mheslep said:
As I recall from the health care law debate it turns out that theory is mistaken. Proponents supposed as you do, that the requirements for routine checkups would save money but when the statistics were actually run opponents found that when counting up the costs for sending all the healthy-anyways people in for routine work outweighed the savings in preventing more expensive to treat disease. This doesn't mean that routine work shouldn't be done, just that it probably doesn't save money.
WhoWee said:
Doctors need test results - to write prescriptions - and recommend specialists.
The latter is debatable. Doctors are as liable to corruption as lawyers. For some reason, lawyers are perceived as sneaky and lacking in ethics while doctors are seen as noble, pursuing their profession only for the good of mankind.
Doctors that make profits off of the tests recommend more tests than doctors that have no financial stake. The latter theoretically only schedules the tests they need. It doesn't the cost the patient extra regardless of how many tests are done, so the patients of the first type of doctor think they're getting great health care from a very thorough doctor. The doctors that have no financial stake in tests follow suit so they, too, can be perceived as very thorough doctors.
Hence, a sound idea (routine preventative health care) gets distorted because a third party is doing the paying and because there's no regulations to prevent doctors from testing for profit. Eliminating third party payers wouldn't eliminate this problem, though. Even if the patient was paying, he'd be put in the position of trying to decide whether he or his doctor knew what tests were necessary or not. The patient would pay for whatever tests he could afford whether they were necessary or not, because doubting the word of his doctor seems foolhardy.
This isn't a new problem. There was a time when doctors wrote prescriptions for profit. In other words, the doctor would prescribe some unnecessary medicine, which the patient would buy from the doctor. Now, there's regulations to prevent a doctor from both prescribing a medication and selling it. Because doctors are no more moral than lawyers (who aren't generally as unethical as the jokes about them would indicate), regulations had to be put in place to keep them from virtually becoming snake oil salesmen.
The same type of regulations need to be put in place for medical diagnostic tests. Eliminate the profit motive and the sound idea of preventative health care actually works in practice instead of only in theory.
And how many diagnostic tests does it take to recommend a patient go see a specialist that will pay the doctor for the number of new customers the doctor sends the specialist's way. This is another practice that needs to be banned.
(sorry)