The govt wants to pay X dollars for a disease, no matter what happens.

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Aug 24, 2016
10:29:16pm

Littlerich All-American

The govt wants to pay X dollars for a disease, no matter what happens.

If you have hart failure the govt will pay the same amount whether you have a lot of complications or no complications. There will be fighting for the piece of the pie by all who are involved in healthcare, including people who had not part in the provided care, so the incentive will be to do the least amount of work to keep reimbursement high for the time spent.

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Littlerich

Bio page: Littlerich
Joined: Apr 8, 2003
Last login: May 6, 2024
Total posts: 20,173 (966 FO)

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Messages

Author

Time

Most effective to decrease healthcare costs?

conetah

8/24/16 10:02pm

Mandatory weight limits

RC Vikings

8/24/16 10:04pm

Tort reform and...

Zlaty Bazant

8/24/16 10:04pm

Medical malpractice costs are down 27% while health care costs are up 64%

8/24/16 11:01pm

What about the costs of the threat of malpractice claims (malpractice insurance)

BYU '80

8/24/16 11:06pm

What are you talking about?

8/24/16 11:20pm

Was that figure included? Doctors pay those costs and it factors

BYU '80

8/24/16 11:25pm

Up front menu costs of all procedures.

tebowned

8/24/16 10:04pm

This. Everything else in life has a price tag when you buy it, why not HC?

ballen

8/24/16 10:06pm

Because health care is complex and unpredictable

Littlerich

8/24/16 10:12pm

True, but I don't see why it would be impossible for a doctor to say, "That X-

ballen

8/24/16 10:15pm

some transparency can happen but it would take a lot of changes to get there

Littlerich

8/24/16 10:19pm

I know it is more complex, but why can my mechanic tell me how much it costs to

ballen

8/24/16 10:23pm

Because the Doctor doesn't know how much it costs.

Littlerich

8/24/16 10:25pm

That just seems insane to me. Why not have a set price and insurance agrees to

ballen

8/24/16 10:30pm

Good question

Littlerich

8/24/16 10:43pm

There are set contractual prices

BYU '80

8/24/16 11:12pm

Hogwash. Whoever is in charge of the business side will know. You cannot have

Spine

8/25/16 12:35am

exactly

bald man

8/25/16 5:39am

which has nothing to do with the actual cost of running the xray machine.

bald man

8/25/16 5:39am

You should be more concerned over the markup for the radiator

BYU '80

8/24/16 11:08pm

I bet it is more than 100% markup.

bald man

8/25/16 5:40am

At least with the radiator I can call 5 different mechanics and get a quote

ballen

8/25/16 5:42am

are you a doctor?

conetah

8/24/16 10:18pm

Yep. I wish healthcare was less complicated, but outcomes are unpredictable

Littlerich

8/24/16 10:20pm

agreed.

conetah

8/24/16 10:24pm

See above, prices vary based upon the negotiated rates with insurance companies

Littlerich

8/24/16 10:26pm

That is how Medicare is starting to pay as we speak

BYU '80

8/24/16 11:14pm

bull honkey. don't bring outcome into a discussion about costs of set

bald man

8/25/16 5:46am

I wish it wasn't as complex at is, but the cost might be "set" but what they

Littlerich

8/25/16 6:07am

It's complex because of insurance. They know the cost to everything

bald man

8/25/16 5:37am

Exactly

Littlerich

8/25/16 6:08am

Sure its complex for certain procedures but it cannot be that tough.

conetah

8/24/16 10:20pm

Prices for individual things could be posted, but true bundled care will

Littlerich

8/24/16 10:21pm

what do you mean bundled care?

conetah

8/24/16 10:25pm

The govt wants to pay X dollars for a disease, no matter what happens.

Littlerich

8/24/16 10:29pm

It's actually the opposite. Doctors are insentivised to cure patients

Schultz is back

8/25/16 2:53pm

And that sounds great in theory, but medicine isn't that simple.

Littlerich

8/26/16 6:04am

I work in the business side of healthcare, and I can tell you

Schultz is back

8/26/16 8:29am

Bingo. there is no secret to fixing costs to things.

bald man

8/26/16 9:53am

Sure we can make individual costs transparent, but it will be difficult to

Littlerich

8/26/16 10:22am

No, not really. Every cost is known. Every step to diagnose a disease and then

bald man

8/26/16 10:31am

The costs might be know for individual steps, the unknown is how many steps it

Littlerich

8/28/16 12:42pm

You aren't familiar with medical coding or bundled payments are you?

