"HeyBub" wrote in
m:

dpb wrote:

The "competition" between physicians for expert medical care is a
fallacy -- in general the consumer has insufficient expertise to
judge quality or to know how to select alternate care options for the
highest efficacy. When forced to make difficult decisions on perhaps
life-or-death issues, in the end its not likely that the overriding
concern will be the cost. Easy enough to hypothesize that's what the
so-called rational consumer SHOULD do, but just as the markets are as
much or more emotion-driven, health care choices are as well.

I can't answer all your concerns, but quality can be judged by those
competent to make the call; in this case, your family physician. If he
refers you to a specialist that's not quite appropriate, some of the
blame will trickle down to him and he'll (usually) adjust his
referrals accordingly.

That's indeed the ideal situation. I wish it were true for more people,
including me, and I work in hospitals, albeit as a bench-type researcher.

My internist has referred me to three different specialists
(opthamologist, plastic surgeon, and orthopedic physician). Upon my
return to him, the internist inquired as to whether I was treated
properly by the referral.

The health-care delivery system in the U.S. is not perfect by any
measure. It is, however, like democracy, better than any other system
available. While there are problems, the vast majority of Americans
are satisfied with their options.

I'm not sure the majority is, and maybe some who are shouldn't be. That
goes vice versa as well. Some patients are just not taking the care they
should. Things as simple as the correct answer to have you recently
taken aspirin or other similar medications are not answered correctly (I
can prove this in my work).

What worries me is that the very real possibility of ****ing-up
something that works properly for 250 million citizens in the hope
that a few under-served people will be helped.

Yes, that is pssible. The reverse is much more likely.

Another issue - and I don't recall whether you mentioned it - is
physician liability. My state, Texas, instituted a severe tort reform
measure four years ago. Among other things, it capped non-economic
losses (pain & suffering, punitive damages) at $250,000. We've stopped
hemorrhaging physicians and, in fact, had a tremendous increase in
doctors moving here from less-enlightened places.

Congratulations. That example should be followed everywhere. In
addition, physicians who make bad decisions should get more than a
friendly pat - some should be really punished, and it should NOT be
covered by insurance.


--
Best regards
Han
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