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

To: Lane3 who wrote (24628)	9/1/2012 12:18:01 PM
From: skinowski	2 Recommendations Read Replies (1) \| Respond to of 42652

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. RVU is like a currency. Each RVU has exact monetary value. When you "determine how many units are in the service" you are effectively determining the price of the service in dollars. In other words, you are fixing prices. I'm just an old doc and I don't know all the answers. But I've lived and worked within the system for decades. Some years ago, I remember being shocked at how many RVU's Medicare assigned for cardiac catheterizations. An internist or a family doc would have to put in a long day in the office and the hospital in order to earn the same number of RVU's. I recall thinking that many surgeries were compensated higher than what a primary care doc could gross in a week. This keeps changing, usually to the lower side, but I submit that both the original pricing - and the later changes - were pulled out of the hat by committees. Why should government price fixing work better in healthcare than it would in any other industry? It doesn't. That is why our healthcare is the product of an ongoing process of accommodations, needed in order to survive arbitrary government pricing decisions. It looks to me that a two tier system may be the best answer. Maybe the only answer, really. We clearly need a taxpayer supported safety net for poor people and for those who cannot help themselves. Those of us who are capable of taking care of ourselves would be served far better if market forces would have a chance to play a role. In the process, the poor would also benefit from improving general attitudes and standards.