BYU '80

8/24/16 11:14pm

<< Deleted >>

Littlerich

8/24/16 10:11pm

FWIW here is an article about a surgery center that started to do this.

conetah

8/24/16 11:32pm

This is a great model for low risk patients with outpatient procedures

Littlerich

8/25/16 6:09am

Right to die. Less end of life heroics. Incentives to living a healthy lifestyle/getting regular well checks/

SuperTank

8/24/16 10:05pm

I feel like this would just be a small drop in the bucket that would

conetah

8/24/16 10:27pm

I don't think so. Those aggressive cancer treatments, weeks in the hospital, etc

ballen

8/24/16 10:32pm

The last 3 months of a person's life account for like 50 percent of the total

I'mBatman

8/24/16 10:37pm

Dylan Thomas said it best.

friscokid

8/24/16 10:54pm

Correct. Lifestyle choices leading to acute illness

BYU '80

8/24/16 11:17pm

Disconnect health insurance from your employer. Make it more free market like

ballen

8/24/16 10:05pm

Not hardly. Employers make huge contributions towards the cost of employee

BYU '80

8/24/16 11:19pm

The problem is there is a HUGE tax advantage to the employer paying directly

Spine

8/25/16 12:39am

Agreed

BYU '80

8/25/16 6:32am

Employers could still contribute money to employee's healthcare as a benefit

ballen

8/25/16 5:36am

Do you not understand how expensive health insurance is?

bald man

8/25/16 5:49am

limit drug patents

CDV

8/24/16 10:05pm

I'm not sure we want to limit the incentive to improve drugs...

Lance71

8/24/16 10:38pm

I'm sure that the abuse of the current system is ridiculous and that we can

CDV

8/25/16 7:44am

what is your plan?

Littlerich

8/25/16 7:51am

for starters, no extensions based on new uses. Most abused part of the system

CDV

8/25/16 7:59am

I am typically for strong patent application, But I agree with this "loophole"

Spine

8/25/16 9:59am

repeal any laws that prohibit importation of drugs from other countries

conetah

8/24/16 10:08pm

RE: repeal any laws that prohibit importation of drugs from other countries

conetah

8/24/16 11:18pm

Death squads

Littlerich

8/24/16 10:09pm

repeal laws that require new clinics to get approval of established area clinics

conetah

8/24/16 10:09pm

That's a thing? I didn't know.

JoMax

8/24/16 10:20pm

RE: That's a thing? I didn't know.

conetah

8/24/16 11:00pm

Remove farm subsidies and eliminate tariffs on produce. Make healthy eating

yahtzee

8/24/16 10:22pm

Work camps for the aged and infirm.

cdr88

8/24/16 10:30pm

Stuff that would work. Soda Tax. Fast Food Tax. Covering less life extending

jbonita

8/24/16 10:35pm

Most people would laugh at this but

I'mBatman

8/24/16 10:46pm

We have couple big problems 1. We are fat. 2. We aggressively extend life.

jbonita

8/24/16 10:50pm

it also takes toooo long for many new, effective procedures to become FDA

Littlerich

8/25/16 7:52am

Decoupling insurance from employers would have the opposite inpact

BYU '80

8/24/16 11:21pm

Complete uncoupling including a change to the way it is taxed.

jbonita

8/25/16 12:31am

I don't know what the answer is, but it's a big problem in our country.

8/24/16 10:42pm

Reduce government oversight on just about everything

slowhiteguy

8/24/16 10:43pm

Bingo. The administrative costs in healthcare are enormous

BYU '80

8/24/16 11:22pm

A couple of things that would GUARANTEE cost reductions

Pacino

8/24/16 10:46pm

#2 is a pipe dream unless payments structures

BYU '80

8/24/16 11:27pm

Incentives could certainly be different but it is the current insurance

Pacino

8/24/16 11:46pm

It's the anti-Obamacare. Certainly a better direction.

Spine

8/25/16 12:43am

1) allow healthy people to sell their kidneys (I'm not kidding)

toadie

8/24/16 10:57pm

Let Market Forces Work

Celeritas

8/24/16 11:08pm

People don't understand the healthcare market concepts well enough for

BYU '80

8/24/16 11:29pm

It's an "easy to say" solution which is hard to implement.

conetah

8/25/16 12:38am

Article I believe touches on a lot of good ways to cut costs.

conetah

8/24/16 11:43pm

Dr should prescribe celery more often than pharma. In reality many of their patients just need more celery.

HarlemCoug

8/25/16 5:09am

Allow nurses to do more. Have Dr's do less.

HarlemCoug

8/25/16 5:10am

???

Littlerich

8/25/16 6:39am

Limit the number of different plans an insurer can offer. Doctors have almost as

bald man

8/25/16 5:35am

Or change it so the insurance pays the individual X amount for issues, and the

Spine

8/25/16 10:04am

Here is a real problem with that approach

bald man

8/25/16 10:14am

You example would definitely happen. There is no panacea, but over all costs

Spine

8/25/16 11:19am

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