The invisible hand has been spanking some costs

[Peter_Puget]

[olyclimber]

maybe if insurance didn't cover any medical expenses they would become cheaper too. then they could get the invisible handjob too.

[billcoe]

maybe if insurance didn't cover any medical expenses they would become cheaper too..then they could get the invisible handjob too.

I always thought that was extra $? I obviously need to learn some negotiation skillz from the master!

[JayB]

maybe if insurance didn't cover any medical expenses they would become cheaper too. then they could get the invisible handjob too.

 

Single-Payer to the (Cost-Control) Rescue!!!!

 

"A Device to Kill Cancer, Lift Revenue

 

Roughly one in three Medicare beneficiaries diagnosed with prostate cancer today gets a sophisticated form of radiation therapy called IMRT. Eight years ago, virtually no patients received the treatment.

 

The story behind the sharp rise in the use of IMRT—which stands for intensity-modulated radiation therapy—is about more than just the rapid adoption of a new medical technology. It's also about financial incentives.

 

Taking advantage of an exemption in a federal law governing patient referrals, groups of urologists across the country have teamed up with radiation oncologists to capture the lucrative reimbursements IMRT commands from Medicare...."

 

http://online.wsj.com/article/SB10001424052748703904804575631222900534954.html

[olyclimber]

buds, you're sort of missing the point here. cosmetic medical procedures like botox...are getting cheaper? they should! they are unnecessary. of course the meaningful medical procedures that save lives and stuff like that....well shouldn't they be more expensive? because lives cost money! pay to play. pay to live. as it should be. the invisible handjob.

[olyclimber]

imagine a world where the wealthiest people in the world are also the most beautiful.

 

 

the invisible hand demands it!

[JayB]

buds, you're sort of missing the point here. cosmetic medical procedures like botox...are getting cheaper? they should! they are unnecessary. of course the meaningful medical procedures that save lives and stuff like that....well shouldn't they be more expensive? because lives cost money! pay to play. pay to live. as it should be. the invisible handjob.

 

 

The point is that when you have a bureaucratic system setting prices, they're typically either so low that providers take an automatic loss, or they're so high that they get a big windfall with public money.

 

When payments are too low for a given treatment - doctors will eventually stop delivering it. When there's a windfall available - they naturally deliver more of the treatment that generates the windfall.

 

When the folks setting prices discover the windfall - they attempt to clamp down, set another price that will either be too high or too low, and the whole kabuki dance continues.

 

Unfortunately for fans of central planning - you can control prices but you can't control costs. Since the actual cost is affected by a gazillion things that the planners have no control over - price controls will always result in prices that are either too high or too low to coordinate supply with demand, and will always produce shortages or surpluses. They don't work any better for medical devices and procedures than they do for oil, wheat, etc.

 

Cosmetic procedures are the result of price transparency and competition. That's why they're declining and virtually nothing else in healthcare is.

[olyclimber]

maybe you are right. or maybe you are comparing apples to oranges.

 

cosmetic medical procedures are generally not covered by insurance.

most "life or death" procedures are.

most "wellness" procedures are.

 

if insurance doesn't pick up the tab, of course the industry is going to adjust the cost to make as much money as they can.

 

Cosmetic procedures are OPTIONAL. Live and death procedures are too, or course. Perhaps only those that can afford to live should.

[JayB]

How do you reconcile this statement:

 

"if insurance doesn't pick up the tab, of course the industry is going to adjust the cost to make as much money as they can."

 

With the data showing that procedures not covered by insurance have been getting cheaper?

 

It's not that the guys running LASIK machines are any more altruistic than, say, interventional cardiologists - and that's why they've been dropping prices - it's because the prices they charge are transparent, subject to competition, and the folks getting their eyes done have an incentive to care about which eye-doc provides the best value for the price.

 

 

[olyclimber]

Because the free market insurance industry is fucked?

 

You know, the invisible handjob?

 

Did you read the part about procedures not covered by insurance being mostly OPTIONAL? Its like comparing buying a new Lexus to getting a life saving kidney transplant. Apples and oranges.

[Hugh Conway]

damnit oly, Jay_B needs a new Lexus. STFU.

[tvashtarkatena]

Um...non profits dont set prices that lose money any more than for profits do. They just dont jack them up to maximize profits at the expenses of the public good like for profits do. Single payer would negotiate prices with competing non profits.

 

Yes, sophistry, bait and switch, and misrepresenting your source material are all coommon jayb lying tactics. Right out of thr GOP playbook.

[tvashtarkatena]

We've had multi versions of this system successfully in place for many decades. Nobody is 'losing money... But care sure is cheaper and far more available.

[tvashtarkatena]

By all means tho we should continue to maintain real estate prices in The Hamptons w our health care dollars. That and hundreds of thousands of medical billing coders, our fastest growing industry, next to pet insurance that is.

[KaskadskyjKozak]

damnit oly, Jay_B needs a new Lexus. STFU.

 

I doubt he has ever owned a Lexus or any luxury car, so you are talking out of your ass again.

[tvashtarkatena]

Yet another joke that passes far, far over head.

Edited December 9, 2010 by tvashtarkatena

[KaskadskyjKozak]

Yet another joke that passes far, far over head.

