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I found the article linked below on the Rick Ray blog on the Archimedes Movement “We Can Do Better” website. I’m wondering what you all think about it. Please reply to the list, not to me, preferably in your own words.
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I have mixed feelings. I think we need more medical effectiveness research, by people who don’t have a financial conflict of interest, with the results published on the Web so that we can avoid unnecessary, and risky, medical treatment. We also need to pay more attention to the research already done. See Overdosed America by John Abramson and Overtreated by Shannon Brownlee.
On the other hand, I’m uneasy about using this research to make rules about what treatments should be paid for by private or public insurance. I would like to know more about how that would work, a specific plan. Who will make the rules? Both private and public insurance, rightly or wrongly, already have treatment exclusions. One of the most bizarre is that Medicare part B doesn’t cover physicals.
The article says, “It’s not the profits of the drug companies or the overhead of the insurance companies that make American health care so expensive, but the financial incentives for doctors and medical institutions to recommend more procedures, whether or not they are effective.”
We have frequently heard that 30 cents out of every health care dollar goes to pay for insurance company profits and administration, and dealing with the insurance companies by health care providers. How can he say that’s not what makes “American health care so expensive”? Surely it’s at least a major factor. It is the reason most health care activists prefer a government-run, “single payer” system.
I do agree that we need to curtail the “financial incentives for doctors and medical institutions to recommend more procedures”. One way to do that, suggested by Brownlee, is to put doctors on salary, as is done by Kaiser and the VA.
Lynn Porter
“Obama’s Difficult Choices on Medicare Spending”
http://wecandobetter.org/node/2911
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