tag:blogger.com,1999:blog-10424035.post4706576272995510029..comments2023-09-11T08:58:24.710-06:00Comments on Reach Upward: Bad MedicineScott Hinrichshttp://www.blogger.com/profile/11831447472339880148noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-10424035.post-20476808837078350422008-02-20T18:10:00.000-07:002008-02-20T18:10:00.000-07:00Casey, thanks for your thoughts.Kevin, you are rig...Casey, thanks for your thoughts.<BR/><BR/>Kevin, you are right that divisions of labor and specialization are a product of free markets rather than being the driver of those markets.<BR/><BR/>Thanks for pointing out that markets serve the desires of the actual buyers, and that this rule applies even in socialized systems. But, as you ably pointed out, the problem with such systems is that the patient is not the buyer.Scott Hinrichshttps://www.blogger.com/profile/11831447472339880148noreply@blogger.comtag:blogger.com,1999:blog-10424035.post-91863163184500464522008-02-20T16:51:00.000-07:002008-02-20T16:51:00.000-07:00I think the carciaturization that free marketeers ...I think the carciaturization that free marketeers argue for specialization is a bit off. Free marketeers argue for freedom. Adam Smith points out that divisions of labor occur in the free market.<BR/><BR/>What happens in a free market is that the market will morph itself to the desires of the buyers in the market.<BR/><BR/>In the American Medical market, the buyers are large employee insurance pools and big government.<BR/><BR/>If individuals, not insurance companies, were buying health care, then the market would re-align itself to the needs of people.<BR/><BR/>Your dad's experience was one where he was dealing with a health care system focussed primarily on the needs of the buyer ... his insurance company. The proper filine of paperwork is the primary concern of this beast. The health of your father is only an incidental secondary item in the equation. <BR/><BR/>So, you are right that it wouldn't have mattered in the least if your father died, because the system has cut the people out of the process.<BR/><BR/>If we had a free market where your dad was paying for care, things would be entirely different. There would still be divisions of labor, but you would see things more along the line of Lasik Surgery and Doulas. <BR/><BR/>Conversely, in all systems where bureaucracies pay bureaucracies, we will see the patients coming in dead last.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-10424035.post-70959654214291992482008-02-20T08:58:00.000-07:002008-02-20T08:58:00.000-07:00The incentives are definitely messed up. It doesn'...The incentives are definitely messed up. It doesn't take much thought to see how changed incentives would make the system better. <BR/><BR/>I always hold up the example of Lasik Eye Surgery. This is a medical service that is not covered by most insurances. Meanwhile the level of service for has gone up and up while the cost has gone down and down. Its amazing what happens when the incentives are lined up to benefit the patient. <BR/><BR/>Granted, it can be argued that a hospital stay is much more complex than eye surgery, but why is it so? Is it not so much more complex because of the very lack of correctly aligned incentives? If I were a doctor competing to treat strokes would I not develop a system that provides the best and simplest care possible for the cost? I realize this is an over-simplified analysis, but do the principles not apply nonetheless?Quesihttps://www.blogger.com/profile/17417229742646096878noreply@blogger.com