Institute of Medicine: CBO estimate wrong, healthcare reform can save $250B a year after 10 years

[SammyJr]

Originally posted by: Genx87

Originally posted by: WhipperSnapper

Originally posted by: Genx87You still havent provided an example of free market healthcare in the world.

I agree with you that the U.S. is an awful example of true free market medicine. Might we properly point to many third world nations that have weak central governments as examples of true free market medicine? Would you agree with me that many African nations have free market medicine? That is to say, if you have the money for medical care, you can purchase it and the government plays no role at all in medical care, neither stealing people's money for it via taxes nor regulating doctors and insurance companies? Might Somalia be a good example?

Under your system of truly free market medicine, what would happen to someone with cancer who misread or misinterpreted his insurance contract prior to purchase, and whom, as the result of a coverage loophole that was buried in boilerplate language in 6 point font on page 209 of the insurance contract, had his insurance policy legally revoked after he was diagnosed with cancer as per the contract?

Should our society leave this person to die? Do we want to live in a society like that? Is it possible that you yourself are potentially that person?

Or, being a smart guy, would you pay a law firm $5000 to hash over your insurance contract first so that you could avoid those types of problems (which would probably also mean that your insurance would be more expensive)? (Since the consequences of missing something in the contract are dire, it seems logical that lawyers might want $5000 to do something like that; after all, they have malpractice premiums to pay.)

What if the lawyer or paralegal who read your contract was having a bad day and missed or misinterpreted the loophole language on page 209 in 6 point font? (Heh heh, the insurance company hired folks at Big Law Firm and paid them $1 million for that piece of text intending that it would fool the small practitioners.)

Would you then sue the lawyer for malpractice? You could do that, but would your cancer put itself on hold until the trial ends? (Since the government would no longer be regulating things under true capitalism, regulation would essentially move to the courts where people would file lawsuits, resulting in clogged up courts and long waiting times for justice.)

What happens if the lawyer didn't have malpractice insurance (under real capitalism no one would be required to have malpractice insurance nor to even be actual, bona-fide licensed lawyers in order to practice law) or if you do receive a favorable judgment but the lawyer's malpractice coverage is shitty and maxes out its coverage at $30,000 or the malpractice insurance company appeals or just plain doesn't have the money to pay for your cancer treatment (if you're still alive at that point, years after your initial diagnosis)?

I have a solution, maybe people could purchase secondary health insurance policies designed to fill in for any loopholes in the primary policies...but what about loopholes in the secondary policies...?

I suspect that the majority of people who say that they want real capitalism would discover that in reality, it isn't a John Galt's Atlantis, but rather, in actual practice, a third world nightmare that would send them screaming back to a mixed economy.

A. You would have to provide a little more information on which African nation represents free market healthcare. Many countries in Africa are anarchy. Others are so poor they simply cant afford anything better and it wouldnt matter if it was govt or privately run. Others live under a strong central govt that squashes economic and personal freedoms.

B. I am not making a case for free market healthcare in this thread. I am simply asking Jokus to provide me an example of a free market healthcare system on this planet that allows him to base his opinion it will lead to waste.

Isn't a free market economy essentially an anarchy? With no Government regulations or involvement, Somalia is as close to a free market as you're going to get!

 

[Genx87]

Originally posted by: SammyJr


Isn't a free market economy essentially an anarchy? With no Government regulations or involvement, Somalia is as close to a free market as you're going to get!

Absolutely not, that is as you pointed out, anarchy.

 

[brandonbull]

Originally posted by: Phokus

Originally posted by: Genx87
You still cant answer the question about where this free market healthcare system exists. No surprise at all.

I showed you an example where it failed, no surprise you chose to ignore that PLUS the economics of why free market healthcare ALWAYS fails.

Do i have to give you "babby's first economics lesson" as a birthday gift or something?

Get back to me when you decide to learn something about how markets work rather than spouting off GOP platitudes.

I've seem to have missed "free market" healthcare. More like "closed market" healthcare.

Did i misread or did the article say something about saving money by moving people away from government managed healthcare?

