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View Diary: Health Care Is the Bomb in Your Living Room (68 comments)

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  •  interesting point (1+ / 0-)
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    jd in nyc

    but I think you would have to pay doctors, not people.  Doctors simply don't have the time or incentives to do preventive care.  To meet with you weekly and coach you on losing weight might earn a doctor a few hundred dollars over the course of a few months; to give you bariatric surgery would yield several thousand dollars in a couple hours.  

    More generally, this diary is impressive.  I would like to hear the author address this sort of preventive vs. disease model.  My understanding that one of the factors driving excess costs is overspecialization, which drives up the costs of specialists (because of training costs) and limits the number of GPs who are available to help with preventive care or who feel qualified to offer care at much cheaper rates (with only marginal quality losses, in many cases.)  

    I'd also be curious to hear about how the pending loss of pharma patents might affect costs.  Nobody talks about this when discussing skyrocketing health costs, but it's hugely important.  Many of the most popular drugs (lipitor, etc.) are going off-patent within the next couple years, which will dramatically lower costs.  (Malcolm Gladwell wrote an interesting article arguing that we do not pay more for drugs than other places as much as we pay a lot more for new drugs and a lot less for generics.)  Obviously, surgeries and so on will continue to remain expensive, but there may be substantial drug savings costs in the future...

    One final point: Cost containment seems tricky and I've long wondered how we could make any significant savings.  Most people agree that health costs in the aggregate are too high; most people with potentially terminal diseases just won't care that much about cost.  The demand will always be there for better care and new technology and drugs.  How do you adress this demand and prevent costs from ballooning?  (Yes, this somewhat contradicts my previous point, but we can ignore that.)

    •  Tax breaks (0+ / 0-)

      For instance, proof of attendance at a health club x number of times per month.

    •  You can pay both (0+ / 0-)

      Actually, financial incentives work for both individuals and physicians.

      You would think that the prospect of living 10 years longer would motivate people to get fit, but it turns out that a small monthly payment (say, $25) for meeting fitness objectives dramatically improves rates of excercise.

      It just goes to show, once again, that humans can be irrational.

    •  health coaching (0+ / 0-)

      A few more thoughts. It is far more cost-effective to pay specialized health coaches, not doctors, to help people get on track to a healthy lifestyle. Basically, they cost less per hour and can focus just on behavior modification techniques.

      I am absolutely and totally in favor of favoring a health promotion model over a health care model. We should think of health care as what we have to do when we've Of course, that just means we have to get more creative about how we make the transition.failed to promote health sufficiently. And yes, in order to achieve that we have to change incentives of providers. But we also have to change our culture, and we have to change lifestyles. These are tasks that require political, social and psychological dimensions far beyond the medical profession.

      •  Health Insurance sponsored (0+ / 0-)
        Seminars.  You get credit toward your insurance premium (or tax break) for attending these seminars.  Particularly if they are life-style altering.

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