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[upper class folks would likely get worse care] I agree that upper-class folks' experience would change in ways that would generate loud protests. But the bigg

by GCA10 3y ago

[upper class folks would likely get worse care] I agree that upper-class folks' experience would change in ways that would generate loud protests. But the biggest anger points likely wouldn't involve quality of care. Instead, we'd hear shouting about: providers' increased emphasis on cost-effective care. (You don't need an MRI because there's nothing in your symptoms that warrants it.) Right now, there's a lot of overtreatment in the U.S. medical system, catering to patients' desire to get big workups. scaling back of today's concierge-level ambiance, with fancy chairs, skyline views, etc.

lostlogin 3y ago
> there's a lot of overtreatment in the U.S. medical system, catering to patients' desire to get big workups. It’s not just happening in the US. What goes on in the US is very influential elsewhere, and both patients and staff get pulled into the vortex of over-testing. And then to top it off, sometimes they are correct and they did need the test.
mistrial9 3y ago
unneeded surgery is also a recurrent theme; prescriptions for just about anything is now the norm
thayne 3y ago
> Right now, there's a lot of overtreatment in the U.S. medical system, catering to patients' desire to get big workups. I think has more to do with a combination of overtreating results in higher income and fear of malpractice suits if you undertreat.
- FireBeyond 3y ago
  Partly. Let's also talk about the ugly world of Certificates of Need and diagnostic imaging and how they collide. CoNs are something lobbied for by hospitals. If you want to open a new hospital or healthcare facility in an area, you need to apply for a certificate of need, which allows/asks existing hospitals if they think there is a need for your facility, to avoid "overservice" (lol, okay) of an area. Diagnostic imaging companies - each of the big ones (Siemens, GE, Philips) offer in house financing for MRI, CT, etc., that they advertise to physicians. They also all offer specialist consulting help to facilitate you getting a CoN for your facility. Hell, they all also well help you find other physicians in your area who'd like to go in on setting up a DI facility (and will assist with spinning up the practice). And then we find that physicians who own a DI practice (or a share in one) refer their patients to diagnostic imaging at rates several standard deviations above other physicians, and at rates that are "statistically improbable" when correlated to underlying ICD-10 diagnostic codes. Upton Sinclair comes to mind ("It is difficult to get a man to understand something, when his salary depends on his not understanding it").

by GCA10 3y ago

lostlogin 3y ago

> there's a lot of overtreatment in the U.S. medical system, catering to patients' desire to get big workups. It’s not just happening in the US. What goes on in the US is very influential elsewhere, and both patients and staff get pulled into the vortex of over-testing. And then to top it off, sometimes they are correct and they did need the test.

mistrial9 3y ago

unneeded surgery is also a recurrent theme; prescriptions for just about anything is now the norm

thayne 3y ago

> Right now, there's a lot of overtreatment in the U.S. medical system, catering to patients' desire to get big workups. I think has more to do with a combination of overtreating results in higher income and fear of malpractice suits if you undertreat.

FireBeyond 3y ago
Partly. Let's also talk about the ugly world of Certificates of Need and diagnostic imaging and how they collide. CoNs are something lobbied for by hospitals. If you want to open a new hospital or healthcare facility in an area, you need to apply for a certificate of need, which allows/asks existing hospitals if they think there is a need for your facility, to avoid "overservice" (lol, okay) of an area. Diagnostic imaging companies - each of the big ones (Siemens, GE, Philips) offer in house financing for MRI, CT, etc., that they advertise to physicians. They also all offer specialist consulting help to facilitate you getting a CoN for your facility. Hell, they all also well help you find other physicians in your area who'd like to go in on setting up a DI facility (and will assist with spinning up the practice). And then we find that physicians who own a DI practice (or a share in one) refer their patients to diagnostic imaging at rates several standard deviations above other physicians, and at rates that are "statistically improbable" when correlated to underlying ICD-10 diagnostic codes. Upton Sinclair comes to mind ("It is difficult to get a man to understand something, when his salary depends on his not understanding it").