[ExI] Medical Costs

[Tom Tobin]

On 2/18/08, Lee Corbin <lcorbin at rawbw.com> wrote:
> Stuart writes
>
> > Well if you saw how much a hospital bills insurance companies for a
> > piece of gauze, you could get the feeling that the medical industry had
> > that attitude. It is a very strange industry to say the least.
>
> The medical industry is "strange" only because a disconnect has been
> created between who receives the service and who pays for it.
>
> If a *patient* received such a bill for a piece of gauze, of course he'd
> be outraged by it, and he'd make sure that the doctors and the
> hospital felt his pain---and most importantly of all, he would
> take his business to another doctor and another hospital. But
> it's only an *insurance* company that gets the bill---and try
> as they might to protest and to try to force doctors and hospitals
> to economize (or forego procedures)---it finally is easiest to just
> raise their rates.

Err, yeah, because I'm in my right mind when I'm badly injured and
need medical care *now*.  ^_^

What *does* seem broken under the current system is the extraordinary
care that goes towards newborn infants, vs. mediocre care for many
adults.  Any adult of at least middling intelligence is worth more
than *any* infant, and it strikes me as insane that medical resources
are poured towards the latter without any thought to cost.

> Later on, for all things it will be only the *government* that gets
> the bill, and the bureaucrats will find that the easiest path is just
> to raise taxes.  Luckily, less than half of the voting population
> pays 95 percent of the taxes, and so the electorate won't have
> any problem with higher taxes.

That isn't necessarily shocking or provoking math; I'm worried more by
democracy than by progressive taxes.  :p

> > Which is why cancer patients end up being diagnosed too late for
> > surgical resection and macho men having heart attacks insist on driving
> > themselves to the hospital.
>
> You sound as though you want to take this freedom away too.
> You'll want to be forcing those macho guys to get checkups
> whether they want to or not?

I want them to realize that they don't have to play
checks-and-balances weighing their life vs. the cost of an ambulance
ride.  Forcing them to get a checkup?  No.

> I admit that medical care will be better if people's choices in
> the matter are taken away. I mean, even after you make cancer
> diagnosis completely free, people will still face "costs", e.g.,
> the inconvenience or fear (or humiliation) of getting a checkup.

I don't think we can reasonably help that; we can only make it as easy
as possible.  We'd get far more bang for our buck, though, by
concentrating on prevention.