 

[alchemize]

Originally posted by: Phokus

Originally posted by: alchemize
Awesome! All we have to do is look to a successful system like the UK's to understand how much we can save with EMR's!
$20 Billion debacle

OR we could emulate what the VA did and increase quality AND decrease costs be implementing a similar IT system like their's (which runs circles around private care systems).

yeah it is pretty awesome, thanks for bringing it up.

LOWER COSTS, HIGHER QUALITY
Roemer seems to have stepped through the looking glass into an alternative universe, one where a nationwide health system that is run and financed by the federal government provides the best medical care in America. But it's true -- if you want to be sure of top-notch care, join the military. The 154 hospitals and 875 clinics run by the Veterans Affairs Dept. have been ranked best-in-class by a number of independent groups on a broad range of measures, from chronic care to heart disease treatment to percentage of members who receive flu shots. It offers all the same services, and sometimes more, than private sector providers.

According to a Rand Corp. study, the VA system provides two-thirds of the care recommended by such standards bodies as the Agency for Healthcare Research & Quality. Far from perfect, granted -- but the nation's private-sector hospitals provide only 50%. And while studies show that 3% to 8% of the nation's prescriptions are filled erroneously, the VA's prescription accuracy rate is greater than 99.997%, a level most hospitals only dream about. That's largely because the VA has by far the most advanced computerized medical-records system in the U.S. And for the past six years the VA has outranked private-sector hospitals on patient satisfaction in an annual consumer survey conducted by the National Quality Research Center at the University of Michigan. This keeps happening despite the fact that the VA spends an average of $5,000 per patient, vs. the national average of $6,300.

http://www.businessweek.com/ma...ent/06_29/b3993061.htm

Gee, you might have a valid point if single payer was being proposed. Because that's the premise what the VA system operates on.

Of course, any EMR system would have to be integrated into our current system, making it a complete clusterfuck and likely ending up even worse than the UK debacle. So I'm going to stick with the CBO estimates.

 

[Phokus]

Genx:

I provided you with a real world libertarian example of free market care that completely failed, you ignore it.

I provided you with the economics behind why free market medicine will always fail (screening, adverse selection, risk selection), you remain ignorant on the topic.

Here's one of the biggest reasons for our enormous medical inflation and not surprisingly the LACK of regulation/cheering of free market 'innovation' is why this happens:

Why do medical costs keep going up? Walk into the University of Maryland Medical Center for a heart bypass operation and you'll see one reason. Maryland is one of the few hospitals in the country to use a robot for heart surgery. Developed first by the military and then for commercial use by Intuitive Surgical (ISRG), the da Vinci robot is manipulated by a surgeon seated several feet away from the patient. The machine takes minimally invasive surgery to a new level, allowing the tiniest of incisions and enabling doctors to operate in extremely tight places. The robot is already a popular option for prostate surgery, and proponents praise its ability to trim patient recovery time by a third.

It does not, however, do the same for the hospital bill. A da Vinci robot costs $1.5 million, and every time it is used in the operating room, some $2,000 worth of parts must be replaced (for safety reasons). It takes a surgeon 12 to 18 months to learn how to use the machine, and a da Vinci operation usually takes longer than a hands-on procedure. Consequently, a University of Maryland study estimates that the robot adds about $8,000 to the price of bypass surgery.

Another study from Dartmouth Hitchcock Medical Center points out that it's tough for most hospitals to earn back the price of the machine, if it wasn't donated. On top of all that, "There is really no convincing evidence that the da Vinci is any better than standard surgery," says Paul Levy, president of Boston's Beth Israel Deaconess Medical Center (which does not have one). "Doctors and hospitals that have one are promoting it, and patients are demanding it," Levy says. Patients are usually unaware of the increased cost of the robot, since their insurance pays the bills. Also there's no competitive pressure to lower costs, as Intuitive Surgery is the only company that makes a surgical robot.

In OTHER countries, they do the cost/benefit analysis (the thing you conservatives bitch about when it comes to things like UK and cancer drugs) before allowing a treatment into their country. In *OUR* country, our FDA does not do such an analysis. THERE'S your medical waste thanks to market forces. Pure supply/demand.

