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|The Bill To Fix Health Care - Permanently; entered at 2017-04-01 11:18:39
Registered: 2011-09-10 Virginia
"You didn't read the ENTIRE SECTION on defensive medicine stoppage."
You are right, I didn't. Arguement accepted. Apology offered.
"What's wrong with a diagnostic charge....Nothing."
Agreed. Your model has to accommodate multiple diagnostic charges over time though. It's not efficient to order the whole universe of testing possible for each first presentation. First round of tests may surprise you and take you in a different direction. Furthermore, disease manifests itself differently over time so your labs can change over time. Autoimmune diseases in particular can take months to pin down. Even then they continue to change. Additionally, some procedures are both diagnostic and therapeutic at the same time. What is also true is that doctors by and large don't own the labs and imaging centers. Other corporations and hospital centers do. They set the prices for much of the diagnostic side. Stark regulations rightly limit the ability to self refer. Currently when I order a CT scan the patient is given a choice where to pursue it. I don't set those prices and the entities that do suffer from the same smoke and mirrors pricing we are fighting against. As a doc I can only charge for my component of the aggregate service. On the therapeutic side we have the same challenges. Multiple parties with their own charge structures. We could do away with Stark and let mega healthcare corporations own everything but then i think we have decreased competition.
"Except you don't like that model in medicine, because you can't assrape the customer any more."
I'm on your side Carl. As your post is a direct reply to my comments and you refer to the model of medicine afterwards I have to assume "you" means me personally. As you have never been my patient you are not in a position to judge how I treat patients.
"How come it didn't cost $300,000 (in today's money) in the 1960s to become a doctor?
Good question. Financialization, federal student loan programs?
"Did the human genome magically change to something 100x more complex?
The human genome did not change significantly. But advances in medicine have increased the complexity significantly.
"Or did you just start fucking people in the ass, starting with an entitled mentality drilled into your head in medical school?"....."You sound an awful lot like the snowflake that takes out $150,000 in debt to learn....... painting. Or.... sociology."
Again, I'm on your side Carl.
And no I did not start fucking people up the ass...with an entitled mentality. I'm no slowfake either. I calculated the risk reward of the cost of my training and borrowed only what I had to. I worked while I was in graduate school to minimize debt. I worked six and seven day weeks for the first ten years after graduation to pay off my and my wife's student loans. I have no debt, I could "leave the system" tomorrow as you have described but I have chosen to keep working because it's what I love to do. Inspite of all the regulation and BS. I've haven't practiced "defensive medicine" and I've personally seen to it that patients who choose to come to me get the most efficient care possible. I've watched docs in my area make more money because they over test, over prescribe, and do unecessary surgery. Everything you've riled against. I've waited for the insurance companies or the feds crack down on this stuff but they haven't. I nievely thought the insurance companies would eventually recognize my and others efficiency on everyone's behalf but it never happened. So like you, I am blessed with a large following of people who see value in the service I deliver.
You are right, I didn't read the whole "bill." But my post was in good faith, attempted constructive criticism, and I kept it to a discussion of the model.