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mr.72 wrote:

ChuckW wrote: Health care costs, to a large degree, are not controlled by the patient. If you have been injured in an auto accident you are not going to shop around for the best deal, you are most likely going to accept anything and everything that the doctor recommends. Same thing for a heart attack or any other serious illness. The same thing is largely true even for a simple thing like an annual physical. If the doctor highly recommends a particular diagnostic procedure, how many patients (health care consumers) are sufficiently knowledgeable to be able to question that recommendation?

So since the consumer is presumed to be ignorant and incapable of making these decisions, we need to make sure they get made by some bureaucrat or senators who didn't even read the bill? Or by the Dr. who also happens to gain from the most expensive of the options?

The solution to the problem you suggested is for consumers of health care services to become educated. Buyer beware! Yeah, maybe if it's a car accident, sure thing. But if you don't have any symptoms of a problem whose diagnosis is improved with an MRI, then there is no need for an MRI.

I have refused procedures quite frequently, including while I was in the hospital following surgery. It really ticks off the doctors when they are reminded that they are not in control. But they adapt.

If you can keep up with medical science so that you know the true medical worth of both common and uncommon medical procedures more power to you! The average person has a very tough time knowing enough about the mechanics of a modern automobile to know whether or not a mechanic is scamming them let alone knowing enough about medical science and human ailments.

I certainly did not suggest that some bureaucrat or senator make make medical decisions. And, my whole previous statement was meant to indicate that the doctor who stands to gain the most ordering expensive options is the among the worst to rely on. What is needed is some independent unbiased backup help available to patients. Sort of an immediately available second opinion.

A lot of good points are being made here but an important point that some are missing is that health care is not like other services/products where you and I as consumers have the opportunity to shop for the best price/quality combination. If you need body work on your car you are going to shop for a place that does quality work at a minimum price. If you are shopping for a new HD TV, you are going to buy one that meets your technical standards at the lowest cost that you can find.

Health care costs, to a large degree, are not controlled by the patient. If you have been injured in an auto accident you are not going to shop around for the best deal, you are most likely going to accept anything and everything that the doctor recommends. Same thing for a heart attack or any other serious illness. The same thing is largely true even for a simple thing like an annual physical. If the doctor highly recommends a particular diagnostic procedure, how many patients (health care consumers) are sufficiently knowledgeable to be able to question that recommendation?

I spent many years as a benefits manager in a large corporation and wrestled with these questions daily. The fact is that the medical care consumer just does not have the control that we have in other purchasing situations. I am not advocating either government run or a totally private health care model here; I am just saying that any solution that does not give the patient some expert backup is guaranteed to keep medical costs on a severely upward spiral.