Thursday, March 27, 2008

More Fuzzy Math

In case you weren't tired of all the shenanigans happening on Wall Street there is plenty of bad math happening with health care too. The theory goes that by adding more patients to an underfunded and understaffed system everything will be fixed. Oh yea, also by having medicare reimbursements so low as to be practically covert doctor taxes more primary care doctors will be trained. Someone needs a desperate lesson in economics and incentives.


Garbo said...

Which is why it is imperative that the system no longer be underfunded and more effort be made to recruit, retain, and, yes, reimburse medical professionals.

While reimbursement may go down under a universal scheme, that could be offset by a substantial increase in medical school and training subsidies. So long as the quality of patient care rises nationwide (not simply in the best hospitals or the wealthiest areas), it is a fair trade-off. If the situation you suggest comes to pass, it would be unfair. More importantly, it would be bad policy.

hot zone said...

I agree that medical school and training should be subsidized, but explain to me how that will save these struggling practices especially with reimbursements falling?

There are plenty of medical professionals, especially in primary care, who are long out of schooling and have paid off all of their loans yet have to see an absurd number of patients an hour to make ends meet. How will these subsidies actually help these people?

Your trade-off reminds me of the old retail saying "We lose money on every sale, but we make it up on volume."

Also, it is usually the "best" hospitals that see the most indigent patients because they will be the few places that can actually afford to take the hit to the bottom line. Patients are often transported to these places because the other hospitals aren't willing to treat the patients at a loss which is awful but a reality of the economics of the system.

Garbo said...

Health care policy is one area where I won't even pretend to be an expert (unlike economic regulation). We need to tread carefully.

But I will say this: Insurance companies, like any for-profit business, have an interest in lowering costs and increasing profits. Whether additional revenue comes from refusals to pay for procedures, decreases in reimbursement, or elsewhere, patient care is not the highest priority. Government, while it does have cost considerations, can have patient care as the highest priority. If that means increasing reimbursement to doctors in order to ensure a higher quality of care, it is possible for government to do that, whereas private insurance would be unable to do so.

The best I can say is that I don't know, but I also don't know how government can be any worse than the insurance companies.