OT: health care was: (UTOPIA) Tax Alert : Stop 150% tax pledge increase

Carl Youngblood carl at youngbloods.org
Fri Apr 18 17:52:02 MDT 2008


There's another wrinkle to all this, however (actually there are
probably many more wrinkles).  There are many procedures that can only
be performed in hospitals, which also have policies of their own.  So
even if your doctor wants to offer his/her services at private rates,
it may not be possible in the hospital.

But I do agree that it would be nice if doctors offered private pay rates.

On Fri, Apr 18, 2008 at 5:43 PM, Jonathan Duncan
<jonathan at bluesunhosting.com> wrote:
>  On 18 Apr 2008, at 15:00, Nicholas Leippe wrote:

> > Personally, I wish there were more private doctors like in the days of
> > old--you could shop around (how much for a visit?, how much to deliver a
> > baby?, etc). Quality of service would determine demand--doctors would be
> > immediately liable for their own success according to their competence,
> > practices (do follow-ups cost the same as an initial visit?), and price. A
> > really good doctor could charge more, and expect it. A new or doctor
> > w/complaints would have to charge less while they (re)establish
> themselves.
> >
> > IMO this is another place where the current model falls short.
> > Right now, is there any visibility to how good a doctor is? Is there any
> > visibility to their prices/compensation? There certainly is very little
> > recourse available for bad doctors--they tend to band together and watch
> each
> > other's backs--a "good-old boys club". Nurses are forbidden to warn
> patients
> > about bad doctors (they lose their jobs if caught, and if I am not
> mistaken
> > can become black listed, keeping them from finding employment in related
> > network facilities). A doctor can put an opinion as fact in your medical
> file
> > and you can do nothing about it. You can't get it stricken, even if it is
> > proved to be false or was just an opinion. You can't hardly even get
> access
> > to your own file. Doctors tend to believe what other doctors have written
> > over what a patient says--of which there are many stories (I know some
> > first-hand) where this goes disastrously wrong. And what do doctors get
> when
> > they screw up? Protected by their fellow doctors. There is no competition
> or
> > open market in this model either. In an open market, such doctors would
> have
> > a publically accessible "bad rap" and have to lower their prices or find a
> > new career.
> >
> > Now, as for the topic of privatization vs UHC, I don't know if either is
> ever
> > a perfect solution, but I do believe competition is possible in both
> models.
> >
> > I think "it would be nice" if there was at least a mandatory minimum level
> of
> > care for acute trauma--a guy shouldn't have to decide which of two fingers
> he
> > cut off to stitch back on. Have some decency and just put the poor guys
> > fingers back on... I honestly don't believe people are going to look for
> ways
> > to abuse acute trauma care in any system. (Who's gonna go cut off an arm
> and
> > a leg just to see if they'll reattach both?) But, this thinking kind of
> runs
> > against what I said above about having an open market and competition.
> >
> > Someone still needs to pay for performing the service, but I would think
> acute
> > trauma care could be fairly easily enumerated, analyzed and divided up. I
> > think perhaps having a UHC model for just acute trauma care could be
> > manageable. I wouldn't mind paying into it--and never having to worry
> about
> > deciding how many limbs to reattach if I ever got into an accident. I
> would
> > feel happy paying so that someone else also doesn't ever have to face that
> > decision either. That's just being a good fellow human being IMO.



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