You can scream 'show me proof of free market medicine in the world!!!', but if you actually think that these skewed incentives are in any way because of government meddling, you're the one who's dense.

 

[Phokus]

Originally posted by: alchemize
Gee, you might have a valid point if single payer was being proposed. Because that's the premise what the VA system operates on.

Of course, any EMR system would have to be integrated into our current system, making it a complete clusterfuck and likely ending up even worse than the UK debacle. So I'm going to stick with the CBO estimates.

UK's system isn't 'single payer' like Canada's is (public insurance/private delivery), it's closer to the VA's (public everything).

And as someone pointed above, One of the reasons why we don't have integration TODAY is vendor lock in (thanks free market!)

Even if the initial costs were 'extravagent', over time, it would definetely be worth it.

 

[brandonbull]

Originally posted by: Phokus
Genx:

I provided you with a real world libertarian example of free market care that completely failed, you ignore it.

I provided you with the economics behind why free market medicine will always fail (screening, adverse selection, risk selection), you remain ignorant on the topic.

Here's one of the biggest reasons for our enormous medical inflation and not surprisingly the LACK of regulation/cheering of free market 'innovation' is why this happens:

Why do medical costs keep going up? Walk into the University of Maryland Medical Center for a heart bypass operation and you'll see one reason. Maryland is one of the few hospitals in the country to use a robot for heart surgery. Developed first by the military and then for commercial use by Intuitive Surgical (ISRG), the da Vinci robot is manipulated by a surgeon seated several feet away from the patient. The machine takes minimally invasive surgery to a new level, allowing the tiniest of incisions and enabling doctors to operate in extremely tight places. The robot is already a popular option for prostate surgery, and proponents praise its ability to trim patient recovery time by a third.

It does not, however, do the same for the hospital bill. A da Vinci robot costs $1.5 million, and every time it is used in the operating room, some $2,000 worth of parts must be replaced (for safety reasons). It takes a surgeon 12 to 18 months to learn how to use the machine, and a da Vinci operation usually takes longer than a hands-on procedure. Consequently, a University of Maryland study estimates that the robot adds about $8,000 to the price of bypass surgery.

Another study from Dartmouth Hitchcock Medical Center points out that it's tough for most hospitals to earn back the price of the machine, if it wasn't donated. On top of all that, "There is really no convincing evidence that the da Vinci is any better than standard surgery," says Paul Levy, president of Boston's Beth Israel Deaconess Medical Center (which does not have one). "Doctors and hospitals that have one are promoting it, and patients are demanding it," Levy says. Patients are usually unaware of the increased cost of the robot, since their insurance pays the bills. Also there's no competitive pressure to lower costs, as Intuitive Surgery is the only company that makes a surgical robot.

In OTHER countries, they do the cost/benefit analysis (the thing you conservatives bitch about when it comes to things like UK and cancer drugs) before allowing a treatment into their country. In *OUR* country, our FDA does not do such an analysis. THERE'S your medical waste thanks to market forces. Pure supply/demand.
You can scream 'show me proof of free market medicine in the world!!!', but if you actually think that these skewed incentives are in any way because of government meddling, you're the one who's dense.

So that makes other countries' healthcare system superior than ours because they calculate the benefit of giving someone medical care?

 

[Phokus]

Originally posted by: brandonbull

Originally posted by: Phokus
Genx:

I provided you with a real world libertarian example of free market care that completely failed, you ignore it.

I provided you with the economics behind why free market medicine will always fail (screening, adverse selection, risk selection), you remain ignorant on the topic.

Here's one of the biggest reasons for our enormous medical inflation and not surprisingly the LACK of regulation/cheering of free market 'innovation' is why this happens:

Why do medical costs keep going up? Walk into the University of Maryland Medical Center for a heart bypass operation and you'll see one reason. Maryland is one of the few hospitals in the country to use a robot for heart surgery. Developed first by the military and then for commercial use by Intuitive Surgical (ISRG), the da Vinci robot is manipulated by a surgeon seated several feet away from the patient. The machine takes minimally invasive surgery to a new level, allowing the tiniest of incisions and enabling doctors to operate in extremely tight places. The robot is already a popular option for prostate surgery, and proponents praise its ability to trim patient recovery time by a third.

