I have often wondered whether the frequent occurrence of a big increase followed by a not-so-big decrease may be an intentional psychological ploy--to ensure that there is less attention paid to the fact that the net effect is a higher price.
You are correct. And I still can't.
Don't get me started on "detail men" for pharma companies. When they walk into the waiting room and then right into see the doctor I always say, loudly, "Hey, did you make an appointment?" (-: I've gotten some great free stuff that way.
My MD said he depends on the reps for free samples he can give to his poorer patients, but it's never a generic sample, always something high priced. Those reps seem so much like heroin pushers at times. The huge fines assessed for pharma companies pushing "off label" prescribing shows how successful detail men are at persuading MDs to use the products they are pushing. The placebo effect guarantees that at least some of that "off-label" treatment will be effective. (-:
I found that for GP's in particular, if you present them with high-quality research about your own particular problem it does help them "keep up" and they appreciate it. It's just crazy what a GP is expected to know, especially in relation to what they are paid (not much compared to specialists).
The good doctors I know that have too many patients are starting to use nurse practitioners for the easier stuff and I have no problem with that as long as I get to see the doctor whenever I really feel the need to.
I tried to find a new GP for my neighbor, whose own doctor retired and just closed down the practice - no one wanted to buy it. All I could find were foreign born and trained GPs which presented a bit of a problem for her because she's a xenophobe.
We're definitely approaching a very serious crisis in US health care.
Although Medicare has been publishing patient-satisfaction scores on its Hospital Compare website since 2008, it will begin using them to adjust payments, reports Kaiser Health News in conjunction with the Washington Post. Under CMS's "value-based purchasing" proposal, Medicare will withhold 1 percent of its payments to hospitals starting in October
2012, putting those funds into a pool to be distributed as bonuses to hospitals that score above average on several measures. Patient satisfaction scores would determine 30 percent of the bonuses, and clinical measures for basic quality care would decide the rest.Read more: Patient satisfaction will impact Medicare reimbursement in October 2012 - FierceHealthcare
I'm finding that harder and harder to believe, overall. With the great emphasis throughout medicine on clinical guidelines, you have the feds and/or the clinical societies doing most of the work. Heck guideline.gov even has a way to compare competing guidelines to let you pick one from column A and one from column B if you want to.
I just realized that I was talking doc and this is talking hospital. I have been spending too much time with hospital based docs recently who usually have a financial dog in the hunt that the outside practice doesn't and like to complain about how this is making their lives miserable...
It's called managing your own health care -- good idea and nicely done.
Tomsic
Plenty of goods and services have experienced long term price reductions. How about the cost of communicating, the cost of transportation and the cost of food. I've come to count on my next computer or electronic device being less expensive than my old one based upon $/unit of performance, not necessarily dollars out-of-pocket. Markets don't like that.
Tomsic
Heck inflation-adjusted gas is the same as it was in 1918....
Part of the problem is that so many people believe that we have the best healthcare system in the world but some troubling statistics put those beliefs in doubt. The problem is that there are so many possible ways to measure health care outcomes that comparisons across different cultures becomes very dicey indeed.
American cancer patients outlive those in most other countries, but some say it is a horribly prolonged death, adding a few months to a person's life that are of very low quality but costing more than the insured ever paid in premiums. Sadly, a huge amount of Medicare money goes towards just those sorts of situations. People in near vegetative states suffering through major operations as their bodies fail. Medicare dollars to treat terminal elderly patients might be better used to provide health care for young who might benefit from those dollars for a much longer time than a senior with dementia.
One good thing about the ACA is that is has finally brought a lot of issues to the table that weren't really being openly discussed before.
What would you recommend to fix those problems?
A lasting legacy of WWII and a reminder of how long the effects of a war can linger:
History is a record of ''effects" the vast majority of which nobody intended to produce. Joseph Schumpeter, 1938
You're right--I forgot about that. On the other hand, you did say "is basing" rather than "will be basing"
I don't know whether our big-wigs saw this coming or not, but for many years, we have tied small but pleasant quarterly bonuses to patient satisfaction surveys. And we don't get them from CMS--we hire independent survey companies to call for us and total up the results.
Actually shows how the effects of governmental expediency can linger. This was a classic government pretending that something isn't what it really is (or was) to avoid a political problem.
I have long trumpeted for a Truth in Bill Naming Act (for example every law having to do with campaign money reform should be called "The Incumbent Full Employment Act" unless it gives the challengers more money to overcome the perks associated with incumbency). And most should include ... "as well as other things we know about and did not tell you and other things that we didn't begin to contemplate but screwed things up royally.." Act.
>
I am writing a whole bunch of stuff on this now (it is has turned into sorta a cottage industry for me along with ICD-10 and PQRS) and sometimes forget that it isn't actually in place yet-grin).
>I was not pleased with the GWB "remove protection from the power of government act" one, and it's follow up bill, two.
. Christ>
Thanks. It's important to evaluate options - and to sniff them out when they're not presented to you so you can ask intelligent questions like: "What is the success rate for this sort of surgery and what it the worst I can expect from a bad outcome?"
Now I'll play the devil's advocate and talk about my poor neighbor who is elderly and totally afraid of the web. I do what I can for her but I also realize a lot of what I am saying is just gobbledy-gook and doesn't make much sense to her. It's not easy to be a intelligent consumer of medical services without having a medical degree and even doctors run into problems when evaluating their own treatment options.
If I had to state the most important rule I've learned it's "Don't get admitted to a hospital without someone who cares about you knowing you're there and even better, staying with you to answer questions and run interference. DAMHIKT!
Why compete when you collude? All sellers win that way. Buyers, not so much.
Sounds like a good explanation of the "stickiness" of prices increases.
Some of the biggest fights that broke out among the economists that helped build the nuclear survivability model DoD used to maintain concerned what would happen to various commodity prices after a nuclear attack. We had a strong, differing opinion from each of the economist on the team, something I came to learn was pretty common with a team of economists.
So we had to design the model to run using several possible scenarios. There was a profiteering model that assumed a black market would arise for critical commodities that even the government would have a hard time competing with and might need to purchase with gold. (Sadly, my pick based on historical experience - profiteering and war go hand in hand.) There was an altruistic model that assumed people would all pull together and there would be no profiteering and a neutral model that said things would generally be the same in the post attack world.
HomeOwnersHub website is not affiliated with any of the manufacturers or service providers discussed here. All logos and trade names are the property of their respective owners.