As I never tire of repeating, diagnosis and prescription are very different things, the more so, the complex the social phenomenon in question. I suspect you and I very largely agree on our diagnosis of the U.S. health care system.
-
-
I remain deeply skeptical that an effective solution involves government provision and "just needs political will."
1 reply 0 retweets 1 like -
Replying to @StephenPiment @_TamaraWinter
By “political will” I meant broad knowledge that we are drastically overpaying, and demand that it stop. Dysfunctional regulatory overhead is clearly a large part of the problem, and a genuinely free market is likely the best solution; but “how” is secondary to “when.”
1 reply 0 retweets 2 likes -
Replying to @Meaningness @_TamaraWinter
It sounds like we may agree more on prescription than I supposed! I'm particularly sensitive to the prescriptive piece because I hear many well-meaning proposals that I believe will actually make the bad U.S. system even worse.
1 reply 0 retweets 1 like -
Replying to @StephenPiment @_TamaraWinter
I think the key is to adopt zero-based cost estimates, instead of tinkering with the existing structure. Whenever I visit my mom in hospital or tske her to a medical appointment, I sum market salaries and equipment cost, add floorspace and 20% for SG&A to come up with actual cost
1 reply 0 retweets 1 like -
Ultimately it doesn’t matter exactly where the 80-90% waste goes; it just matters to know we *could* provide the same service for 10-20% of the current cost.
1 reply 0 retweets 1 like -
Replying to @Meaningness @_TamaraWinter
I concur with your estimates. I also believe that many who are most active on this issue would fight tooth-and-nail against the only effective means of reducing prices to near the actual costs, screaming about the evils of "Uberization," etc.
1 reply 0 retweets 3 likes -
Replying to @StephenPiment @_TamaraWinter
I believe you are right. OTHO, if India does it, it will be hard to say we can’t.
1 reply 0 retweets 1 like -
Also, important to emphasize that provider salaries are NOT where the money is going, and decreasing them is not part of the solution. Most are already underpaid by US standards, and the zero-based analysis shows they are a small fraction of the cost.
1 reply 0 retweets 1 like -
Replying to @Meaningness @_TamaraWinter
True, although there may be a reduction in the number of persons employed in the system, especially in middle-man roles. So that's salary, just not for those we would consider "providers."
1 reply 0 retweets 0 likes
Yes. OTOH I suspect lots of people would be upset about nurses losing their jobs and few people would be upset about insurance claims deniers losing their jobs.
-
-
Replying to @Meaningness @_TamaraWinter
Totally. And, in general, I consider it a net good for those in roles that are unneeded to find employment elsewhere.
1 reply 0 retweets 1 like -
New conversation -
Loading seems to be taking a while.
Twitter may be over capacity or experiencing a momentary hiccup. Try again or visit Twitter Status for more information.