4 ms·

Your theory falls apart to the evidence of health systems in basically every other OECD country. A theory that fails to match the data in any case doesn't seem

by rtpg 10y ago

Your theory falls apart to the evidence of health systems in basically every other OECD country. A theory that fails to match the data in any case doesn't seem to be much of a theory, is there something I don't know about that's happening in other counties?

drumdance 10y ago
My guess is that doctors in other countries have less choice. In the US a doctor can opt out of Medicare and offer concierge services instead. Which many of them have done because Medicare reimbursements are much lower than in the private market. US doctors also can make money through self-referrals such as ordering a test be done through a clinic in which they are an owner. This article from 2009 talks about the latter case in detail: http://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum http://www.newyorker.com/magazine/2009/06/01/the-cost-conund... I supposed we could try to outlaw that practice, but a whole lot of doctors would lobby like hell to prevent that bill from making it through Congress.
- rtpg 10y ago
  So in France you have a similar system: There are base prices for operations, doctor visits and the like. But doctors can choose to charge above this price (and mostly do so in places like Paris, where rent is too high to charge just base price). Doctors have to declare whether or not they do this. So if you're a price-sensitive person you can lookup doctors "inside" or outside the system. In my experience, there are longer waits for things like optomotrists, but that's more due to government-mandated limits on how many can graduate in a year than the price controls (that you can opt out of anyways). General practitioners are fine though. Like "call for an appointment, show up the next day" sort of fine. And even in big cities I would always end up at a doctor charging "base" price. The visits would end up only costing something like 7 euros.

by rtpg 10y ago

drumdance 10y ago

My guess is that doctors in other countries have less choice. In the US a doctor can opt out of Medicare and offer concierge services instead. Which many of them have done because Medicare reimbursements are much lower than in the private market. US doctors also can make money through self-referrals such as ordering a test be done through a clinic in which they are an owner. This article from 2009 talks about the latter case in detail: http://www.newyorker.com/magazine/2009/06/01/the-cost-conundrum http://www.newyorker.com/magazine/2009/06/01/the-cost-conund... I supposed we could try to outlaw that practice, but a whole lot of doctors would lobby like hell to prevent that bill from making it through Congress.

rtpg 10y ago
So in France you have a similar system: There are base prices for operations, doctor visits and the like. But doctors can choose to charge above this price (and mostly do so in places like Paris, where rent is too high to charge just base price). Doctors have to declare whether or not they do this. So if you're a price-sensitive person you can lookup doctors "inside" or outside the system. In my experience, there are longer waits for things like optomotrists, but that's more due to government-mandated limits on how many can graduate in a year than the price controls (that you can opt out of anyways). General practitioners are fine though. Like "call for an appointment, show up the next day" sort of fine. And even in big cities I would always end up at a doctor charging "base" price. The visits would end up only costing something like 7 euros.