Controlling rising health care costs

[Fishteacher73]

We have consistantly seen the wonders of de-regulation. From the air-line industry to the power providers there have been great results from letting the "free-market" police the industry. In something that involves the irational decision making of a crittical patient or a distressed spouse, there will be very little careful planned though outside of save them/me.

[Biochemist]

Originally Posted by Fishteacher73

We have consistantly seen the wonders of de-regulation. From the air-line industry to the power providers there have been great results from letting the "free-market" police the industry. In something that involves the irational decision making of a crittical patient or a distressed spouse, there will be very little careful planned though outside of save them/me.

Sure, but most health care decisions are not made on a critical timetable. Even most major surgeries (coronary artery bypass (CABG) grafts, stents, total hips, total knees, ) are planned significantly in advance. The surgeons could be compared on outcomes and price.

Further, for those instances where patients do not have time to price in advance (like urgent cardiac bypass grafts) those patients would still get the package price, because SOME patients shop in advance. BMWs are priced to compete with Volvos and Saabs, whether or not the buyers are actually comparing to those vehicles. And selecting a CABG surgeon is LESS complicated than comparing a BMW to a Volvo.

...And this does not require any deregulation. All it requires is for consumers to demand it. And they will only demand it if they are paying for it, or at least part of it.

[bumab]

Originally Posted by Biochemist

I was certainly NOT suggesting any govenrmental controllled system.

Sorry, I wrote that and missed your previous post addressing that subject.

Originally Posted by Biochemist

It works now reasonably well for the services that are already consumer oriented. Corrective eye surgery is usually not covered by insurance. As a result, surgeons bundle the package of services into a fixed price and consumers select between competing providers based on experince and outcomes. The real-dollar cost of eye surgery has fallen over the last 10 years. What a surprise. This model could apply to over half of all US healthcare utilization.

True, but that's a relativally minor, one-time deal where people know what they are getting and they have a perfectly viable alternative- not having the surgury. It's not that industry that's the problem, it's non-elective medication (pain meds, cancer meds, etc.) where there is no alternative. Calm, reasoned decisions are less likely in that case, and the companies can charge what they will, because no alternative exists.

Originally Posted by Biochemist

But for competiton to work, consumers have to know 1) what they are buying and 2) what is costs. Then they could compare. The government could not officiate this.

Is that possible? The current TV ads for pharmacuticals shows how deceptive the companies can be. While I agree competition in theory could control prices, I'm a little curious how you think the companies could be made to fully explain what they are selling and getting the consumer to fully understand what they are buying.

[bumab]

Originally Posted by Biochemist

...And this deos not require any deregulation. All it requires is for consumers to demand it. And they will only demand it if they are paying for it, or at least part of it.

This is a great point, although as someone who must pay for their own insurance (and it's pricey), I'm still strugglin'

[Fishteacher73]

The "kits" used for a particular surgery are the same. Pre-packaged and sterilized. The specific cost of a kit is dependent upon the supplier. Most of these have reasonably stable prices and give larger buyers price breaks. This discount does not seem to trickle down though. Pehaps standardization of procedural costs w/ variances added in or subtracted due to doctor performance.

Socialized medicine has been demonstrated as quite effective in other countries and I just do not understand the fear of moving to such a system in the states.

[bumab]

Originally Posted by Fishteacher73

Socialized medicine has been demonstrated as quite effective in other countries and I just do not understand the fear of moving to such a system in the states.

Me either, although the message that "it's lower quality, thus you will all suffer" has been drummed into the collective conciousness pretty hard.

[Biochemist]

Originally Posted by bumab

True, but that's a relativally minor, one-time deal where people know what they are getting and they have a perfectly viable alternative- not having the surgury.

Now we are getting somewhere. Do you have a choice not to have a car? You still shop for them, and they are reasonably complicated products.,

it's non-elective medication (pain meds, cancer meds, etc.) where there is no alternative.

This is getting better. Let me suggest a novel notion. Health consumers are looking for one of two things: a diagnosis and/or a treatment. They do NOT buy a drug. They hope it is a treatment. If a physician gave you a fixed price for a treatment, the treatments would get a)better and b) less expensive. Right now, most of the delivery system is not organized to do this. But they could be, and it would NOT require any regulation. It requires consumers to act like it matters.

Is that possible? The current TV ads for pharmacuticals shows how deceptive the companies can be.

That is because the current state of the market is for consumers to assemble their own care. It would be like asking you to select the correct brake line or fuel injection for your car. That is not what you should be buying. You are buying a car.

[Fishteacher73]

I do not know where the " lower quality" issue has come from. I lived in Sweden with a host family whose father was a doctor. He was exceptionally trained and able in his job. He spoke across Europe as well as the states about his specialty (Laser skin therapy).

I know there are certain problems with socialized medicine but they are minor in comparison to the quagmire now here in the states.

[Biochemist]

Originally Posted by Fishteacher73

I do not know where the " lower quality" issue has come from. I lived in Sweden with a host family whose father was a doctor. He was exceptionally trained and able in his job. He spoke across Europe as well as the states about his specialty (Laser skin therapy).

I know there are certain problems with socialized medicine but they are minor in comparison to the quagmire now here in the states.

The healthcare cost growth rate in all western countries is about the same. The US has some unique problems in it, but the cost control problem is ubiquitous.

[bumab]

Originally Posted by Biochemist

Now we are getting somewhere. Do you have a choice not to have a car? You still shop for them, and they are reasonably complicated products.

I do have a choice- I don't have a car I ride a bike.

Originally Posted by Biochemist

Let me suggest a novel notion. Health consumers are looking for one of two things: a diagnosis and/or a treatment. They do NOT buy a drug. They hope it is a treatment. If a phycisian gave you a fixed price for a treatment, they would get a)better and b) less expensive.

It is a novel notion, and a good one. What about the cost of devloping new treatments? Also, treatments are often incorrect at the time, and must be refined. If the doctor always knew exactly what was wrong, this system would be great. It would be like ordering parts for a bike- it's not shifting, get a new derailuer. But it's not that simple, and doctors would not want to pin themselves down with an "estimate" since they can, and often are, wrong at first.

Originally Posted by Biochemist

That is becasue the current state of the market is for consumers to assemble their own care. It would be like asking you to select the correct brake line or fuel injection for your car. That is not what you should be buying. You are buying a car.

Good analogy, however you could arrive at the same point with universal health care. I know you are argueing for efficiency, which is another matter, but the argument that people should be buying treatments, not individual pieces of care, is an argument from the socialized medicine standpoint as well. One monthly fee, you get anything you need.