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> look at what happens to pricing when the government is your sole customer. Based on the available evidence for healthcare: it drops like a stone because the

> look at what happens to pricing when the government is your sole customer. Based on the available evidence for healthcare: it drops like a stone because the sole customer has all the leverage.

AnimalMuppet 10y ago
You already see this with Medicare. For some treatments, they reimburse less than the doctor's direct costs. But if you try to do that with all the doctor's customers, it doesn't work.
- brianwawok 10y ago
  I mean, it will work. That is not working because you have Medicare interacting with private practice doctors.. the same problems with ACA + private health insurance offices. If the government directly pays the Doctor a salary.. he doesn't care what the "profit" on a procedure is. In fact, base his pay on how good his outcomes are and how efficient he is.. i.e. pay him more to do better. Then we don't need to worry about some doctors not offering some procedures, because they are paid by salary and not salesmen. Right now private practice doctors are salesmen. They are compensated MORE for selling unnecessary procedures. If the they can sneak it by the insurance? They do it.
  - r_smart 10y ago
    That's the nationalization I was referring to earlier. Also, government workers are rarely held to a high standard and rarely fired, so why you think that's going to happen with healthcare when it doesn't happen anywhere else is beyond me. Most doctors make a salary, they don't care what the 'profit' on a procedure is. They probably don't even know what most of the stuff costs. It's like college professors and textbooks. Also, who's worrying about some doctors not offering some procedures?
- abritinthebay 10y ago
  There is no healthcare in the US where the government is the sole (or even primary) customer. So using anything from the US as a counter example is going to fall flat.
talmand 10y ago
Well, some would say that based on available evidence that government-based price controls doesn't always turn out well. Especially for people trying to obtain the product or service under said price control.
- abritinthebay 10y ago
  While that may be true in certain exceptional cases the available evidence (every other 1st world country) would say it isn't the regular case. Even IF that's the case it's still wildly better than the current system.
  - r_smart 10y ago
    Firstly, the US is different, and the way it would get structured would be different. Second, what evidence do you have that it would be cheaper in those countries than if they were using a private medical system? Are there numbers from before the NHS was put together? That would be an interesting analysis.

> look at what happens to pricing when the government is your sole customer. Based on the available evidence for healthcare: it drops like a stone because the sole customer has all the leverage.

AnimalMuppet 10y ago

You already see this with Medicare. For some treatments, they reimburse less than the doctor's direct costs. But if you try to do that with all the doctor's customers, it doesn't work.

brianwawok 10y ago
I mean, it will work. That is not working because you have Medicare interacting with private practice doctors.. the same problems with ACA + private health insurance offices. If the government directly pays the Doctor a salary.. he doesn't care what the "profit" on a procedure is. In fact, base his pay on how good his outcomes are and how efficient he is.. i.e. pay him more to do better. Then we don't need to worry about some doctors not offering some procedures, because they are paid by salary and not salesmen. Right now private practice doctors are salesmen. They are compensated MORE for selling unnecessary procedures. If the they can sneak it by the insurance? They do it.
- r_smart 10y ago
  That's the nationalization I was referring to earlier. Also, government workers are rarely held to a high standard and rarely fired, so why you think that's going to happen with healthcare when it doesn't happen anywhere else is beyond me. Most doctors make a salary, they don't care what the 'profit' on a procedure is. They probably don't even know what most of the stuff costs. It's like college professors and textbooks. Also, who's worrying about some doctors not offering some procedures?
abritinthebay 10y ago
There is no healthcare in the US where the government is the sole (or even primary) customer. So using anything from the US as a counter example is going to fall flat.

talmand 10y ago

Well, some would say that based on available evidence that government-based price controls doesn't always turn out well. Especially for people trying to obtain the product or service under said price control.

abritinthebay 10y ago
While that may be true in certain exceptional cases the available evidence (every other 1st world country) would say it isn't the regular case. Even IF that's the case it's still wildly better than the current system.
- r_smart 10y ago
  Firstly, the US is different, and the way it would get structured would be different. Second, what evidence do you have that it would be cheaper in those countries than if they were using a private medical system? Are there numbers from before the NHS was put together? That would be an interesting analysis.