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> I suspect that the care-providers and care-purchasers are too close, and that collusion is a source of the extra cost that Americans experience. (They also ha
by chimeracoder 8y ago
> I suspect that the care-providers and care-purchasers are too close, and that collusion is a source of the extra cost that Americans experience. (They also have far reduced waiting times, which is a genuine expense).
You've got it completely backwards - the providers and payers are dramatically less connected in the US compared to the NHS in the UK.
In general, the US is moving towards more captitated models, but if anything, this is bringing their incentive structure closer in line to what providers in the NHS already experience.
- bovine3dom 8y agoSorry, I meant the somewhat cosy relationship between the drug companies, the insurers and the doctors. Care provider was probably a poor choice of words. Maybe it's because of the newspapers' portrayal of NICE as a death panel here, but I find it hard to believe that they're cosy with anyone.
- chimeracoder 8y ago> Sorry, I meant the somewhat cosy relationship between the drug companies, the insurers and the doctors. Yes, and this is exactly what I'm talking about. > Maybe it's because of the newspapers' portrayal of NICE as a death panel here, but I find it hard to believe that they're cosy with anyone. NICE is many things, but they're certainly not "nice". And where that shows the most is in treatments for complex conditions (especially cancer). But beyond that: providers under the NHS have dramatic leeway in determining appropriate steps for care (that's inherent to the practice of medicine itself), and they are both explicitly and implicitly expected to consider costs as a factor in that decision-making.