From: boron_elgar@hotmail.com
On Sat, 23 Jan 2021 13:17:48 -0000 (UTC), "Kerr-Mudd,John"
wrote:
>On Sat, 23 Jan 2021 00:45:04 GMT, Bob wrote:
>
>>> I'm not wedded to single-payer as a solution, since there are
>>> examples of industrialized countries where their multiple-payer
>>> system is effective. (It still requires strong government
>>> regulation.) But single-payer does seem like the obvious system to
>>> simplify health insurance. The problem, and the resistance, comes
>>> from the thousands of clerical workers, medical analysts, etc. who
>>> work at insurance companies and the hospitals. Most of them would no
>>> longer be needed.
>>
>> What makes you think they wouldn't? No matter who does the paying,
>> there'd be a need to control costs by paying for certain cases and not
>> others. That's going to require the same people to look at each
>> service and each potential service and decide whether it is/was needed
>> badly enough, as against whatever policy is adopted. Nobody's ever
>> going to pay unquestioningly for everything, and people are going to
>> push up against the limits of whatever policy is adopted. It can
>> never be reduced to a simple no-judgment formula, because medicine
>> always involves judgment. Nor can you let the person getting paid
>> have the last say as to that judgment.
>>
>> Bob in Andover
>>
>You could look at other countries, those with an actual health service,
>and learn from them.
I have a kid who lives in Taiwan and whose medical records are
instantly available to anyone treating him. His wife's prenatal care
is top notch so far. Another friend is in Costa Rica and the health
system is pretty much the same over there, but she is classified as a
senior and the system offers her all sorts of benefit sand older
person might need and does so automatically.
Both of these systems are responsive, accurate, govt managed, and dirt
cheap to the patients.
Two anecdotes, of course, but it is pretty obvious that basic care can
be handled as single payer with decent record keeping capability.
Smaller countries for sure (Taiwan is 24 mil, CR is 5 mil), and
scaling up can be fraught with problems and under funding that leads
to even more problems, but it isn't as if we have no examples at all.
A note harkening back to a previous posting about computerized record
keeping in the US. It was the Feds who made the initial requirements-I
assume to better monitor and manage Medicare, but the private sector
ran with that ball all over the place and is still running.
One other deficit of these computerized exam room systems is their
inflexibility. I have a few unusual twists and turns with meds,
disorders, follow-ups, etc, nothing exotic, actually, but even so,
there are many times the nurse, who does the vitals, med lists,
pre-screen stuff, as well as the MDs during exam and discussion, have
to find work-arounds within the programming to account for these
slightly out of the ordinary characteristics. These hiccups are not
caused my unfamiliarity with the systems, either, but in the nature of
the systems themselves.
Good examples and easily recalled, are the wild adventures one can
have with calling customer service for some vendor and getting dumped
into IVR and having to listen to advertising push, unnecessary info
and all sorts of other drivel just to drill down to what is really
needed- assuming one can get that far at all. Vendors love it, and
there are fewer CS reps for them to deal with, but as a customer, I
absolutely detest having MY time wasted dealing with their internal
systems. Many of the computerized in-room med systems can be just as
unwieldy- even the best of them.
--- SoupGate-Win32 v1.05
* Origin: you cannot sedate... all the things you hate (1:229/2)
|
