Posted here as a separate subject, although there have been indirect references to it in other threads... ie "10 tests to avoid".
The wiki reference is here:
Evidence-based practice - Wikipedia, the free encyclopedia
but there are numerous references thoughout Wiki and the Medical community
with terms such as "Evidence Based Medicine", Outcome Based Practices etc...
It may be important to all of us, monetarily, in the very near future, as medical costs spiral upward.
To begin, is to acknowledge and understand that there are vested interests that come into play, on two sides. One, is the total effect that medical costs has on the economy, and the "WHO" who pays for the products and services. On the other side, are those who benefit from these same products and services. Thus the political importance of the issue.
On the one hand, the point of the "Greater Good"... the overall effect on society as a whole, as in saving money for all... and the interest of others, who are directly affected.
An extreme example might be the costs of developing a medication (let's say $100 million) to the benefits to a small group of 20 persons that this medication might help, or even save their lives.
And so we come down to the basic issue: The acceptance and furtherance in medicine of those products and services that are cost efficient. That would eventually mean that costs would go down, because insurances of all kinds, private and government would eventually reduce payments for, or not pay at all... for medical pharmaceuticals or procedures that had an tiny chance of being successful... (a made up example)... a full hand transplant that cost $300K, but had only a 3% chance of success.
We experienced an example of this kind of selective payment system, when my wife experienced severe leg pain, from varicose veins. Prior to the operation (stripping the veins), the doctor performing the operation had to get clearance from Medicare for payment. Medicare rejected the request, and the question for approval had to be put before a board of doctors, who eventually recommended approval.
Since the subject is coming more to the fore, knowing something of the background of the Why's... may help to understand the coming news items and progress of "outcome based medicine".
As mentioned in the "tests to avoid" thread... the AARP/insurance connection, should not be overlooked as motivation for the article.
The wiki reference is here:
Evidence-based practice - Wikipedia, the free encyclopedia
but there are numerous references thoughout Wiki and the Medical community
with terms such as "Evidence Based Medicine", Outcome Based Practices etc...
It may be important to all of us, monetarily, in the very near future, as medical costs spiral upward.
To begin, is to acknowledge and understand that there are vested interests that come into play, on two sides. One, is the total effect that medical costs has on the economy, and the "WHO" who pays for the products and services. On the other side, are those who benefit from these same products and services. Thus the political importance of the issue.
On the one hand, the point of the "Greater Good"... the overall effect on society as a whole, as in saving money for all... and the interest of others, who are directly affected.
An extreme example might be the costs of developing a medication (let's say $100 million) to the benefits to a small group of 20 persons that this medication might help, or even save their lives.
And so we come down to the basic issue: The acceptance and furtherance in medicine of those products and services that are cost efficient. That would eventually mean that costs would go down, because insurances of all kinds, private and government would eventually reduce payments for, or not pay at all... for medical pharmaceuticals or procedures that had an tiny chance of being successful... (a made up example)... a full hand transplant that cost $300K, but had only a 3% chance of success.
We experienced an example of this kind of selective payment system, when my wife experienced severe leg pain, from varicose veins. Prior to the operation (stripping the veins), the doctor performing the operation had to get clearance from Medicare for payment. Medicare rejected the request, and the question for approval had to be put before a board of doctors, who eventually recommended approval.
Since the subject is coming more to the fore, knowing something of the background of the Why's... may help to understand the coming news items and progress of "outcome based medicine".
As mentioned in the "tests to avoid" thread... the AARP/insurance connection, should not be overlooked as motivation for the article.
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