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To: QQQQQ
These numbers ring true for me--

Cost-shifting, IMO, was an effective way for the medical system to cover the care of paupers. But as medical care costs rise, it will become untenable.

One thing that is tough to face for the resentful public is that their medical care is far better than it used to be--the treatments are much more effective. Just look at survival rates for cancers, and the reduction of the crippling effects of heart disease. More and more surgery is handled by nifty little miniature gadgets that make for smaller incisions and quicker healing times.

In short--it gets better and better, and more and more expensive.

Medical care is unique among consumer goods in that the consumer has no choices as per quality. That is--you can buy an old clunker to drive, or you can choose to buy a sleek upper-end Mercedes. But in medical care, you can only buy the Mercedes. There is only one kind of medical care available--the newest, brightest and best.

You did not mention the huge costs we incur in supporting the lawyer class--not just in legal fees and settlements, but in the defensiveness of hospital administrations. They sure won't risk buying anything but the Mercedes, even when the old clunker would do just fine!! It's a matter of demonstrating "good faith" in court. There are many older treatments that could be used to save costs that would not result in poorer quality, just less sparkle and whizzbang.

In short, provide a legal safe harbor for cost-consciousness.

68 posted on 06/08/2005 12:43:17 PM PDT by Mamzelle
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To: Mamzelle
Very good points. You hit on one of my pet peeves though... definitions:

Efficacy= better than nothing
Effectiveness= better than what is already available
Quality= meeting expectations
Value= Quality/Cost

Healthcare in the U.S. has high Quality, but poor value. Using such outcome measures as survival rates gives evidence of effectiveness, possibly quality, but not necessarily value.
71 posted on 06/08/2005 12:56:21 PM PDT by Dr. Free Market (Character is doing the right thing when nobody's looking.)
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