We should let doctors be physicians and not the insurance company. Procedure oriented billing is just to enticing. Let the doctor decide with the patient and remove the economic motivation for procedures. Let one doctor practice one way and another doctor practice another way. There is no one right way, and such beliefs have created public health disasters. As long as a doctor's practice is within the realm of "medicine". Get off procedure based billing and you may not need "managed care" or cost benefit analysis like Kaiser. I truly believe if you just let doctors do what they are trained to do, with no incentives or interferences, everyone would be better off for less money too. But, that's just me. Yes to single payer and all Americans are members, even Congress. No opting out. But, allow private medicine. However, I would not allow health care establishments who deal in private care to also deal in single payer care. Then it is like the office with a PPO line and an HMO line. Guess which one they give priority. Unlike <beware> I would not forbid private medicine under a single payer program. You like ? Moi M.D. ret.
So what you're suggesting is that we should turn into a single payer system and salary all of our doctors? Allowing doctors to "practice the way they want" is not going to change anything. Just look at the behavior of salaried physicians, who aren't paid by the procedure. Do they do less procedures? Not really. They will continue to follow the "standard of care" whatever that is. The problem in the US, isn't that we do too many procedures. There are a few procedures that we do a lot of , but for the most part, we do about the same as other industrialized nations. The problem is that we pay too much for each procedure. And I'm not talking about physician reimbursement, which is a small piece of the pie. I'm talking about reimbursement to hospitals and device manufacturers. Why does it cost twice as much to perform a surgery in the US, when the same surgery can be performed in Canada or Britain for a fraction of the price? The only way to decrease healthcare costs is by limiting reimbursement for procedures. And the only way to do this is by some sort of single payer system that sets the standards for reimbursements. And that's what is starting to happen.
"The only way to decrease healthcare costs is by limiting reimbursement for procedures." I cannot reference but, I would bet a greater percent of the Health Care Dollar is going to administration and profit and less is going to the health care provider, hospital, physician, support staff - then decades ago. Also New Procedures are terribly over priced. I bet a twenty dollar chest x-ray would be hundreds, if not thousands of dollars if invented today. Moi
i wouldn't say that. there are many examples of highly effective government programs and regulations. the problem is--many of them have been eroded by a party that doesn't believe in government. and when you don't believe in government, and you are in charge of running the government, guess what happens? It would be like hiring a CEO who despises his own company. And when he does a poor job running the company (probably because he despises it), he then uses that as evidence that the company is worthless, and despises it even more. Is that who you want running your company?
exactly correct. that's why we need to limit reimbursements--not to physicians, but to administrators, device manufacturers, drug companies, etc. We need to limit reimbursements for new procedures that dont have established efficacy. it's actually interesting--when you look at the various forms of healthcare insurance, guess who has been able to control costs the best? http://graphics8.nytimes.com/images/2013/09/21/opinion/092113krugman2/092113krugman2-blog480.png Medicaid. Medicaid is able to control costs, basically by controlling reimbursements. And it works.
The problem is that they've had enough of an influence on the government to effectively handcuff it. Republicans are like the cancer in the government--every time you try to do something useful, they block you and water down your bills so they are completely ineffective. And then they blame the government for being ineffective! It's a self-fulfilling prophecy.
The GOP continues to collapse like a house of fake voter ID cards in a hurricane under the auspices of the Bush's FEMA. The uncivil war that has Rafe and the Cruisers ranting about Nazis and being smacked down by Punk McCain is consuming the Party like Ebola with a binge-eating disorder. Can't we all just get along?
Partisan Democrats may be enjoying the spectacle of Repubs savaging one another, but their lack of coherence does not serve the nation. This sort of internecine carnage occasioned by Turdblossom's War Against the TPs is becoming a banquet for the Donner Party of Lincoln. Save room for desert.
One comical aspect it that the Party that has an extensive rap sheet of being openly hostile to government and hellbent on sabotaging its operation, now actually tries to blame the Party that attempts to make it work for shutting it down. Teddy and the Cruisers are now in the NRC's crosshairs in Turdblossom's War with the TPs.
