Don't forget that America is a textbook example of socialised medicine. The government spends 14% of GDP on healthcare. Yet Australian socialists seem to point out that all the obvious failures of the American health system are evidently because it is a 'user-pays' system.
Forget any efforts to analyse the policy regime in the U.S.....If America was really a user pays free market, then how can this happen ?
In the US, we don't have prices, and so don't have a market.
The following is a transcript of conversations I very recently had with some U.S. health care providers, written down during or immediately after each conversation:
Conversation with Stanford Hospital:
Me
My wife needs a colonoscopy: Could you give me a price on it?Stanford Hospital: (businesslike tone)
Twenty five hundred to thirty five hundred.Me
You do this all the time. Can't you give me a specific price?Stanford Hospital: (cooler tone)
SorryMe
Is $3500 the all up, all included price to both myself and my insurance?(Previous research shows that mystery surprise additional charges are usually around a thousand dollars)
Stanford Hospital: (businesslike tone)
It only includes the doctors fee, and does not include any additional servicesMe
So after I have this done, any number of people could then charge me any fee they like in addition to the thirty five hundred?Stanford Hospital: (distinctly chilly tone)
I am afraid so.O'Connor Hospital
Me
My wife needs a colonoscopy: Could you give me a price on it.O'Connor Hospital
Do you have a primary physician.Me
Yes, my primary physician has advised this procedure, but it seems expensive. I am looking for a price.O'Connor Hospital (indignantly)
We don't give out prices.Mercy General Hospital
Me
I am looking for a price on a colonoscopy.Mercy General Hospital hangs up without a word.
Saint Joseph's medical center of Stockton:
I am transferred to financial counselling, who
transferred me to "Estimates" The estimating lady
appreciated my problem and made sympathetic noises.She then asks me for a CPT code. I then research what CPT codes are, and discover that a colonoscopy can result in any CPT, and any number of CPTs. I discover that no matter what CPT I give, it is unlikely to be correct or sufficient, that additional CPTs can show up any time. A CPT would only be useful if it was possible to know in advance what CPTs would result from a colonoscopy, but the CPTs are only decided after the colonoscopy, usually long after the colonoscopy.
A better example of a free market in health is Singapore, which only spends 1.3% of GDP
No comments:
Post a Comment