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This is not the market fault it's the political system and reimbursement rules which creates perverse incentives. Some hospitals have begun to get reimbursed ba
by ThomPete 10y ago
This is not the market fault it's the political system and reimbursement rules which creates perverse incentives. Some hospitals have begun to get reimbursed based on how well the patients gets treated called value based treatment.
- maxerickson 10y agoI was implying that the US doesn't really have a market.
- ThomPete 10y agoCompared to Europe it does though. I.e. the us healthcare system does't get most of it's payment through taxation. Thats an important distinctions.
- maxerickson 10y agoI guess. Medicaid and Medicare are more than a third of spending and don't necessarily cover the total costs of the care provided under the programs (any unmet costs are a hidden tax). The VA is not nearly as expansive as those programs but is another couple whole percentage points of US health spending. And you've also got Tri Care and some BIA stuff, and state expenditures that are outside of Medicaid.
- ThomPete 10y agoNot sure we are discussion the same thing. My point is that a singlepayer system payed by the taxpayers and budgeted by the politicians isn't making money it can only spend less money. A system like the american overall can make money, it's it's goal to profit. That's the difference between whether it's a market driven market or not IMO.
- maxerickson 10y agoFor me, to be "market driven", you have to have easy entry on the supply side and not have huge amounts of mandated care on the demand side. The US has all sorts of constraints on the supply side and a lot of the demand side is treated under various mandates. Without easy entry on the supply side, there can't really be a market response to changes in demand, hence not really market driven. When care is provided to comply with government mandates and incentives rather than because it can be priced above cost, not a market driven transaction.
- ThomPete 10y agoWe were talking relative to ex. europe. Not some ideological defintion. Then the US isn't a market driven economy. Thats not a useful way to look at things.
- maxerickson 10y agoCreation of new supply seems more in the "words mean things" bucket than the ideological bucket.