Private sector or public sector: Which is more efficient?

[Tupac Shakur]

Have some consideration for your quality of life, man.

[Hauldren Collider]

Breaking a caffeine addiction is easy. Wusses

[Tupac Shakur]

You've never experienced the real work and real responsibility that makes caffeine necessary.

[Aeson]

Caffeine isn't necessary. You're just weak.

[Kitschum]

Caffeine is the blood in your veins. It is life. If you're against caffeine, you're against life itself.

[Tupac Shakur]

Caffeine is the blood in your veins. It is life. If you're against caffeine, you're against life itself.

[Hauldren Collider]

This brings up an important question: Do Mitt Romney and Jon Huntsman drink coffee?

[Flubber]

A lot of years back I worked for a law firm that represented doctors and attended a few disciplinary hearings. Discussions about fraud in the public system largely centred on how difficult it was since fees were mandated and daily/weekly and monthly amounts, while not capped back then, were routinely monitored and if a doc claimed the equivalent of say 18 hours of office visits in a day he might find himself flagged for review. Also since docs were in relatively short supply ( a result of essentially government mandated prices being fixed below "market" -- meaning the rates US hospitals were willing to pay to lure them away---) no doc needed to ever invent patients or illnesses to keep busy. Oh and unnecessary tests? Wouldn't happen much since an xray or scan or bloodwork was at a hopsital and the doc billed nothing for the test -- might get a small fee for reviewing the results, but thats about it .

The main area of focus for fraud investigations was basically on overstating the nature or length of an appointment. They never found much . . . . probably becasue it was such a freaking small place that everyone knew everyone in the medical community



IN my sons case in Florida, I don't know if some thiongs were padded or not. Did they need two scans of his abdomen at something like 3 grand each . I had no idea and never cared . I was a worried parent with full insurance so I did not care about efficiency-- that was for the insurance company to worry about (their case nurse called me pretty much every evening and always seemed to be pretty current -- about 6-8 hours behind what was happening )

[Flubber]

There is loads of evidence to suggest that this is simply not true in all cases. Much preventative medicine has negative expected value relative to allowing illness to present itself.

I won't dispute you . I am sure discovering prostate cancer early and curing it at a cost of hundreds of thousands with all those annoying expensive follow-up tests-- has a far worse "expected value" to the system than say me finding out in time to be told I was rife with cancer and had a week to live--- But for me as an individual its GOLD.


THis goes to the goals of a health care system. The cheapest system might simply be to "kill the ill" although I am sure KH can do a more complex analysis and find that in certain cases it is best to save people (based on their statistically likely probable contribution to society)-- So perhaps we save the 23 year old with a ruptured appendix but the 50 year old with colon cancer is treated with a single morphine shot??

[KrazyHorse]

I won't dispute you . I am sure discovering prostate cancer early and curing it at a cost of hundreds of thousands with all those annoying expensive follow-up tests-- has a far worse "expected value" to the system than say me finding out in time to be told I was rife with cancer and had a week to live--- But for me as an individual its GOLD.

I can't imagine that the studies I've seen don't somehow credit patient outcomes, but it's been a year since I looked at them, so

[Zevico]

Tupac, how did you learn so much about life and the wonders of a free market economic system?

[Tupac Shakur]

Rappers are the ultimate capitalists...

[KrazyHorse]

[Flubber]

I can't imagine that the studies I've seen don't somehow credit patient outcomes, but it's been a year since I looked at them, so

I know that any legitimate study has to "credit patient outcomes". The question though is how you do that. Obviously some preventative medicine is too expensive or resource consuming. Even if a test would completely diagnose and lead to the cure for 6 people and prevent their deaths, you are not going to do it if the test costs 5 grand a person and needs a person to attend at an appointment for 4 hours. People wont expend that much time or money to do a specific test to find something thats 6 in 300 million. But a general physical can fairly cheaply check you out for a number of ailments

I suspect the studies might have less problem with things like routine physicals and bloodwork and may take issue with other more extensive routine testing but I haven't read them either so I'll leave it at a suspicion for now.