Healthcare commentary

[unixronin]

From an OOB discussion with johnkzin:  Prevention may be better than cure, but treatment is WAY more profitable than prevention.

Discuss.

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(Crossposted to neph_politics)

Comments

[bratling.livejournal.com]

No, this doesn't follow.

Non-profit and not-for-profit want to minimize cost. A for-profit organization wants to maximize profit, which isn't necessarily the same thing. Given a procedure with a cost of $40,000 on which they can make a profit of $20,000, or a procedure with a cost of $75,000 on which then can make $60,000, many for-profit operators will opt for the $75,000 procedure, even if it's no better for the patient.

okay, let's check our definition of terms. we may not be talking about the same thing.

an HMO is a Healthcare Management Organization. They are basically a healthcare insurer, except they also often are providers as well. As a provider that is paying themselves for the service, where do they make money?

Now, in the case of me, where i used to have Blue Cross/Blue Shield, but used an HMO as my provider because it was close to home, fast and competent (and referrals involved walking down the hall, not driving across the city and taking another day off of work), yes, in such a situation that HMO would be motivated to run a more expensive procedure, because they aren't paying for it. but this is a very atypical scenario for HMOs -- i had an unmanaged healthcare plan where i could choose my own provider, and used an HMO. that's not an HMO's bread and butter.

i'm pretty sure that you're describing a non-insuring provider (such as a hospital, doctor or clinic), not an insurer or a self-paying insurer-provider (which ultimately foot the $90,000 bill).

[unixronin.livejournal.com]

Oh, I'm sorry. I think I inadvertently over-generalized your statement.

[bratling.livejournal.com]

i thought so.

i've actually been spending a lot of time lately wondering where the money goes. everybody talks about the high cost of healthcare, but why is it so high?

Nurse Practitioners are very well paid -- starting salaries around here are $70,000 -- but that still breaks down to not very much per patient visit. Surgeons assistants are paid almost criminally low wages for the painstaking work they do. Doctors are well paid, but have over a decade's education to pay back -- i don't think most are overpaid, especially not the GPs that most people see most of the time. i'm convinced that not much of the money goes to the individuals providing the services.

i should probably just scape together some money, buy some Phizer stock and call it a night...

[unixronin.livejournal.com]

I know one thing I have heard of is that in many areas, particularly rural areas, general practitioners are opting out of the insurance system altogether. They won't take any insurance, but they save enough by not having to jump through all the paperwork hoops that they can afford to charge office-visit fees close to the copayments required by many insurance plans for the same office visit.

[bratling.livejournal.com]

wish i could find one of those...