The article about medical specialists is hard for me. I understand some of the problems but Im stuck on ideas for solutions.
1. The article kept mentioning that you cant track their true income as they have ownership in treatment facilities and other things of that nature. That shouldnt be included in their income (as regards this story-taxes are obviously different) as it is a separate business venture, not a medical one. The problem is in the self referral. On the one hand anyone would want to work in an ideal environment: the tools you like, the staff you trust, etc… But isn’t there a conflict of interest that should be disclosed? Can you legislate that? Should we? Im a teacher and we see a lot of laws passed by people who dont know anything about the profession or day to day realities and its not a good things. Could the AMA pass some ethics rules? How do we get them to do that?
2. Insurance is a stupid way to arrange the system. Its costly for doctors (hiring staff to work with the insurance) and for patients.One of the things that came up over and over during the ACA’s debate in congress was that, “the government should stay out of the doctors business and the invisible hand of the market will lower prices.” The trick is the insurance companies are all up in the doctors business and prevent the market from functioning as it otherwise would. If health is the actual goal of the health care insurance industry then gym memberships, healthy foods and a dietitian would be things prescribed by your doctor and covered in your plan. Insurance makes sense if you want to hedge your bets against an expensive procedure or even a broken leg but why do they need to be involved in my annual checkup or routine procedures? And they are, from who I can see (who paid to be part of their plan) to how much they charge. My gripe about the PPACA is that it just adds to the power and influence of a middle man who controls access to health care for the public and patients to doctors. Maybe a medical loan program like student loans could work? As another article explained a vast number of people are poor at some point in their life. If they make it to stability later then they could repay but until you make X dollars you are in deferment?