tag:blogger.com,1999:blog-32053362.post7572890082059080069..comments2024-03-18T06:27:51.599-04:00Comments on Not Running a Hospital: Inertia supports Baumol's diseasePaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-32053362.post-65083059588057605822012-10-11T22:17:07.781-04:002012-10-11T22:17:07.781-04:00Education and healthcare are largely paid for thro...Education and healthcare are largely paid for through wealth distribution using the tax code. Because we artificially decrease the price to the consumer of education and health care the demand and therefore the overall cost are both artificially high. There is little innovation in healthcare and education because there is no reason to innovate - the market is secured by propped up demand for the service. Until this dynamic changes neither industry will change.Tomnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-57813572221159196712012-10-11T15:43:06.456-04:002012-10-11T15:43:06.456-04:00First, I wonder why prices per service, test or pr...First, I wonder why prices per service, test or procedure are so much higher for U.S. hospital based care compared to the same care in developed other countries. Are U.S. hospital costs per licensed bed really that much higher and, if so, why?<br /><br />Second, there are at least four cultural issues that drive up U.S. healthcare costs well beyond what they should be in my opinion. They are:<br /><br />1. Executing a living will or advance directive and talking to one’s spouse and adult children about what care you want and don’t want in an end of life situation could eliminate a lot of futile and unwanted care at the end of life but 75% of us don’t do it.<br /><br />2. A culture of litigiousness that makes too many people want to sue someone in the event of an unfortunate outcome even if the doctors and the hospital did nothing wrong. This results, in turn, in defensive medicine that pervades the medical culture.<br /><br />3. A culture of fraud among too many providers that bills for everything from services never provided to unnecessary care to inappropriate upcoding.<br /><br />4. A culture of opacity between insurers and providers that precludes the disclosure of actual contract reimbursement rates to both patients and referring doctors. Inefficiency is easy to sustain when price discovery is impossible and when someone else (the taxpayer or an insurer) is paying the bill.<br />Barry Carolnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-65923911755109863362012-10-11T08:42:01.053-04:002012-10-11T08:42:01.053-04:00Paul, I strongly agree with your friend, regardin...Paul, I strongly agree with your friend, regarding "the traffic will bear it". I also see another slight spin -- in healthcare anyway, the decision makers (providers and patients) don't apply pressure to prices, and insurers don't have the power or will to do it either. This leads to higher prices and more services (sometimes unnecessary or ineffective).<br /><br />GaryGary Nissenhttp://www.linkedin.com/in/garynissennoreply@blogger.com