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View Diary: ACA's narrow networks allow insurance companies to gouge public, doctors (97 comments)

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  •  Okay. (2+ / 0-)
    Recommended by:
    JesseCW, aliasalias

    1) How are they different? How does that difference result in higher costs?
    2) How big of a cost increase does it cause?
    2) Why will this take a "generation" to undue? Can't you just change what comes up on that computer screen? Why will the doctor have to unlearn and relearn all the medical knowledge they learned at medical school?

    •  You can't just change what is on the computer (5+ / 0-)

      screen because what is on the New York screen is the standard of care for US physicians and patients. The London screen has been shaped by decades of policy and experience of the NHS. For our New York physician to deviate from the US standard of care requires him/her to expose themselves to professional and legal risks. The US standard of care is the result of hundreds of peer reviewed articles and a consensus of the various US medical societies.

      In the UK, and the rest of Europe, they have developed a standard of care that involves less technology, particularly less expensive technology and more observation and touch and feel by the physician. In the US it's easier using high tech diagnostics to reach a conclusion quicker. It's also more expensive. In terms of therapy the UK and EU will do less intensive and invasive cardiac procedures in the cath lab for a patient with the same systems. And per capital they use fewer stents and perform less open heart surgery. In the last fifty years the practice of medicine in the UK and EU have been structured to be very cost efficient. Budgets for the single payer systems are always under political pressure and it significantly influences how medicine is practiced. At times it may put the patient at more risk, and not be as satisfying as in the US, but it costs a lot less.

      So that's why it is a hard problem to solve. These are procedures and protocols developed over many decades and engrained into the teaching curriculum of the medical schools in the US and those in Europe. There is no easy fix.

      "let's talk about that"

      by VClib on Sun Nov 24, 2013 at 07:43:35 PM PST

      [ Parent ]

      •  It seems like this description is (1+ / 0-)
        Recommended by:

        consistent with what I posted above (or somewheres in these nested threads) about how the fault of the US system in making it very expensive is that it is overly procedure based.

        It seems like that's pretty much exactly what you're saying here.

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