Fewer options, better healthcare?

Discuss

21 Responses to “Fewer options, better healthcare?”

  1. EH says:

    That would decrease the influence of marketing.

  2. awjt says:

    We know for a fact that when given a humane, informed choice of treatments, patients tend to choose the less expensive one.  …AND have better outcomes.

    (I work in epidemiology and this is one of the keynotes that we’ve been working to shape policy with.)

    • dioptase says:

       I often try to explain to people that basic universal healthcare could be pretty cheap.  Immunizations, prenatal, etc. have huge benefits at relatively low cost.  I think that could be sold to the American public pretty easy.

      • PaulDavisTheFirst says:

        “basic universal healthcare” is not what the argument about healthcare in the US tends to focus on. its true that we need to do a better job on this stuff too, but the contentious stuff seems to be the transplants, the hip replacements, the cancer treatments, and so forth. how to grapple with the very different attitudes that people seem to have over whether these should be part of “basic universal healthcare” or limited to privately (insurance or personally) funded treatment is a central problem in reaching any kind of consensus.

        then there is “basic” stuff like the cost of a single day in hospital (without any particular treatment), or basic in-hospital treatment and tests (xrays, mri etc).

        • awjt says:

          Heroic measures at the end of life account for an order-of-magnitude disproportionate share of medical spending in the USA.  To do anything proactive about curbing those costs risks getting yourself branded as a “death panelist.”  It’s not the health care that’s the problem.  It’s the greater problem called “pig-ignorance.”  That is, ignorance flavored with extreme recalcitrance.  The USA will need a lot more than just new ideas… we have to get past the old, bad ones at the same time.  Easier said than done.

          • digi_owl says:

            This seems to be humanly universal. We will “euthinice” a animal for the slightest issue, yet keep a human on life support long after the brain has rotted away.

  3. Layne says:

    Or you know, we could always just let people choose for themselves…Nah, decisions by committee groupthink are ALWAYS better for innovation and happiness. While we’re at it, let’s limit the selection of computers, cars, haircuts, books, food, etc etc ad infinitum. Too many choices for the poor, mentally overwhelmed plebes!Some people can’t rest if they’re not *trying* to come up with even stupider ways of making life one huge red-tape ordeal…

    • Todd Knarr says:

       Except that this isn’t like the choice of food. Food doesn’t require extensive research and education to understand, and mostly it doesn’t matter exactly what food you eat when it comes to getting nutrition. Medical treatment, OTOH… I go to the doctor *because* I don’t have the background to know which treatment’s going to be the most effective with the fewest side-effects and which treatments are snake-oil. To get to that point I’d have to go to medical school and become a doctor myself. So why exactly shouldn’t we let the people who know the subject do the research, figure out what works best and what doesn’t work at all, and then accept their advice when it comes to their specialty?

      I roll my eyes at that position just like I roll them at the MBA with zero experience with computers and who’s proud of the fact trying to tell someone who’s been doing software development for 25 years how they ought to be doing their job.

      • PaulDavisTheFirst says:

        I agree with everything you’ve said, but I would note the opening of the original article:

        The common belief is that only doctors truly know what works and what doesn’t. But the argument falls apart because most doctors lack the evidence to compare various treatments in any absolute way.

      • Antinous / Moderator says:

        So why exactly shouldn’t we let the people who know the subject do the research, figure out what works best and what doesn’t work at all, and then accept their advice when it comes to their specialty?

        Well, the fact that in the real world the studies would all be funded by drug companies who would stop funding researchers who didn’t come up with marketable results might be a bit of a problem.

    • SedanChair says:

      Just stop, your right-wing talking points will find no resonance here.

    • C W says:

      “Or you know, we could always just let people choose for themselves…”

      The false dichotomy of “allopathic” and “holistic” medicine is a sign that this is a terribly stupid idea. Reality doesn’t care about your opinions.

    • Shinkuhadoken says:

      Or you know, we could always just let people choose for themselves…Nah, decisions by committee groupthink are ALWAYS better for innovation and happiness. While we’re at it, let’s limit the selection of computers, cars, haircuts, books, food, etc etc ad infinitum. Too many choices for the poor, mentally overwhelmed plebes!Some people can’t rest if they’re not *trying* to come up with even stupider ways of making life one huge red-tape ordeal…

      Your analogy is poorly considered. I can grow vegetables in a garden, and invite my friends over for a delicious salad I made myself. What I can’t do is perform surgery. It’s against the law for a very good reason: I don’t know what the hell I’m doing and someone could die or be seriously injured from my ignorance.

      It’s long been understood that medicine can only be practiced by certified professionals. And while patients do have choices, they require the guidance of someone who can legally practice medicine.

      Consumerism makes for bad medicine that offers terrible choices, with problems ranging from unnecessary procedures consuming limited resources; to emergency rooms filled with near-death uninsured rather than offering a route to cheaper preventative medicine; to overpriced “me too” medicines that don’t susbtantially offer anything different than its previous, cheaper iteration. Pressuring doctors to maximize profit over what’s medically necessary is a big reason for the spiraling costs to health care that’s en-route to crippling the entire American system.

      • digi_owl says:

        Consumerism in general is a poor concept, as it masks the  issue that a customer is also a worker. Only the very elite can actually live a consumerist lifestyle, as their funds and such basically provide them with a never ending supply of spending power.

  4. It would also halt accidental discoveries.

  5. MichaelDalin says:

    I know this is a little off topic, but does anyone really believe that the democrats could have changed this country’s opinion about Obamacare if they had sold it better? I mean, if half the country truly believes that this bill set up death panels, how are the democrats suposed to rationally convince these people otherwise? 

    • StreetEight says:

      Given that the majority of Americans apparently believe that they are entitled to (a) receive all the health care they might possibly desire to consume, and (b) stick someone else with the bill, it seems likely that any attempt to introduce fiscal or demographic realities into the discussion is going to result in accusations of “death panels” and Nazi-style eugenics.

  6. StreetEight says:

    Ideally, the government program should cover a limited range of treatment options, while those desiring a non-covered alternative should pay their own way.

    • awjt says:

      It already does. The problem is that those people still have comorbidities and strain the system with ER visits and pesky little issues like dying slowly.

  7. niktemadur says:

    Freedom of choice is what you’ve got.
    Freedom from choice is what you want.

    http://www.youtube.com/watch?v=dVGINIsLnqU

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