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View Diary: Medicare: What can we do about it? (314 comments)

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  •  from the point of view (5+ / 0-)

    of someone who was without access to conventional medical care for some years and has only recently begun using allopathic care again, what I see is a system that really, really doesn't work.

    It has less to do with the excess paperwork (creating jobs, but kind of crappy jobs) than with doctors who seem not to be trained in assessing the entire patient. The approach now seems to be to glance quickly, then divide subsequent checks of this and that into visits to various specialists, who require various high-tech tests. All within the same large practice, of course, so it's a revenue-generator.

    While the newer breed of doctors seems to be quite up to snuiff on all the fancy toys, I haven't observed that they are any better educated in things like basic nutrition and low-tech medicine.

    How much of our sky-high medical costs could be reduced if a) doctors were trained in more whole and less mechanistic methods of diagnosis and b) patients were encouraged to take responsibility for keeping themselves healthy instead of asking for drugs and more drugs (which benefits BigPharma)?

    Yeah, I know. And what is the sound of one hand clapping?

    I still think the wars in Iraq and Afghanistan were and are unnecessary, the whole "war on terror" is just a reaction to self-induced fear. I still think there is a war on women. -- from LaFeminista

    by Mnemosyne on Sun Aug 21, 2011 at 08:39:09 AM PDT

    •  The CT and MRI scanners (1+ / 0-)
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      are installed at great cost and are manned 24/7/365.

      To actually use them four hours a day instead of three hours a day doesn't cost much more.

      Testing equipment is highly automated. Regents are produced in factories. To produce 3,000 gallons a year instead of 2,000 gallons of year of regent X doesn't cost much more.

      All this stuff can be bought on a per capita basis.

      If an MRI scanner costs $1 million per year to buy and run and serves a population of 50,000 people, pay $20/person/year for it.

      With CT scanning, there are radiation concerns, so doctors can't order CT scans simply because the marginal cost is small.

    •  Basic nutrition? Very few patients change (1+ / 0-)
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      their eating patterns based on the advice of a 20 minute conversation with a physician.

      If it were that easy, dieting would not be such a billion dollar industry in America, and we wouldn't need so many self-help books.  

      There is a reason why doctors do tests.  Their patients demand and shop for doctors who do tests.  A physician who does a physical and tells you there's nothing wrong with you without running a test makes the patient feel like he's not getting his money's worth.  It also puts the physician on the hook for malpractice liability if there was indeed something.  

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