It does not, however, do the same for the hospital bill. A da Vinci robot costs $1.5 million, and every time it is used in the operating room, some $2,000 worth of parts must be replaced (for safety reasons). It takes a surgeon 12 to 18 months to learn how to use the machine, and a da Vinci operation usually takes longer than a hands-on procedure. Consequently, a University of Maryland study estimates that the robot adds about $8,000 to the price of bypass surgery.

Another study from Dartmouth Hitchcock Medical Center points out that it's tough for most hospitals to earn back the price of the machine, if it wasn't donated. On top of all that, "There is really no convincing evidence that the da Vinci is any better than standard surgery," says Paul Levy, president of Boston's Beth Israel Deaconess Medical Center (which does not have one). "Doctors and hospitals that have one are promoting it, and patients are demanding it," Levy says. Patients are usually unaware of the increased cost of the robot, since their insurance pays the bills. Also there's no competitive pressure to lower costs, as Intuitive Surgery is the only company that makes a surgical robot.

In OTHER countries, they do the cost/benefit analysis (the thing you conservatives bitch about when it comes to things like UK and cancer drugs) before allowing a treatment into their country. In *OUR* country, our FDA does not do such an analysis. THERE'S your medical waste thanks to market forces. Pure supply/demand.
You can scream 'show me proof of free market medicine in the world!!!', but if you actually think that these skewed incentives are in any way because of government meddling, you're the one who's dense.

So that makes other countries' healthcare system superior than ours because they calculate the benefit of giving someone medical care?

Part of it. In any healthcare system, whether fully free market, socialized, or in between, you will have to ration care somehow since healthcare is a limited good and the demand is quite high.

If you accept any and all 'innovations', you may have to give up healthcare in other areas.

For example, say there is a drug that prolongs a liver cancer patient's life for 6 months but costs $54k (this is a real drug and one that conservatives criticized the UK for not approving at first). But there's a hypothetical drug that cures breast cancer for $10k

Say you DON'T raise taxes or deficit spend in a socialist system (or raise premiums in a free market system), then if you extend the life of that 1 liver cancer patient for six months, then several people will die of breast cancer.

The reason countries do that is because they want the most Pareto efficient outcome. Whereas, in a free market system, every and all technique/drug gets approved without looking at the cost or benefit, you have a Pareto inefficient outcome.

Like i said 100 times before, there's good rationing and bad rationing. Conservatives scream about socialized health care rationing while never acknowledging rationing in free market care.

 

[alchemize]

Originally posted by: Phokus

Originally posted by: alchemize
Gee, you might have a valid point if single payer was being proposed. Because that's the premise what the VA system operates on.

Of course, any EMR system would have to be integrated into our current system, making it a complete clusterfuck and likely ending up even worse than the UK debacle. So I'm going to stick with the CBO estimates.

UK's system isn't 'single payer' like Canada's is (public insurance/private delivery), it's closer to the VA's (public everything).

And as someone pointed above, One of the reasons why we don't have integration TODAY is vendor lock in (thanks free market!)

Even if the initial costs were 'extravagent', over time, it would definetely be worth it.

So we have the following examples:

#1 EMR in the US (VA), very self-contained, very small population, single payer system, integrated healthcare for many years, no lobbyists, etc.: Pretty good
#2 EMR in the UK, whole population, single payer system: Complete disaster

You think #1 is the appropriate example that applies to our complex, multi-payer, public/private, heavily lobbied, fucked up, world's worst system, in a highly bloated government that 99 times out of 100 can't implement Windows on a desktop, much less a highly complicated IT system?

Pardon me for questioning your optimism.

 

[Phokus]

Originally posted by: alchemize

Originally posted by: Phokus

Originally posted by: alchemize
Gee, you might have a valid point if single payer was being proposed. Because that's the premise what the VA system operates on.

