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Medicare and Medicaid are the definition of price controls for paying physicians: they pay below market rate such that private insurance is billed higher to off

Medicare and Medicaid are the definition of price controls for paying physicians: they pay below market rate such that private insurance is billed higher to offset. There are week price controls for medical equipment and pharmaceuticals and the failure to address overuse of unnecessary equipment costs way more than the savings from price controls. Testing for strep and prescribing antibiotics represent the smallest fraction of healthcare resources. Why didn't you include brain or spine surgery on your list of things that shouldn't require 7 years of training? Expensive end of life care isn't the fault of hospitals or clinicians: it's the fault of families who can't say no to excessive and futile end of life care. If you want to get into getting rid of "wasteful" spending, why aren't you recommending everyone should smoke a pack of cigarettes per day? Most people would work and live a productive life until they die of lung cancer at age 65? Saves 15-25 years of unnecessary "end of life" care.

jeffreyrogers 8y ago
Sorry, you are right about price controls. I think it's still a problem that they incentivize unnecessary care. I don't think we're actually that far apart on what we think the problems are. I wasn't trying to say that requiring large amounts of school in order to test for strep and antibiotics are the only cause of our high costs of healthcare, but they obviously contribute. I agree (and I think any thinking person would agree) that you should have training to perform more specialized procedures. Expensive end of life care is partly the fault of clinicians who get paid to authorize expensive procedures and who don't want to tell their patients and their families that there is very little they can do to prolong their life, so they should just surround themselves with loved ones and prepare to die. And we can both agree that there is wasteful spending without arguing that people should kill themselves sooner. Just looking at our healthcare expenses relative to other countries shows we pay somewhere between 1.5-2x more for roughly the same level of care. That's obviously a market failure.

jeffreyrogers 8y ago

Sorry, you are right about price controls. I think it's still a problem that they incentivize unnecessary care. I don't think we're actually that far apart on what we think the problems are. I wasn't trying to say that requiring large amounts of school in order to test for strep and antibiotics are the only cause of our high costs of healthcare, but they obviously contribute. I agree (and I think any thinking person would agree) that you should have training to perform more specialized procedures. Expensive end of life care is partly the fault of clinicians who get paid to authorize expensive procedures and who don't want to tell their patients and their families that there is very little they can do to prolong their life, so they should just surround themselves with loved ones and prepare to die. And we can both agree that there is wasteful spending without arguing that people should kill themselves sooner. Just looking at our healthcare expenses relative to other countries shows we pay somewhere between 1.5-2x more for roughly the same level of care. That's obviously a market failure.