Forcing Medical Patients To Be Consumers Wreaks Havoc on Our Health System

[marmar]

from Health Beat, via AlterNet:




Forcing Medical Patients To Be Consumers Wreaks Havoc on Our Health System

By Niko Karvounis, Health Beat. Posted February 22, 2008.

The price tag of health care for the uninsured is over $40 billion. Maintaining a market-driven system will only drive that bill higher.



One of the most common justifications for consumer-driven medicine is reduced health care costs. The reasoning here is two-fold:

* Since they're high-deductible and low premium, consumer-driven health plans require more out-of-pocket spending. Consumers are more cost-conscious when they have to actively shell out for purchases. As a result, they will user fewer health care services -- and thus overall health care costs will fall.

* If consumers are in the driver's seat, competition in an open market will drive prices down. For-profit providers will want to offer the best deal to get the most business. Consumers will also have better information thanks to the commoditization of medicine, which will translate medical jargon into universally comprehensible knowledge. Smarter consumers translate into less over-payment for services.

This is standard-issue free market orthodoxy at its finest. Unfortunately, this isn't the whole story. In fact, there's an even stronger argument to be made that consumer-driven health plans could lead to higher health care costs.

The Wrong Patients Forgo the Wrong Care

Research by the RAND Corporation's health insurance experiment shows that when you shift costs to the consumer, patients forgo both wasteful and effective care. And this is particularly true of the patients who cost us most in the long run -- those suffering from chronic diseases.

A 2007 paper from the National Bureau of Economic Research looked at retired California public employees on Medicare, and its findings contradict some of the basic assumptions of the consumerist movement. .......(more)

The complete piece is at: http://www.alternet.org/healthwellness/77396/

[Delphinus]

1. I'll read the whole story when I get home from work,

but wanted to comment that I know, firsthand, that even though I have insurance, it costs me so much to have it, I've no extra money to go see the doctors for care.

I've no problem with people and companies making money - we all need to in this society - but I think we need a Universal Healthcare Plan.

[izquierdista]

2. The word "consumer" is fallacious

One of the axioms of free-market capitalism is that the "consumer" has free access to all available information and is thus making an informed selection of the choices available to him. In the case of medical services, the patient knows only that he has symptoms and wants them cured. He has no specialized medical knowledge, no idea of the range of treatments that are available, no way of comparison shopping recommended treatments, and very little choice of what doctor to go see, and very often is not conscious to make a decision (as in the case of emergency room admissions).

It's too bad that the only way to convince a conservative that he is not a "health care consumer" is to plunge a knife into him, and while the blood is pouring out, ask him if he would like the wound closed with catgut or nylon, and explain that while one is cheaper, the other is less likely to itch later....and then there are the absorbable sutures that don't even need to be taken out later...or if you are concerned about the cosmetic appearance, you could put in some butterfly sutures, approximate the edges, and finish with some tissue glue on top....but that would be the most expensive option, since it is the most time consuming...take your time, your haven't lost too much blood yet, now once you decide which kind, let me tell you about the different brands you have to choose from, the Chinese is, of course, the cheapest, but for almost the same price, you can get the Pakistani brand.

[flashl]

7. Well said. nt

[dysfunctional press]

3. the problem with having the appearance of so many choices in everything-

is that consumers simply can't be that savvy about everything.

cell-phone contracts, insurance plans, mortgage/home-equity loans, car loans, medicare drug plans, and on and on...

most 'consumers' are just average people- they aren't experts in finance or contract law or marketing- but the sellers have people who are. and the people doing the selling only have to be experts in their chosen field- in order to make the best choices, consumers have to be or aquire expertise across a wide range of products/services...and many if not most people would be most interested in a quality basic product that can perform it's main intended function in a simple and dependable manner- instead we get all sorts of unnecessary/unwanted/unused 'bells & whistles' that can be added on to increase the price, but not offer any real added value to the consumer.

is it too much to ask for basic products and services that are priced fairly and understandably?

[flashl]

5. Elegantly and succinctly stated. nt

[edhopper]

4. So I'm lying there

in the emergency room with acute appendicitis. The Doc tells me I need an immediate appendectomy. I say, What are your rates. And I want to call around to see if I can get a better deal from another hospital. He says I have an hour to live and as I pass out I say I want service agreement with my operation.
Free market medicine, an oxymoron.

[fascisthunter]

6. The American Economy Thrives Profits from Human Tragedy

people wonder why some of us call free-marketeers the BORG.