Of course, any EMR system would have to be integrated into our current system, making it a complete clusterfuck and likely ending up even worse than the UK debacle. So I'm going to stick with the CBO estimates.

UK's system isn't 'single payer' like Canada's is (public insurance/private delivery), it's closer to the VA's (public everything).

And as someone pointed above, One of the reasons why we don't have integration TODAY is vendor lock in (thanks free market!)

Even if the initial costs were 'extravagent', over time, it would definetely be worth it.

So we have the following examples:

#1 EMR in the US (VA), very self-contained, very small population, single payer system, integrated healthcare for many years, no lobbyists, etc.: Pretty good
#2 EMR in the UK, whole population, single payer system: Complete disaster

You think #1 is the appropriate example that applies to our complex, multi-payer, public/private, heavily lobbied, fucked up, world's worst system, in a highly bloated government that 99 times out of 100 can't implement Windows on a desktop, much less a highly complicated IT system?

Pardon me for questioning your optimism.

Yeah, it's not like other countries have successful COUNTRY WIDE health IT systems, oh wait:

Taiwan (whose administrative costs are lowest in the word at less than 2%):

http://www.smartcardalliance.o...ealth_Card_Profile.pdf

The total population of Taiwan is now 22.5 million, and 96% of Taiwan citizens joined the National
Health Insurance (NHI) program that was established 8 years ago. A total of 16,558 hospitals
and clinics (90% of the total) registered in the NHI program, creating a service network for insured
applicants nationwide. Taiwan had a strong IT foundation: the original paper-based health care
system included 92% of contracted medical institutions with a computerization rate of at least
70% and public satisfaction levels of 71%.
The NHI program recognized revenue from insurance premiums of US$8.3 billion in 2001. Total
health expenditure is 5.5% of Taiwan?s GDP.
Before the smart card was introduced, paper cards were used by the Bureau of National Health
Insurance (BNHI) to audit patient information, then reimburse service providers monthly. The
card is renewed after the patient uses medical services up to six times. Even though reporting
and information handling is well run and maintained, the system has certain problems, such as
identity fraud, excess false insurance premium claims from health care institutions, complex
program vouchers, waste of resources due to high frequency of card replacement, and high
losses due to discontinuity of insured applicants. To solve these problems, in April 2001 the
Bureau of National Health Insurance (BNHI) issued 22 million smart health care cards using Java
Card technology to Taiwanese citizens.


The smart card is a microcontroller-based card and has 32 kilobytes (KB) of memory, of which 22
KB will be used for four kinds of information:
? Personal information, including the card serial number, date of issue and cardholder?s name,
gender, date of birth, ID number, and picture.
? NHI-related information, including cardholder status, remarks for catastrophic diseases,
number of visits and admissions, use of NHI health prevention programs, cardholder?s
premium records, accumulated medical expenditure records and amount of cost-sharing.
? Medical service information, including drug allergy history and long-term prescriptions of
ambulatory care and certain medical treatments. This information is planned to be gradually
added depending on how health care providers adapt to the system.
? Public health administration information (such as the cardholder?s personal immunization
chart and instructions for organ donation).
The Taiwanese government has reserved the other 10 KB of memory for future use.
Moving to the smart card system has resulted in the following changes:
? Hospitals and clinics upload electronic records daily to BNHI.
? After every six patient visits, card information is uploaded online for data analysis, audit, and
authentication.
? The reimbursement process is faster.

 

[heyheybooboo]

Originally posted by: xchangx

Its not that it can't be done. I think its a classic case of vendor lock in. Meditech doesn't want people to easily move to Epic or IDX.

Yeah, some of it is vendor lock, but you have to think about billing, pharmacy, etc...



Perhaps like a HL-7 type interface where systems can talk together. I personally believe there should be some type of way other hospitals could get a patient's healthcare record in case of emergency.

"Open Source" "Open Platform" "Open Socket" "Open Document", whatever .... would take away their proprietary profit and substantially minimize their margins. You would no longer be tethered to their 'back office' proprietary management systems.

This is a case where the tech needs to come from the 'bottom up' instead of the 'top down' (i.e., from the gov't). There will be a great deal of money made in the private sector for those who get in front of this 'convergence'.

