there are market forces and biases that affect what the actual compensation levels are for various occupations. Compensation is never totally fair. But you can evaluate how much of that compensation amount is objective and how much is something else. Within an organization jobs are compensated base on units of value. In the Army, for example, you'll find jobs classified as a specialist 4 or specialist 5 or whatever they call them because specialist 5 work calls for more units of value. Back to RVU's. If you look at how much to compensate for lancing a boil vs delivering a baby and you no longer have usual and customary fees as your foundation, you assign weights to each in terms of the number of units required to do the job, skill level, time consumed, risk, or whatever those units might be, and you come up with a dollar amount. That result may be skewed somewhat by bias but it's a lot less biased than coming up with dollar amounts from whole cloth. The fewer opportunities in the process that exist for introducing bias, the less bias affects the bottom line. It would be nice if compensation were still rooted in historical market prices but that is not longer feasible. So it's better than compensation was rooted in something that at least was intended to represent actual worth. It may be that the underlying factors in the RVU model are off or that their weighting isn't in the right proportion or that that particular procedures are not well understood so the units assigned are wrong. The model may have flaws, but is it better to have no model and make compensation solely a matter of pulling numbers out of a hat or which constituency exerts the most influence? Seems to me that the RVU approach lessens what would otherwise be an arbitrary call.