My point is that we shouldn't exactly be relying on the U.S. government to do it. The best systems in the world are highly regulated but not actually run by governments.
One of the things they do, though, is force a price list on providers, something you've taken off the table.
On the other hand, the VA actually has quite a good reputation these days. That's sort of your experiment right there. Costs are holding steady despite a pretty messed-up patient population, doctors and patients like the system, they have a very good electronic medical records system (which they've opensourced, btw) and they use those records to analyze the data and use the treatments that the evidence shows are most effective.
It's been widely reported that about 98,000 people a year die from avoidable medical errors, a lot of it from medication errors. Most hospitals won't talk about their error rates. The VA told everybody, then they fixed it. For example, in a VA hospital every patient has a barcoded wristband. So does every nurse, and every medicine bottle is barcoded too. Every time a nurse gives a patient a pill, she scans all three barcodes, and a computer checks to make sure the patient is getting the right medicine at the right time.
Most private hospitals have little incentive to fix errors, and certainly none to report them. Reporting just gets you sued, and in a fee-for-service system, fewer errors just means less money.
> My point is that we shouldn't exactly be relying on the U.S. government to do it. The best systems in the world are highly regulated but not actually run by governments.
My point is that the US govt will be doing the regulating.
Note that the US govt doesn't actually provide medical services under medicare either - it just "regulates" them.
I didn't say anything about what Obama could do - free rein means he gets to decide. He can go with regulation, govt hospitals, whatever.
> in a fee-for-service system, fewer errors just means less money.
IIRC, Medicare mandates fee-for-service. Under the terms of my deal, Obama gets to change that.
My private health care doesn't work on a fee-for-service system (at least as far as doctors and medical staff are concerned). I doubt that it's the only one.
Yes - it's in the US. If its existence surprises you....
One of the things they do, though, is force a price list on providers, something you've taken off the table.
On the other hand, the VA actually has quite a good reputation these days. That's sort of your experiment right there. Costs are holding steady despite a pretty messed-up patient population, doctors and patients like the system, they have a very good electronic medical records system (which they've opensourced, btw) and they use those records to analyze the data and use the treatments that the evidence shows are most effective.
It's been widely reported that about 98,000 people a year die from avoidable medical errors, a lot of it from medication errors. Most hospitals won't talk about their error rates. The VA told everybody, then they fixed it. For example, in a VA hospital every patient has a barcoded wristband. So does every nurse, and every medicine bottle is barcoded too. Every time a nurse gives a patient a pill, she scans all three barcodes, and a computer checks to make sure the patient is getting the right medicine at the right time.
Most private hospitals have little incentive to fix errors, and certainly none to report them. Reporting just gets you sued, and in a fee-for-service system, fewer errors just means less money.