But this transition needs to be done with the gov't big stick ---- if you (the private sector) cannot do it for yourselves and the country, 'we' (the gov't) will be forced to do it for you.

So get to it.

 

[Hayabusa Rider]

Heaven knows I'll be glad if they ever get these medical records straight. They're less accurate than written orders.

 

[Phokus]

Originally posted by: Hayabusa Rider
Heaven knows I'll be glad if they ever get these medical records straight. They're less accurate than written orders.

According to a Rand Corp. study, the VA system provides two-thirds of the care recommended by such standards bodies as the Agency for Healthcare Research & Quality. Far from perfect, granted -- but the nation's private-sector hospitals provide only 50%. And while studies show that 3% to 8% of the nation's prescriptions are filled erroneously, the VA's prescription accuracy rate is greater than 99.997%, a level most hospitals only dream about. That's largely because the VA has by far the most advanced computerized medical-records system in the U.S. And for the past six years the VA has outranked private-sector hospitals on patient satisfaction in an annual consumer survey conducted by the National Quality Research Center at the University of Michigan. This keeps happening despite the fact that the VA spends an average of $5,000 per patient, vs. the national average of $6,300.

The VA has that covered. Written scrips are what causes mistakes.

The VA IT system is truly a marvel. They input your prescription in the computer, you go down to the VA pharmacy, they scan your bracelet with a bar code, and a machine dispenses your medicine. Much to the chagrin of conservatives everywhere, the VA system is exponentially more accurate than private care.

This also works with bed ridden patients: nurses are alerted when patients need their medicine, they scan the medicine to make sure it's the right medicine and shows the dosage on their computer screens.

 

[WhipperSnapper]

Originally posted by: Genx87

Originally posted by: SammyJr


Isn't a free market economy essentially an anarchy? With no Government regulations or involvement, Somalia is as close to a free market as you're going to get!

Absolutely not, that is as you pointed out, anarchy.

Note that the only difference between true laissez-faire capitalism and anarchy is that under laissez-faire you have a military, a police, and courts. That's it. The government wouldn't regulate nor interfere with the economy at all <period>. The closes you might come to regulation is that courts would prevent fraud and enforce contracts. Exactly how the government would be funded is open for debate. Some have suggested something akin to a stamp tax, where people would need to purchase stamps in order to make their contracts binding and enforceable. Others have grudgingly acknowledged that perhaps a small level of taxation might be needed.

 

[WhipperSnapper]

Originally posted by: alchemize#2 EMR in the UK, whole population, single payer system: Complete disaster.

Complete disaster in the UK...by what standard?

I have yet to hear of anyone in the UK advocating the elimination of the UK system and the adoption of the current American system or a real laissez-faire system. I wonder why. In fact, when it comes to health care, the British think that Americans are retards.

 

[fskimospy]

Originally posted by: WhipperSnapper

Originally posted by: alchemize#2 EMR in the UK, whole population, single payer system: Complete disaster.

Complete disaster in the UK...by what standard?

I have yet to hear of anyone in the UK advocating the elimination of the UK system and the adoption of the current American system or a real laissez-faire system. I wonder why. In fact, when it comes to health care, the British think that Americans are retards.

There is a reason why there is no significant political party in the UK that has made the elimination of the NHS part of their campaign platform, and that's because the program is overwhelmingly popular.

People who think the UK's health system is a disaster are woefully ignorant of it.

 

[piasabird]

There are a lot of people who have made a choice not to buy health care so they can pay for their house. So if everyone has to pay for healthcare and they have to pay around $800-$1,200 per month, how many people will be having to be forclosed on?

 

[brandonbull]

Originally posted by: Phokus

Originally posted by: brandonbull

Originally posted by: Phokus
Genx:

I provided you with a real world libertarian example of free market care that completely failed, you ignore it.

I provided you with the economics behind why free market medicine will always fail (screening, adverse selection, risk selection), you remain ignorant on the topic.

