3 ms·

I find it really interesting that we don't have, for example, a cheaper way of doing front-line health care than teaching people to diagnose every possible ailm

by zxcmx 9y ago

I find it really interesting that we don't have, for example, a cheaper way of doing front-line health care than teaching people to diagnose every possible ailment. Similarly that that the mechanics of surgery aren't considered a manual skill practicable in a largely assembly line fashion. Apparently, everyone gets artisanal health care, regardless of the level of complication (or not) of their condition. Nothing wrong with doctors at all, but curious that this field above all others is so resistant to the methods of industry which have worked so well to reduce costs in every other field.

tertius 9y ago
> Apparently, everyone gets artisanal health care, regardless of the level of complication (or not) of their condition. Because biology is complicated.
maxerickson 9y ago
Generic OTC drugs are healthcare. They often cost ~$3-5 a month. Pretty cheap, available to treat a wide variety of issues. And increasingly, first contact will not be with an MD or DO (there's several paths, nurse practitioners, physicians assistants, etc).
- ghaff 9y ago
  And in fact, lots of common prescription drugs that people may take daily don't even hit $15 copay levels for a month's supply.
  - maxerickson 9y ago
    You do have to go through a relatively expensive gatekeeper for those though. And they won't lightly pass on the opportunity to monitor things.
baldfat 9y ago
Robots have been in the operating room for several years now. People are just not aware they certainly aren't there to reduce cost as much as reduce risk from human error. http://fortune.com/2016/07/11/robots-medical-surgeons/ http://fortune.com/2016/07/11/robots-medical-surgeons/
- firebird84 9y ago
  The two concerns are intertwined, as reduced risk from human error means fewer malpractice claims, and slower premium increase (assuming a well functioning malpractice insurance market). Also, improved outcomes (due to fewer errors) also improve costs, as patients won't have to come back due to complications as often.
brightball 9y ago
It's a valid concern and this is where the free market aspects really come into play. If a school opened up with the goal of training people to diagnose and treat cold and flu symptoms, so that the graduates could diagnose those symptoms and their severity, then recommend a course of care or call in a prescription...here are the potential barriers. 1. Insurance companies wouldn't pay for it at all because those graduates would lack any type of professional credentials. 2. Those graduates wouldn't actually be allowed to call in prescriptions, also due to lack of credentials. 3. Getting credentials approval would require a lot of money to push things through the process, if at all. Then the school would have to be setup in an effort to recoup those costs. The school would be setup with the goal of making money most likely and everything else in the process would have to happen before the school even became feasible. Assuming all of those things happen, then insurance companies would largely decide whether or not to even pay for those services and people who had companies that wouldn't...would not likely go to those providers. If they did pay for them and the pay was too low to justify the time commitment of dealing with the insurance companies, additional costs would be involved in terms of staff to deal with billing and followup. (Insurance companies often deny on first request, requiring rebilling). When it comes to cash flow, insurance changes at the beginning of every year can cause payments to be delayed for up to 3 months which becomes a huge problem for office leases and payroll. Between all that if the compensation isn't high enough, it disincentives people to go into the field at all. The alternative is pure private pay and allowing individuals to decide, this care is good enough for me. Which would require signing something indemnifying the practitioner from legal recourse since they wouldn't be able to get malpractice insurance. If that care costs more than the co-pay at their regular doctor...they will have no reason to choose it. And even with private pay, those same practitioners still wouldn't be able to call in prescriptions. That is the industry that has been created by removing health care from the free market.
- coredog64 9y ago
  LNPs have the ability to write prescriptions for low schedule drugs. That's pretty much the basis of those tiny clinics in retail stores. More movement in that direction could lower health care costs, or at least improve utilization.

by zxcmx 9y ago

tertius 9y ago

> Apparently, everyone gets artisanal health care, regardless of the level of complication (or not) of their condition. Because biology is complicated.

maxerickson 9y ago

Generic OTC drugs are healthcare. They often cost ~$3-5 a month. Pretty cheap, available to treat a wide variety of issues. And increasingly, first contact will not be with an MD or DO (there's several paths, nurse practitioners, physicians assistants, etc).

ghaff 9y ago
And in fact, lots of common prescription drugs that people may take daily don't even hit $15 copay levels for a month's supply.
- maxerickson 9y ago
  You do have to go through a relatively expensive gatekeeper for those though. And they won't lightly pass on the opportunity to monitor things.

baldfat 9y ago

Robots have been in the operating room for several years now. People are just not aware they certainly aren't there to reduce cost as much as reduce risk from human error. http://fortune.com/2016/07/11/robots-medical-surgeons/ http://fortune.com/2016/07/11/robots-medical-surgeons/

firebird84 9y ago
The two concerns are intertwined, as reduced risk from human error means fewer malpractice claims, and slower premium increase (assuming a well functioning malpractice insurance market). Also, improved outcomes (due to fewer errors) also improve costs, as patients won't have to come back due to complications as often.

brightball 9y ago

It's a valid concern and this is where the free market aspects really come into play. If a school opened up with the goal of training people to diagnose and treat cold and flu symptoms, so that the graduates could diagnose those symptoms and their severity, then recommend a course of care or call in a prescription...here are the potential barriers. 1. Insurance companies wouldn't pay for it at all because those graduates would lack any type of professional credentials. 2. Those graduates wouldn't actually be allowed to call in prescriptions, also due to lack of credentials. 3. Getting credentials approval would require a lot of money to push things through the process, if at all. Then the school would have to be setup in an effort to recoup those costs. The school would be setup with the goal of making money most likely and everything else in the process would have to happen before the school even became feasible. Assuming all of those things happen, then insurance companies would largely decide whether or not to even pay for those services and people who had companies that wouldn't...would not likely go to those providers. If they did pay for them and the pay was too low to justify the time commitment of dealing with the insurance companies, additional costs would be involved in terms of staff to deal with billing and followup. (Insurance companies often deny on first request, requiring rebilling). When it comes to cash flow, insurance changes at the beginning of every year can cause payments to be delayed for up to 3 months which becomes a huge problem for office leases and payroll. Between all that if the compensation isn't high enough, it disincentives people to go into the field at all. The alternative is pure private pay and allowing individuals to decide, this care is good enough for me. Which would require signing something indemnifying the practitioner from legal recourse since they wouldn't be able to get malpractice insurance. If that care costs more than the co-pay at their regular doctor...they will have no reason to choose it. And even with private pay, those same practitioners still wouldn't be able to call in prescriptions. That is the industry that has been created by removing health care from the free market.

coredog64 9y ago
LNPs have the ability to write prescriptions for low schedule drugs. That's pretty much the basis of those tiny clinics in retail stores. More movement in that direction could lower health care costs, or at least improve utilization.