[Walking Man]

I was just reading through the thread about Nurse Practitioners. One issue that came up was bringing down health costs. In my experience attempts to bring down costs, primarily by insurance companies, end up costing them more. For example they don't want to pay for the drug you doctor prefers, so they require you try one that doesn't work first, and then you get the one your doctor wanted to prescribe. You need a referral to see a specialist, so you have to make two appointments instead of one. The doctor refuses to order an MRI so you have to see two or three doctors to get the MRI you knew you needed in the first place, and things are now worse. There are a lot of examples. Do you think all of these measures end up costing everyone more?

[ZilchHour]

In my opinion, some systems need to be operated above the concept of monetary benefit. Healthcare is amongst those systems. The aim of the system should be comfort and well-being of people with health issues rather than the costs involved. Also if a doctor prescribes a treatment and the patient is comfortable with that, then it should not be abandoned merely because it is not the most economical way forward. And yes, I agree, in the end it costs more; both the discomfort and money.
Lastly, I wish we all realise that money want meant as a medium of exchange to serve mankind and not to be the master which would govern every single aspect of our lives.

I have been half-reading a book called "Overtreated" by Shannon Brownlee recently. It's about the U.S. healthcare system.. It was written in 2007, before the ACA, so some parts of it are outdated, but it's an interesting book overall.

The writing isn't the best. I have tried to read it before and failed.

But anyway, back to your question. I think some people who have a long history of health problems become "knowledgeable patients" and it's frustrating for those people to deal with the restrictions that you mentioned. In their cases, it probably does end up costing more having them follow those rules.

One thing I read in the book that I didn't know is that the US has fewer physicians per capita than most western developed countries and they see more patients per day than in other countries.

The move to adding nurse practitioners may have started with cost control, but now that the ACA has taken effect, it's probably essential just to have enough providers.

I keep hearing that the US is going to move towards paying providers for results rather than for number of procedures performed. I'm not sure how that's going to be implemented. The idea sounds good.

[Walking Man]

Jo: I've been going to a hospital where all the physicians are on salary. I think it's great. They spend a lot of time with patients. I'm not for for "results" pay, because the best doctors have the worst patients. I would be a poor result for anyone! It's only because doctors are willing to take on patients with poor prognoses that they get help.

Zilch: "I wish we all realise that money was meant as a medium of exchange to serve mankind and not to be the master which would govern every single aspect of our lives." I agree, and think public discourse about healthcare is too focused on cost. I mean it's important, but not as important as people. I think that gets lost.