Here's one of the biggest reasons for our enormous medical inflation and not surprisingly the LACK of regulation/cheering of free market 'innovation' is why this happens:

Why do medical costs keep going up? Walk into the University of Maryland Medical Center for a heart bypass operation and you'll see one reason. Maryland is one of the few hospitals in the country to use a robot for heart surgery. Developed first by the military and then for commercial use by Intuitive Surgical (ISRG), the da Vinci robot is manipulated by a surgeon seated several feet away from the patient. The machine takes minimally invasive surgery to a new level, allowing the tiniest of incisions and enabling doctors to operate in extremely tight places. The robot is already a popular option for prostate surgery, and proponents praise its ability to trim patient recovery time by a third.

It does not, however, do the same for the hospital bill. A da Vinci robot costs $1.5 million, and every time it is used in the operating room, some $2,000 worth of parts must be replaced (for safety reasons). It takes a surgeon 12 to 18 months to learn how to use the machine, and a da Vinci operation usually takes longer than a hands-on procedure. Consequently, a University of Maryland study estimates that the robot adds about $8,000 to the price of bypass surgery.

Another study from Dartmouth Hitchcock Medical Center points out that it's tough for most hospitals to earn back the price of the machine, if it wasn't donated. On top of all that, "There is really no convincing evidence that the da Vinci is any better than standard surgery," says Paul Levy, president of Boston's Beth Israel Deaconess Medical Center (which does not have one). "Doctors and hospitals that have one are promoting it, and patients are demanding it," Levy says. Patients are usually unaware of the increased cost of the robot, since their insurance pays the bills. Also there's no competitive pressure to lower costs, as Intuitive Surgery is the only company that makes a surgical robot.

In OTHER countries, they do the cost/benefit analysis (the thing you conservatives bitch about when it comes to things like UK and cancer drugs) before allowing a treatment into their country. In *OUR* country, our FDA does not do such an analysis. THERE'S your medical waste thanks to market forces. Pure supply/demand.
You can scream 'show me proof of free market medicine in the world!!!', but if you actually think that these skewed incentives are in any way because of government meddling, you're the one who's dense.

So that makes other countries' healthcare system superior than ours because they calculate the benefit of giving someone medical care?

Part of it. In any healthcare system, whether fully free market, socialized, or in between, you will have to ration care somehow since healthcare is a limited good and the demand is quite high.

If you accept any and all 'innovations', you may have to give up healthcare in other areas.

For example, say there is a drug that prolongs a liver cancer patient's life for 6 months but costs $54k (this is a real drug and one that conservatives criticized the UK for not approving at first). But there's a hypothetical drug that cures breast cancer for $10k

Say you DON'T raise taxes or deficit spend in a socialist system (or raise premiums in a free market system), then if you extend the life of that 1 liver cancer patient for six months, then several people will die of breast cancer.

The reason countries do that is because they want the most Pareto efficient outcome. Whereas, in a free market system, every and all technique/drug gets approved without looking at the cost or benefit, you have a Pareto inefficient outcome.

Like i said 100 times before, there's good rationing and bad rationing. Conservatives scream about socialized health care rationing while never acknowledging rationing in free market care.

So private insurance companies not wanting to insure high risk patient = Bad, but government calculating that your life isn't worth the cost = Good?

 

[alchemize]

Originally posted by: WhipperSnapper

Originally posted by: alchemize#2 EMR in the UK, whole population, single payer system: Complete disaster.

Complete disaster in the UK...by what standard?

I have yet to hear of anyone in the UK advocating the elimination of the UK system and the adoption of the current American system or a real laissez-faire system. I wonder why. In fact, when it comes to health care, the British think that Americans are retards.

The emr implementation was (still is) a complete disaster. Reading comprehension issues?

 

[Phokus]

Originally posted by: brandonbull

So private insurance companies not wanting to insure high risk patient = Bad, but government calculating that your life isn't worth the cost = Good?

Extending the life of a liver cancer patient at $54k for 6 months and letting an uninsured person with a curable disease die = bad

Not approving such a drug and allowing more people to be insured and lives being saved = better (Pareto efficient)

Everyone being insured and every treatment being approved = fantasy land.