Medical Economics 101
12/08/09 - MDOD by 911Doc
911Doc practices Emergency Medicine. He writes about what happens to doctors and patients when a bureaucracy sets prices and rewards. The emergency department became a jungle. He now works for lower pay in an environment where he can be a doctor under reasonable rules.
[edited excerpt] What happens when the government imposes price controls? You can find out for yourself by reading "Basic Economics" by Thomas Sowell. (For purchase at Amazon or free online as PDF -ag) He is a black conservative with the Hoover Institution, so half of you can quit reading, because you care more about that fact than you do about logic.
Here is what happens in my little branch of the world. When price controls are imposed in medicine, EMTALA is a good example, then particular medical procedures and services lose any meaningful relation to their actual worth. Price and cost cease to have any real relation.
I'm happy with my pay cut and have no plans to go back and use my unique skills in the ER. The ER is a circus of pain and silliness, and the same kind of silliness is being debated right now in Washington. You should pray that it doesn't pass.
I find myself in agreement with what Shrodinger's Cat said a few years ago. They could pay him four times as much, and it would not make it worth working in the ER. Good luck all.
[edited] A lame piece on PBS pushed government healthcare, highlighting the amazing medical services of several other nations and how cheap they are. They used Japan as an example.
My inlaws have lived in Japan for over 20 years. They have ample experience with the healthcare system in Tokyo. The government sets the cost of everything from an office visit to an aspirin. PBS didn't mention that Japanese health care is based on rationing. It is not overt rationing, but that is exactly what it is.
They depend on Eastern medicine first. No matter what you come in with, they give you a little purple powder to mix up and try first. If it doesn't work, you come back and get a crack at Western medicine. Maybe you get sick and die, too bad. No one under the age of 12 can get an organ transplant. Hospitals do not accept ambulances. If you have a heart attack, you die in the bus. Japanese doctors strongly rely on the wait and see approach, even if current medical literature stresses prompt action.
Healthcare in Japan is 20 years behind the US. Yes, they make those robots for laproscopic surgery, but they don't use them, or they don't know how.
My mother-in-law fell and had a blow-out fracture of the orbit. She had a sagging eyeball and severe double vision. Her Japanese surgeon insisted that she wait a month to see if it got better. If not, they would operate to remove a piece of bone from her hip to plug the hole in her eye socket. This is about 20 years behind what a U.S. surgeon did, two weeks after the accident.
My in-laws can buy the best. The problem is, you just can't buy that in Tokyo thanks to the government.
(There is more.)
ER Medicine and Bureacracy
08/31/08 - MDOD by 911DOC
Medicine becomes more expensive, harder to do, with worse outcomes, as government imposes intrusive regulation and arbitrary quality measures, despite good intentions.
Government Motto: You say you are a caring doctor, so treat the poor for free.
The Medicare Tomato Market
06/24/09 - EasyOpinions quotes The Happy Hospitalist
A readable analogy and explanation of Medicare economics. Say that tomatoes were declared vital to life and made available free through the Medicare National Tomato Bank. The story of the healthcare market is translated to the tomato market.
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