I'm not so sure about this skin-in-the-game argument. Maybe with elective surgery - cosmetic, hip replacement and the like. And maybe if the copay is substantial enough to make you really think twice about it. But do we really want to encourage people to hobble around all their life rather than get a knee replaced? ...
The copay for a regular doctor's visit is not a good example of how to have the patients getting more involved. Most of the health care cost is in hospitalization, I believe.
Doctors decide on how to treat patients, but here is a national panel that decides on whether the NHS will pay for a treatment. Recently there have been some cases where an experimental cancer drug was not available on the NHS and this gets headlines. That's the deal you make for overall care for everyone. The UK populace likes that deal and the NHS is UK's political "third rail". I don't think such as system would be appropriate for the US because of it's emphasis on individualism rather than the collective good.
Yes! There are people who argue that human lives are so precious that no expenses should be spared, no experimental treatments should be denied. We can bankrupt any country that way.
On the other hand, if people want to pay out of their own pocket for any nebulous treatment, I hope that they are allowed to.
From Tadpole:
"Anyone who has not read this article from the New Yorker really should because too little of the conversation goes down to the health care delivery area:
McAllen, Texas and the high cost of health care : The New Yorker"
I've been a registered nurse working in health care for over 35 years. This article reminds me of something a colleague said many, many years ago...which was "The most expensive thing in health care is the ball point pen in a physicians hand."
I can't even begin to describe the thousands of useless tests, procedures, consults and therapies I have seen prescribed. But....health care is a product, and if you go to where they sell it....they will try and force you to buy top-of-the-line, even when there is no clear advantage to your health.
Thank you, thank you for sharing this article!
It shows how the lack of top-down coordination and a nationwide policy result in such disparity in hospitalization costs between different parts of the country, and how more money spent does not result in better health care.
About "having own skin in the game", I can relate to this with my own experience. As I worked part-time at my leisure during the last year of my late father's life, I was able to spend a bit of time with him in the hospital, although not as much as my mother who was there everyday. I saw various tests done on my father, some repeatedly with ambiguous results. When I pressed the staff about what would be done if the test results were positive, they replied that nothing would be done anyway. My father's poor health would mean he would not come out of the operating room alive. And as his body was falling apart, there were some conditions that had no treatments.
My mother, being an assertive woman, wanted to be sure that no available tests or procedures would be spared, no matter how nebulous some of these were. I could tell that doctors had given up on my father, but he wanted to live, and my mother could care less about how much something cost or what little result that would bring. If the cost came out of my mother's pocket rather than Medicare, perhaps she would get a bit more involved in understanding what the tests were for.
Did the hospital do all those tests because they wanted more money, similarly to the story told by the article referenced by Tadpole? Or were they afraid of getting sued for not pursuing all avenues? I do not know the answer, but the one thing I was sure of was that many things were done to no avail.
As I loved my father, I was torn to see him put through these fruitless procedures that gave him even more discomfort. But how could someone tell a patient, particularly your loved one, that it was hopeless? People do not live forever, no matter how much money is available. I have been trying to tell my family members that beyond a certain point, money does not buy longevity. Billionaires die too, and do not necessarily live longer than us peasants.
