This is what free market medicine looks like

[daddyo]

As stated in the video, this is a growing trend. I'm wondering if there's such a place as this in Middle TN:

http://www.youtube.com/watch?feature=player_embedded&v=0uPdkhMVdMQ

[Chucktshoes]

Imagine that, being responsible for the services you receive as a direct consumer. Imagine that!

[Sam1]

I have mixed feelings about this... Without big money in these things, there will not be the same level of research in it. But I also personally know what it's like to see $600,000.00 worth of medical bills including an $8000 titanium rod, or a $12,000 steel hinge, or $400 screws that look like a 35 cent wood screw you get at Home Depot.

Everyone wants cheaper medical coverage, but I can assure you that when you're on the table, you don't care about costs, your only concern is that the technology exists to help you. Some places may be able to perform functions that have been discovered by the hospitals and research centers, but when those places start losing money, there is little motivation to continue investing resources in research.

An argument can be made that some medical professionals don't do it for the money and while that is true, it is a very small number.

[Guest 6.8 AR]

There's a place in Brentwood that has ads on 99.7, I think that operates like that. I don't know about their services,
though.

[1gewehr]

'Big Money' is required for research? And define 'big money'? If by that you mean government research grants, you are dead wrong. Most useful medical advances come from private companies funded by investors, as well as from small companies started by someone who has an idea.
If by 'big money' you mean a large investment, you are mostly correct. New drugs, medical procedures, and medical devices require a large investment of capital to get through the FDA approval process. But when that capital comes from private sources, there is a greater incentive to make sure that the research proves fruitful. When our tax money is used, the primary concern is whether the results meet some political goal.

Without profit as an incentive, why should a doctor work more than the minimum hours needed, or provide good service? 'Just good enough' becomes normal, instead of trying to achieve excellence.

At least 50% of the increase in medical costs since 1970 is a direct result of government regulation. Some of the rest is due to the cost of liability insurance resulting from high-dollar legal lottery winners.

Expect to see a LOT more doctors drop out of Medicare, Medicaid, and other government programs. If you ask around, you can find doctors who run a 'cash' business without taking any forms of insurance. They are also usually much cheaper than other doctors as their administrative costs are almost insignificant.

[Guest FIST]

I think the biggest hurdle to high quality, affordable health care is frivolous law suits. I applaud the efforts of those in the video and hope the care provided there is commensurate with a larger hospital, however that decision rests with the individual.

Our society has become obsessed with unnecessary procedures and medication. I opted for surgery to repair ligaments in my ankle and wish I never had done it. I know that's on me but consider it "lesson learned". As a whole I believe society latches on to the quick fix instead of treating the root of the problem.

But then again, I'm not a doctor, nor did I stay at a Holiday Inn Express

[Guest FIST]

[quote name='1gewehr' timestamp='1353077906' post='846514']
high-dollar legal lottery winners.
[/quote]

Beat me too it.

[Sam1]

[quote name='1gewehr' timestamp='1353077906' post='846514']
'Big Money' is required for research? And define 'big money'? If by that you mean government research grants, you are dead wrong. Most useful medical advances come from private companies funded by investors, as well as from small companies started by someone who has an idea.
If by 'big money' you mean a large investment, you are mostly correct. New drugs, medical procedures, and medical devices require a large investment of capital to get through the FDA approval process. But when that capital comes from private sources, there is a greater incentive to make sure that the research proves fruitful. When our tax money is used, the primary concern is whether the results meet some political goal.

[/quote]

By big money I meant investments, that's why I think if profits are removed, there isn't much enticement for these people to continue on with what they're doing now.

[tercel89]

[quote name='6.8 AR' timestamp='1353077798' post='846509']
There's a place in Brentwood that has ads on 99.7, I think that operates like that. I don't know about their services,
though.
[/quote]

Not trying to get off topic but 99.7 is a great station to listen to and they , mostly Phill Valentine , talks about this topic a lot and is very good to listen to .

[Guest 6.8 AR]

I think it's one of Phil's advertisers. Thanks Uncle Phil and Mark Levin are the only ones I listen to, when I can.

[Sam1]

[quote name='6.8 AR' timestamp='1353083728' post='846594']
I think it's one of Phil's advertisers. Thanks Uncle Phil and Mark Levin are the only ones I listen to, when I can.
[/quote]

Check out Michael Berry on 1510am if you can pick it up, he's on at 5pm

[Guest AmericanWorkMule]

I hated working at hospitals. The administrative employees squeeze the life out of patients and staff both.

[quote]
"One reason our prices are so low," says Smith, "is that we don't have administrators running around in their four or five thousand dollar suits."

In 2010, the top 18 administrative employees at Integris Health received an average of $413,000 in compensation, according to the not-for-profits' 990 tax form. There are no administrative employees at the Surgery Center.
[/quote]

[dats82]

My understanding of the hospitals I have worked in is that their reimbursement is not itemized, but rather based on DRGs. My understanding my be incorrect, but with this type of system, the hospital is paid a fixed price for a given diagnosis or procedure. This gets rid of the incentive to be wasteful, and in fact gives an incentive to be efficient.

Another aspect of billing that was briefly mentioned in the clip is that providers are never paid what is billed. You may get a EOB in the mail that states the bill is 20K, but the actual reimbursement is maybe only 10K for whatever was done. Well, what this leads to is that if what was done was really worth 20K, the providers realizes that they must bill for 40K in order to get 20K. That little game is fine until you have a self-pay patient or the deductable is not met or whatever, and now the patient are sitting there holding a bill for 40K thinking they have to pay all that.

As mentioned above, I think one of the most effective way to reduce the cost of medicine, especially for physicians is to limit all the lawsuits. I know ob/gyn's who are now just gyn's because they could not afford to continue to pay the insurance for delivering babies. One such person was paying about $100,000/yr just for ob malpractice. She was practicing in an area that was mostly medicaid and self-pay patients, so the numbers simply did not compute to good business practice. I personally have the opinion that if you are on an entitlement program for healthcare, in which other people are paying for your care, you should not be eligible for some type of windfall payout. If you are injured as a result of poor care, you should be able to file complaint for an investigation with corrective action taken by the medical board, but you will not receive financial compensation.