Panda Bear minces no words:
1. Patients are not encouraged or expected to take personal responsibility for their own health . . .2. As every insurance scheme insulates the patient from the true cost of health care, there is no incentive for patients to make good economic decisions . . .
3. The legal environment makes it impossible for anyone in authority to exercise common sense . . .
4. Futile care, which is in no way discouraged . . .
5. Doctors don’t know how to say “no” or admit defeat.
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More to add:
Charges aren’t published.
Patients can’t select from among a menu of options; dependent on prescribing practices of physicians
Comparison shopping isn’t feasible – insurers determine who providers are and what is reimbursable – often at odds with preventive care strategies.
Patient seen as dependent in the physician-patient relationship (I’m not advocating for complete independency, either). Doesn’t have the knowledge necessary to make the most informed decision when options are available (Type of CT scan, frequency of testing, formulary vs. nonformulary medications, bundling or unbundling and selction of diagnostic testing, etc.).
Barriers to lowest cost healthcare: access, disparity, available transportation, employer demands, insurer participation demands, availability of services, degree of perceived discomfort, fear, lack of education.
Why don’t we just conveniently leave out the most basic economics argument as to why US healthcare is so damn expensive…
Anon 3:03 – See # 2.
Reason #1. Health care in the USA is expensive because hospitals have a kind of oligopoly that is supported by insurance companies. Doctors in the USA are expected to become rich whereas anywhere else in the world, a Doctor is just another professional that can become rich, but only by working hard and being the best.
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