re: Spinoff: The Commonwealth Fund Healthcare 2017 rankings. US basically ranked last

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Would the feds really be the defendants? Wouldnt they just be the "insurance company" aka the third party payer

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In theory, yes. But I don't think it would ever get to them being the defendant. I believe healthcare entities that treat single payer or public option patients will get some measure of tort protection if they are to effectively ration care (i.e. not practice defensive medicine) on behalf of the government.

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You can't sue Medicaid right now for a bad outcome

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Exactly like that.

It will be a challenge to maintain enough providers if you are going to reimburse them for all their services at the Medicaid level.

I'm always against raising taxes. There is no end to it.

What has resulted in the increase in costs in 1980?



Doctor's salaries haven't increased much compared to 1970-1980 when you consider inflation

What has increased is:

Regulations
Number of administrators
Cost of medical devices
Cost of drugs



Is there anything I'm missing?

But we have lower utilization than the European countries (if you are talking about number of doctors visits)

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To expand on Road's point: Utilization of labs, imaging, beginning and end of life therapies, cancer therapies, experimental therapeutics, new pharmaceuticals, etc...

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I agree with that definition of over utilization

But aren't those things what drives innovation and advancement?

Think about preterm babies as an example...
At first saving a 30 week old probably could have been argued as being wasteful. Now we are saving 26 week old babies and it is easier and cheaper to save 30 week old babies. That's innovation and advancement. I'm not here to debate whether it is worth it or what is moral and immoral.

Labs and imaging are due to defensive medicine

I guess my thoughts are that we need to:
- Reduce regulations
- Tort reform
- Streamline billing with a standardized system of payment
- More aggressive ability to negotiate with device manufacturers and drug companies. We need to demand prices closer to the European countries. Let the device companies figure out how to bring products to market for that price point, this will prevent R&D for worthless iterations of the same drug. Why do we need 100 different biologics, or 15 different cholesterol medicines just because one has 40% side effect of itching rather than 50%?
- Reduce insurance plans to cover extraordinary events and make patients have a higher stake in payment for outpatient visits procedures outside of routine primary care visits

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More aggressive ability to negotiate with device manufacturers and drug companies.

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What is your expected savings here? And I mean in real dollars.

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Reduce insurance plans to cover extraordinary events and make patients have a higher stake in payment for outpatient visits procedures outside of routine primary care visits

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I will say that as young Mom in a city where I really didn't know anyone I ran my children to the doctor for every little sniffle. It was worth the 10.00 co-pay.

You hear horror stories and are scared witless. I think more could be done on educating parents on the day to day things. Like a runny nose and low grade temp.

$14B is a nice start. It's a tad more than the USS Ford cost to build.

$3.2T is a massive number.

The numbers on CT scans... Would save 18.6 billion

Slightly off topic but if we reduced all 203,000 primary care physicians (includes pediatrics too) pay to that of Germany we would save 19.5 billion

So the difference we pay in one imaging study (CT scans) is equivalent to how much more we pay our primary care doctors

We haven't even talked about how much more we pay for:
Prescriptions drugs (arguably the biggest cost)
Cancer treatment
Medical devices
Etc.