Like Japan, reward doctors when they _cure_ patients.
I don't like this because they may unknowingly introduce a biased form of triage.
Don’t let the providing doctor triage.
They should be providing care anyways.
Nurses triage.
We Need to Design Health Care Reform That Puts Patients Before Profits
201–206 of 206 posts
Re: We Need to Design Health Care Reform That Puts Patients Before Profits
#202Earlier quoted context omitted.
> The public rhetoric frustrates me as someone who favors universal healthcare. Demonizing corporations and rich people is red meat for partisans, but it’s not a solution. How do we pay for this system? How do we cut costs? There are already two pieces of legislation, the Jayapal and Sanders bills, they account for their costs. Tim Faust’s new book likewise walks through all of these concerns in detail: https://www.m…
You're using "account for their costs" in a different sense than I think Rayiner meant. When Sanders "accounts for his costs", he means that they've added up the total projected costs of their plan and then accounted for it with tax revenue. That's fine, but it doesn't address the fundamental problem of US health care costs, which is --- regardless of "who pays" --- "why does it cost so fucking much". If all we do is…
"why does it cost so fucking much"
Isn't it because there are so many people's salaries and companies products/services involved with the "unnecessary" overhead? The last ten times I went to the doctors office/clinic there were 3 to 5 check-in receptionists all sitting behind nice new desks and computers with no one in line. How many people at the clinic are just trying to figure out insurance coverages and costs, and how many people at the insurance company review what's submitted, and how may people's job exists to "fight" the charges? Sadly, too many people rely on and depend upon expensive health care for putting food on their table. Until we come up with a plan (free training/education in other industries, sectors, and areas of need/demand?) people will cling to what they know and their JOBS. Look at accounting and tax reform. The complicated-ness of it is by design according to those that lobbied for and those that implemented it.
Re: We Need to Design Health Care Reform That Puts Patients Before Profits
#203Earlier quoted context omitted.
You're using "account for their costs" in a different sense than I think Rayiner meant. When Sanders "accounts for his costs", he means that they've added up the total projected costs of their plan and then accounted for it with tax revenue. That's fine, but it doesn't address the fundamental problem of US health care costs, which is --- regardless of "who pays" --- "why does it cost so fucking much". If all we do is…
"why does it cost so fucking much" Isn't it because there are so many people's salaries and companies products/services involved with the "unnecessary" overhead? The last ten times I went to the doctors office/clinic there were 3 to 5 check-in receptionists all sitting behind nice new desks and computers with no one in line. How many people at the clinic are just trying to figure out insurance coverages and costs, an…
I don't want or need health insurance to cover routine health care/maintenance. My car insurance doesn't cover oil changes. I think we need to start with getting to affordable routine health CARE [checkups]. The fact that many family insurance plans cost $1000s a month in premiums and don't kick in until $10,000+ of deductible is spent first is ridiculous. People that have coverage still don't go to the doctor until they are very sick to avoid the high costs, this compounds things because the cost to deal with a minor respiratory issue is drastically less than when/if it turns into pneumonia.
Re: We Need to Design Health Care Reform That Puts Patients Before Profits
#204Earlier quoted context omitted.
I don't have an opinion about profit margins in the US health care system and am receptive to arguments that profits in the system are themselves exorbitant (it's Rayiner who consistently argues for perspective about comparative profits; ironically, Rayiner supports a national health plan, and I oppose it). My argument is orthogonal: it's that there is a payer side of the system and a provider side, and the national…
Sure, and that's one of the reasons I like Belk's site: he tries to explore more facets of the overall US health care clusterfuck than most other researchers and journalists. For the hospitals' portion of the mess, he finds that despite an overall decline in hospital stays [1], the amount that hospitals bill over what they actually collect has grown dramatically [2]. This in turn is caused by differences in incentive…
>although most US hospitals are non-profit business entities. (This doesn't mean they don't make money, of course.)
Where I used to live...
https://www.wpr.org/data-shows-la-crosses-gundersen-hospital...
I always cringed when I heard them asking for donations for capital improvements to build their new hospital wing.
Re: We Need to Design Health Care Reform That Puts Patients Before Profits
#205Earlier quoted context omitted.
And why do you think that is? Part C and D have privatized options because it offers gap coverage from Part A and B, so yes, privatized Part C and D would disappear if the gaps are closed.
At the point where you're saying we simply "close the gaps" in existing Medicare, you're really not talking about Medicare anymore; you're just using it as a synonym for a hypothetical US NHS. That's fine, but you should be up front about it if you do; you're not just expanding Medicare to new customers, but building a fundamentally new system and giving it the old Medicare name.
"Medicare for all" is redefining medicare. You can argue semantics that it's not the same as before but that is the point of the term, that it's a new and improved iteration.
Re: We Need to Design Health Care Reform That Puts Patients Before Profits
#206> We can and must design the next round of insurance reforms with patients as a priority. With low deductibles that actually facilitate the consumption of care, our health care system can directly benefit the well-being of low- and middle-income people—not just the holders of for-profit hospital stock. We have this already to an extent with managed care. The old system of fee for service incentivizes healthcare provi…
There are still plenty of abuses in managed care plans that I've seen (I'm closely related to several healthcare professionals working in home healthcare and in/outpatient service providers). For example, often times, healthcare professionals are encouraged/pressured to report improvements during the managed care plan at ambiguous levels (lie) to continue regimes to the allowable extent before they're discharged. Tho…
Most of the managed healthcare plans base the patient outcomes on a number of factors, and the doctors report is either not a factor at all or a small factor. If the patients are being readmitted multiple times that will outweigh what is misreported.
But more generally I agree that there will always be financial pressure weighing against ethical issues or patient outcomes. But a managed care plan is strictly better than fee for service in aligning patient outcomes and incentives for healthcare providers. And there is market pressure going the other way, patients can switch healthcare plans or switch providers if they have a better alternative with better outcomes.