Re:I'm a Brit and America, your health care system is tortur...
by tptacek on Friday January 04, 2019 @05:09PM
(#18828159)
There are a bunch of ways to rebut that argument. First, you can look at private systems that don't have these problems (ie: all the rest of the private systems). Second, you can note that Medicare, our single-payer system, interacts with the same structurally inefficient provider system. And, of course, if we switch to single-payer tomorrow, we're still going to be doing most care on an outpatient basis (because we should), and are still as a result going to be overprescribing procedures to patients.
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Re:I'm a Brit and America, your health care system is tortur...
by dragonwriter on Friday January 04, 2019 @05:14PM
(#18828203)
> Second, you can note that Medicare, our single-payer system,
Medicare is not a single payer system, but a partial-subsidy voucher system for highly-regulated private insurance with (for the core inpatient and outpatient components) a fully-paid public option.
Re:I'm a Brit and America, your health care system is tortur...
by tptacek on Friday January 04, 2019 @05:17PM
(#18828237)
Fair enough. Consider my rebuttal so revised.
Re:I'm a Brit and America, your health care system is tortur...
by dragonwriter on Friday January 04, 2019 @06:42PM
(#18828829)
Let me expand on that: Medicare has recognized the problems you mentioned and has, fairly recently, begun directing efforts through payment system at the first broad class (inefficient interventions) through adoption of a variety of quality-incentive payment systems. But those aren't going to be as broadly effective, even for Medicare fee-for-service patients, as they could be if delivery systems and practice is shaped by conflicting incentives from different payers (who may be involved in covering some of the same claims, because coordination of benefits is a real thing, and even when they aren't for the same claims, will often over time be for treatment of the same patient.)