Healthcare reform

my$0.02 · 06-19-2009, 01:52 PM

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President Obama spoke to the American Medical Association this week to assure doctors that changes in health care would help them better serve patients. Many studies have shown that patient care and spending vary enormously from community to community, depending on local practices, which are largely determined by doctors.

The health care system has long been accused of emphasizing the quantity — rather than the quality — of care, giving doctors and other health providers incentive to order extra tests and procedures when they don’t improve the outcome. “It is a model that has taken the pursuit of medicine from a profession — a calling — to a business,” President Obama said of the system.

Here are opinions from eight "experts" on what needs to be done. Like it or not, there will be some action on health care this year.

Doctors’ Pay, a Key to Health Care Reform - Room for Debate Blog - NYTimes.com

my$0.02 · 07-07-2009, 01:41 AM

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Few people believed the recent pledge by leaders of the hospital, insurance and drug and device industries to cut billions of dollars in wasteful spending. We’ve heard it before. Without fundamental changes in health financing, this promise, like the ones before it, will be impossible to fulfill. What one person calls waste, another calls income.

http://www.nytimes.com/2009/07/07/he...7essa.html?hpw

my$0.02 · 07-25-2009, 02:20 AM

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Doctors in the United States are usually paid fees for each service they provide. The more procedures and tests they order, the more money they pocket. There is widespread agreement among health policy analysts that many of these procedures are unnecessary, raising costs in ways that often do nothing to improve patient health.

By contrast, Bassett — like the Cleveland Clinic and a small number of other health systems in this country — pays salaries to all of its doctors. No matter how many tests or procedures are performed, they take home the same amount of money. Medical costs at Bassett are lower than those at 90 percent of the hospitals in New York, while the quality of care ranks among the top 10 percent in the nation, surveys show.

http://www.nytimes.com/2009/07/25/he...octors.html?hp

Princess'Dad · 07-26-2009, 04:36 PM

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Doctors in the United States are usually paid fees for each service they provide. The more procedures and tests they order, the more money they pocket.

I know of no doc who is paid for each procedure or test "they order". In fact that is illegal. They are paid for length of service and procedures they DO (ie if they drain an abcess, they get paid for it) just as auto mechanics, etc are.

rocketman08 · 07-26-2009, 10:57 PM

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I know of no doc who is paid for each procedure or test "they order". In fact that is illegal. They are paid for length of service and procedures they DO (ie if they drain an abcess, they get paid for it) just as auto mechanics, etc are.

I'm not sure what the OP was referring to in terms of tests, but there is indeed a lot of controversy over physicians profiting from what most experts see as unnecessary tests.

The classic case is when a physician (or group of physicians) buys an expensive scanner and then over uses said scanner, charging insurance each time, with the net result that they pocket a bunch of $$$ while their patients undergo what would normally be considered unnecessary tests.

This is of course illegal too... it's essentially insurance fraud... but it's very real and difficult to enforce. When you hear folks talk about 'cracking down on healthcare costs' this sort of shady practice is exactly the sort of thing they're talking about.

Dad_of_3 · 08-16-2009, 09:17 PM

Another reason for a lot of tests is CYA because of the malpractice situation. As noted earlier, the only tests a doc benefits from is those where the practice owns the equipment and bills for the test too. We do a whole lot of tests that doesn't fit this description in the US. When we compare costs with western European countries, the one factor that is not usually mentioned is that docs there don't have to order a battery of tests or risk lawsuits like they do here.