At 4/15/2012 4:37:59 PM, darkkermit wrote:
At 4/15/2012 4:30:20 PM, Contra wrote:
At 4/15/2012 4:25:57 PM, darkkermit wrote:
At 4/15/2012 4:18:17 PM, Contra wrote:
At 4/15/2012 4:16:42 PM, darkkermit wrote:
It also lowers incentives for doctors to try to be more efficient and innovative since they get paid anyways and equally under the single payer system. Thus it leads to long-run stagnation of the health sector.
Doctors could get paid per patient, and when a patient meets a certain goal (ex: stops smoking), the doctor could get a bonus since it lowers that patient's care costs (they do this in the UK). Doctors would still be innovative, perhaps more because patients would have free choice of their doctor, not restricted by their insurance plan.
You really think a doctor should get credit for a patient deciding to stop smoking which:
a) isn't really something that requires medical expertise
b) is something the patient did on his own accord
When a patient meets notable health goals like smoking or losing weight, a doctor does get credit and a bonus since overall the costs of the patient will be less. Thus, a doctor has an incentive to keep his patients healthy and lower costs.
That's not something the doctor did though. That's something the patient did. Why should the doctor get credit for this? These aren't exactly innovations either.
The doctor gets a bonus if they get a patient to stop smoking. These aren't really innovations, they are incentives.
And anyways, a thought came to my mind. If costs are essentially fixed, how does one determine what is considered "acceptable care". The incentive to provide poor care, since prices are fixed are high?
Acceptable care would be determined by the doctor, and the payment situation would be dealt with the public input, political leaders, and the Federal Health Board to coordinate an effective health care framework. Also, spending more money on care doesn't really equal better results, look at the US.
It would seem the only possibility to get around this is to create a bureaucratic system to decide what is considered "acceptable" and "not" which will further cripple innovation. I mean, the US already kind of has that system which has contributed to rising costs o the healthcare professions. It will just be worse.
As I said earlier, political leaders, the public input, and the Federal Health Board would determine what to cover, and the rest could actually be covered by private insurance. All medically necessary care would be covered. And yes, our current hybrid system is a mess, it is the worst of both systems, since we can't cover all, or take advantage of lower administration costs.
If a doctor wants to try a new system for treatment, he/she will not be successful since he/she will have to go through a bureaucratic nightmare to get approval for it. And for what purpose? He/she isn't going to get a higher salary from it.
In reality, our fragmented for profit system has a much higher bureaucracy than single-payer systems, in both terms of the size and costs of bureaucracy. So, SP would allow more freedom in health care in choosing medical professionals, and the medical decisions are left to the doctor and patient, not bureaucrats like the current system.
"If you live long enough, you make mistakes. But if you learn from those mistakes, you'll be a better person." - Bill Clinton
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