A guy with a minor cut on his back is bombarded with a 24/7 targeted ad campaign for ScarAway!TM, that convinces him this experimental...er..."cutting-edge!" UV treatment is the only thing standing between him and a constant stream of fawning, eager females twenty years his junior. He then obtains this treatment from his "true believer" local doctor at the low, low price of a $2,000 "co-pay" for himself and $20,000 from his insurer. After three months of ScarAway!TM his back is of course completely disfigured and looks far worse, at which point his own wife refuses to sleep with him, necessitating years of therapy. A decade passes and he is diagnosed with melanoma from the UV he was exposed to and dies one year and one million USD in healthcare costs later. The most memorable moment of his son's wedding is a tearful toast to his deceased father, whilst each of the doctors involved in his "treatment" as well as the ScarAway!TM salesman cut checks to their engaged children.
> I don't know why people keep setting up false equivalences and false dichotomies in these discussions.
Maybe it's fun? I honestly don't know. This scenario is certainly vivid. It's not the only option other than... I'm not sure what alternative people are planning, as I said above. They tend to gloss over who actually decides when a procedure isn't worth it. And they gloss over how normal people without lobbyists get the system changed when it stops working.
>There are very few scenarios now where the consumer benefits from saying "no" or "less" to their doctors.
is totally off base. The primary benefit to saying "no" is avoiding damage to your health from dangerous and unnecessary treatments that American doctors have a financial incentive to sell. People in the U.S. have their life expectancy reduced every day because we, almost uniquely among developed countries, have removed nearly all limits on the cultural acceptability of medical professionals and the medical industry as a whole treating patients as sales marks rather than patients. If you would like to experience this firsthand, respond to any AdWords or TV advertisement for a medical treatment. The sleaze is limitless.
>They tend to gloss over who actually decides when a procedure isn't worth it.
Salaried civil servants with advanced degrees who have an interest in cutting through BS to protect the health of the country. If you want to reduce people like Frances Kelsey to "unelected government officials" be my guest, but you're only showing how naive you are.
Who wants doctors out of the loop? I want them more in the loop.
Doctor-patient relationships don't work that way. If they did, we wouldn't have people getting illicit prescriptions from doctors. Doctors, surprise, do listen to their patients wishes and accommodate them when they're OK with what the patient wants.
Doctors should be advising us, "Here are your options (with prices). What do you want to do?" One option on the table for "laceration on your back" should be "have an uglier scar and give a big check to your son as a wedding present". Right now, with good insurance, there's no incentive not to treat you like an underwear model that needs scar-free skin and do experimental scar-lightening UV treatments.
If a procedure (or doing nothing) is foolish, of course good doctors won't put that on the table. But single payer doesn't have doctors and patients making these decisions. They would instead look at a pre-determined schedule of options as handed down from the Bureau Of Wellness. Maybe, because of lobbying and political infighting, "uglier scar" is the only option. "Check for my engaged son" certainly isn't on the schedule.