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View Diary: The last battle for single-payer (67 comments)

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  •  The other basic failure (1+ / 0-)
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    is lack of expertise.  Almost by definition you are looking for an expert in a field you don't understand.

    Start with the fact you are a poor judge of the expert's ability, and add to that the institutional barriers to getting data about the physicians.   What public quality measures can you get, even when you have time to choose?  

    We have some proof of this fact.  The justification for increasing copayments and sharing premium costs is that it makes the patient a more careful consumer of healthcare.  This would, by the magic hand of the free market, lower utilization and reduce overall costs.  This particular drum was being pounded pretty hard as far back as 1985, when I worked in health data analysis.  

    So far, implementing cost sharing for the last thirty years has accomplished... cost sharing.

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