Re: a sad day

From: Glenn Everhart (Everhart_at_gce.com)
Date: 06/11/05 

Date: Sat, 11 Jun 2005 14:08:52 -0400

Bill Todd wrote:

> JF Mezei wrote:
>
> ...
>
>> Where government runned systems differ greatly is that they do not
>> overspend on facilities/equipment. A city may have 3 hospitals, but it
>> may need only one MRI machine to handle the case loads that really need
>> MRI. Since the 3 hospitals work together instead of competing against
>> each other, they have no problems transfering patients from one to the
>> other since they don't see this as the loss of a profitable customer to
>> a competitor.
>
>
> Another area in which significant savings occur is in treatment of
> relatively indigent patients. In the U.S. system, such patients wind up
> in the emergency room in the late and expensive stages of whatever
> they're afflicted with and the paying customers wind up indirectly
> footing the bill, whereas in a system where *everyone* is covered for
> preventive or early-stage treatment such people walk in, get treatment
> which is usually far less expensive, and are on their way.
>
> It has been argued fairly credibly that everyone in the U.S. could be
> covered medically without spending an additional dime in total, or
> reducing the quality of treatment one iota, or reducing medical staff
> salaries. But only by cutting out the superfluous (but extremely
> influential) elements of the system which are not contributing one whit
> to the medical end of it.
>
> *Of course* people who are getting all the care they need under the
> current system don't see any need to change it. But more and more
> people are not getting that care, because anything resembling full
> coverage is far beyond their ability to pay.
>
> What are they, chopped liver?
>
> - bill
Elements like the insurance system
(as some of my MD friends argue) which turn the practice of medecine into
an exercise in paper pushing and second guessing? they argue that for
most non-catastrophic illnesses, ordinary folks are better off self insuring,
or would be IF the system didn't penalize cash customers so highly with vastly larger
bills. I gather that is where (per these sources) the bulk of insurance profits
come from..the ordinary stuff, not the catastrophic cases...and where most of
the interference with medical practice occurs.

Now, it is also true that there is not A medical system in the US; there are
myriads of local ones. I've been surprised by the differences in treatment
at different centers, only a dozen miles apart, for the same problems. Remarks
like "I didn't know anyone was still doing that...we haven't done those procedures
for decades" from a doctor at a teaching hospital give a flavor. The current
system does not alter this, but it may be that the primary care provider schemes
help keep it from being discovered by patients too often.

Could be there are a few key reforms (a RICO conviction of hospitals and HMOs
et alia to destroy the practice of charging cash customers so much more than
insurance pays might be a good start) that would help. But I am not holding
my breath.

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