One who intends to leave others better off for his having existed.

2/1/12

Dylan Ratigan on Greensboro's [Cone Health's?] healthcare monopoly?: "Auction 2012: Bought Health Care"

"The point of seeing a doctor -- or being one -- should be to improve health.

...what I've found,
...is that the same incentives distorting banking, energy, education, and government
are distorting our very bodies.

The American health care system has incentives
so out of alignment for everyone involved...

For [some] American health care providers, the goal isn't to get you healthy,
but to get you paying.

And similar to banking where the costs of a low interest loan
might be a hidden balloon payment,
the costs of our health care system are hidden from the end consumer.

One basic problem with the system is ...the fee for service model.

In fee for service models, doctors are paid based on the treatments they deliver
rather than the health outcomes they generate.

...if you need an expensive surgery, your doctor gets paid to operate.

If you don't need surgery, your doctor doesn't get paid.

This creates an obvious incentive to recommend surgery,
even when you don't need it.

And it also discourages looking at the evidence of what works and what doesn't,
because expensive but ineffective procedures
create more profit for the doctors and hospitals that host and perform them.

This prioritizing of money over health outcomes shows up in the political influence
the American Medical Association uses to stifle competition.

...the AMA used its political influence to insist that only doctors could deliver babies,
even though midwives have performed this service for years.

...Then there's the prescription drug problem,
where pharmaceutical companies leverage their political influence
to protect and expand drug monopolies.

...a company called KV Pharmaceuticals got the FDA to give it an exclusive franchise
over a hormonal agent used for years by obstetricians.

The price jumped from $300 a treatment to $25,000.

Pharmaceutical companies advertise to convince you that you are sick,
and spend $61,000 per doctor on promotional costs
to get doctors to prescribe you their drugs.

This wouldn't be affordable for most of us if we had to pay the sticker price.

But we don't,
because most of us are covered by increasingly expensive third party health insurance
(through our employers, which is yet another problem).

This insurance is protected by a law granting health insurance companies
the right to monopolize state coverage, a monopoly retained by the enormous sums
spent by the health insurance industry in Washington
($263 million from 2009-2010 alone).

...They are after all operating according to certain incentives,
and those incentives are malleable."

Dylan Ratigan

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