 

*yawn* Keep talking about how smart you are. Really, it's convincing.

[tvashtarkatena]

Imbecility is apparent to even the most pedestrian of intellects.

[JayB]

Because the free market insurance industry is fucked?

 

You know, the invisible handjob?

 

Did you read the part about procedures not covered by insurance being mostly OPTIONAL? Its like comparing buying a new Lexus to getting a life saving kidney transplant. Apples and oranges.

 

In this case - the "free market insurance industry" has nothing to to with the procedures that are getting progressively cheaper - because they're virtually never covered by insurance, and nothing to to with Medicare's payment for this particular procedure - because it's...Medicare.

 

There are indeed emergency medical procedures that can't be scheduled. Then there are things like child-birth, cataract surgery, colonoscopies, etc, etc, etc that can be planned for and/or scheduled on a non-emergency basis.

 

The primary difference between, say, LASIK and a colonoscopy (aside from the fact that one involves the eye and the other the colon) isn't that one is optional and that the other is necessary - it's that one isn't covered by third-party payers and the other is. People who want to get LASIK done have a strong incentive to minimize the cost of the procedure, prices are transparent, and there's abundant competition. This isn't the case for procedures covered by insurance - either private or public, which is one of the primary reasons why the price of these procedures is continually increasing.

 

[JayB]

Um...non profits dont set prices that lose money any more than for profits do. They just dont jack them up to maximize profits at the expenses of the public good like for profits do. Single payer would negotiate prices with competing non profits.

 

Yes, sophistry, bait and switch, and misrepresenting your source material are all coommon jayb lying tactics. Right out of thr GOP playbook.

 

Except in this case - the prices at the rapacious and boundlessly greedy and selfish for-profit clinics that are dropping, and the prices at the non-profits that are steadily increasing.

 

Speaking of which - anyone remember McAllen and El Paso?

 

"“In contrast to the Medicare population, the use of and spending per capita for medical services by privately insured populations in McAllen and El Paso was much less divergent, with some exceptions,” the article’s abstract states.

 

“For example, although spending per Medicare member per year was 86 percent higher in McAllen than in El Paso, total spending per member per year in McAllen was 7 percent lower than in El Paso for the population insured by Blue Cross and Blue Shield of Texas. We consider possible explanations but conclude that health care providers respond quite differently to incentives in Medicare compared to those in private insurance programs.”

 

http://content.healthaffairs.org/content/29/12/2302.abstract

[JayB]

damnit oly, Jay_B needs a new Lexus. STFU.

 

I doubt he has ever owned a Lexus or any luxury car, so you are talking out of your ass again.

 

Listen - if a 99 Buick Century with a cracked bumper and a driver's side window held in place with mini-cell foam left over from outfitting my last boat doesn't qualify as a luxury vehicle than I don't know what does!

 

I certainly wouldn't trade it for a Lexus that comes along with a $50K loan!

 

 

[tvashtarkatena]

Um...non profits dont set prices that lose money any more than for profits do. They just dont jack them up to maximize profits at the expenses of the public good like for profits do. Single payer would negotiate prices with competing non profits.

 

Yes, sophistry, bait and switch, and misrepresenting your source material are all coommon jayb lying tactics. Right out of thr GOP playbook.

 

Except in this case - the prices at the rapacious and boundlessly greedy and selfish for-profit clinics that are dropping, and the prices at the non-profits that are steadily increasing.

 

Speaking of which - anyone remember McAllen and El Paso?

 

"“In contrast to the Medicare population, the use of and spending per capita for medical services by privately insured populations in McAllen and El Paso was much less divergent, with some exceptions,” the article’s abstract states.

 

“For example, although spending per Medicare member per year was 86 percent higher in McAllen than in El Paso, total spending per member per year in McAllen was 7 percent lower than in El Paso for the population insured by Blue Cross and Blue Shield of Texas. We consider possible explanations but conclude that health care providers respond quite differently to incentives in Medicare compared to those in private insurance programs.”

 

http://content.healthaffairs.org/content/29/12/2302.abstract

 

Yeah, I remember the New Yorker article about McCallen (highest per capita health care costs in the country). It flamed private health insurers and providers, and sung the statistical praises of well run non-profits, most notably Kaiser Permanente, as models for how we might move forward.

 

Prices are coming down amongst private health insurers? REALLY?

 

You are not a skilled liar, but you are a prolific one.

[tvashtarkatena]

Worry not, however. Billcoe still worships you.

[olyclimber]

just skimmed what you wrote as i have to take off, but it sounds like we are, in part, agreeing. however, maybe i just misread what you wrote. the two are apples and oranges.

 

 

getting back to my original joke: get rid of medical insurance all together! if you don't have the money for a liver transplant you should probably die. there are slight ethical problems with this, thats why I call it a joke. Is it a joke to you?

[tvashtarkatena]

just skimmed what you wrote as i have to take off, but it sounds like we are, in part, agreeing. however, maybe i just misread what you wrote. the two are apples and oranges.

 

 

getting back to my original joke: get rid of medical insurance all together! if you don't have the money for a liver transplant you should probably die. there are slight ethical problems with this, thats why I call it a joke. Is it a joke to you?

 

It's called the 'African System'. We already have it.