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  • Health system shake-up, 'pay per cure'

    I just read this article:

    DOCTORS should be paid on the basis of making their patients healthier rather than just the number they see because the current system is failing.

    My first reaction was 'awesome idea'. This might also have a knock on effect. As a long term psoriasis sufferer I know there's plenty of treatments out there and no cures. I suspect because research is funded by pharmaceutical companies whose share holders are better served if the research produces a treatment rather than a cure.

    But then I realised doctors might start 'cherry picking', only treating easy to solve cases and leaving people with difficult problems out in the cold. (I don't mean any disrespect to the doctors who are in the business for good and noble reasons.)

    So, do you think 'pay per cure' is a good, workable idea?

  • #2
    oncology would cease to exist as a specialty as most cancers don't have a cure.
    I think there would be a good deal of "cherry picking" and patient health on a population level would likely deteriorate.
    my 2c

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    • #3
      In America docotrs do refuse to treat some patients who are terminal because it will mess their mortality rates up. Very very wrong IMO.

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      • #4
        i think its a case of rearranging deck chairs on the titanic. socialised medicine is the problem, take that away and you dont have these problems. but thats just my humble opinion and i realise people will react to it without thinking and apply all sorts of labels to me to imply that i lack intelligence and/or compassion.
        Originally posted by Friedrich Hayek
        "The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design."

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        • #5
          Originally posted by Infusi0n View Post
          In America docotrs do refuse to treat some patients who are terminal because it will mess their mortality rates up. Very very wrong IMO.
          How can they refuse to help after taking the Hippocratic oath?

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          • #6
            I think socialised medicine is the answer. Everyone treated, everyone treated the same, regardless of how much money they "contribute".

            Pay per cure should put us in a position where our doctors will only want to talk to us if we've got something they can fix quickly. Scares the comfort out of me.

            Edit:
            Don't their insurance companies own hospitals over there? So the pen pusher can decide who the doctor sees next. It might not be a doctor's choice to not treat terminal patients, but they might not have the option to do it.
            This is general advice only and does not take into account your individual objectives, financial situation or needs (your personal circumstances). Before using this advice to decide whether to purchase a product you should consider how appropriate it is in regard to your personal circumstances.

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            • #7
              Originally posted by Taylor View Post
              I think socialised medicine is the answer. Everyone treated, everyone treated the same, regardless of how much money they "contribute".

              Pay per cure should put us in a position where our doctors will only want to talk to us if we've got something they can fix quickly. Scares the comfort out of me.

              Edit:
              Don't their insurance companies own hospitals over there? So the pen pusher can decide who the doctor sees next. It might not be a doctor's choice to not treat terminal patients, but they might not have the option to do it.
              socialised medicine is the answer? isnt this a problem with socialised medicine? in non-socialised medicine doctors get paid by their patients who choose to use them for their own reasons. you wouldnt have to worry about how to work out doctors pay then, youd just have to worry about which doctor you think does a good job based on what you think a good job is.
              Originally posted by Friedrich Hayek
              "The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design."

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              • #8
                Originally posted by dr00 View Post
                socialised medicine is the answer? isnt this a problem with socialised medicine? in non-socialised medicine doctors get paid by their patients who choose to use them for their own reasons. you wouldnt have to worry about how to work out doctors pay then, youd just have to worry about which doctor you think does a good job based on what you think a good job is.
                If you are referring to the UK system where you are assigned a GP based on where you live then I agree with you. A family member of mine got crap treatment because she lived in a crap area. The family member moved to a nicer suburb and actually got to see a decent GP. The good aspect of this system is no need to ever pull out a wallet and good continuity of care.

                The system we have here where you are free to see any GP you want and are partially or fully subsidised by medicare is pretty good I think. It would arguably be better if medicare increased its reimbursement levels so all consults could be bulk-billed, but I don't see that happening.

                The selection of good doctors by patients occurs here anyway, so I'm not quite sure what your point is in regards to socialised medicine.

                *edit* So much potentially wrong with this proposed reform re: what taylor and infusi0n have typed...
                Last edited by Drenelin; 01-09-2009, 03:11 PM. Reason: Actually read article

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                • #9
                  Quite easily desmo, they take a look, realise that they can get paid more by treating someone with a chronic illness and then choose to ignore the suffering of the others. They might read the hippocratic oath, but I doubt that a lot of them care about it, they are paying close to 300k for a degree though that gets interest charged on it, so I can see why they focus on money.

                  Is a private system the way to go? Fuck no, the most fully private scheme is the USA and their world ranking is shocking. France has the most socialised and ranks #1 but that is a lot to do with the quality of Dr they produce (very very good). I think a happy medium between socialised and private is the best (and it's what we have).

                  Fully private also means that Dr's can charge whatever they want, and we get a system where (yet again) the poor miss out on a basic service, exactly like what is happening with dentistry in australia. You can tell someones socioeconomic status by their dentistry work or lack thereof.

                  Taylor: Not all hospitals are owned by insurance companies, but a whole lot are and they do have people whose entire job it is, is to find issues with peoples health insurance and cancel their support. Think the start of the "incredibles" movie "our job is not to help the customer but our stockholders". Therein is a huge conflict of interest IMO.

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                  • #10
                    At end of the day Health Care/Medicare and Insurance is going up to
                    cover whatever Crudd wants to do...


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                    • #11
                      Pay per cure is a really bad idea!! Reserving further judgement till i read the article

                      Ok, after reading the article the basic concept seems fairly good, however would be really difficult not only to implement but to govern. However in saying that, at my work, we have just started implementing some new strategies aimed at developing a stronger primary health care focus, and we are currently undergoing some huge changes directly related to primary health focus. So it will be interesting to see where it does lead.
                      Last edited by who me?; 01-09-2009, 04:19 PM. Reason: read article

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                      • #12
                        Originally posted by dr00 View Post
                        socialised medicine is the answer? isnt this a problem with socialised medicine? in non-socialised medicine doctors get paid by their patients who choose to use them for their own reasons. you wouldnt have to worry about how to work out doctors pay then, youd just have to worry about which doctor you think does a good job based on what you think a good job is.
                        Soo in this scenario of free market the amount of doctors trained is not restricted? Have you run this past the AMA?
                        They hung a sign up in our town "If you live it up, you won't live it down"-Tom Waits

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                        • #13
                          Hey there? got a cold, no problems, take this and this. Come back in a week to make sure your feeling better.
                          1 Week later:
                          Hi, how you feeling? all good, great, sign this form saying I cured you and thats $350 thanks.
                          :stupid:

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                          • #14
                            Originally posted by Wedge View Post
                            Hey there? got a cold, no problems, take this and this. Come back in a week to make sure your feeling better.
                            1 Week later:
                            Hi, how you feeling? all good, great, sign this form saying I cured you and thats $350 thanks.

                            I could so see that happening

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                            • #15
                              Originally posted by chew View Post
                              Soo in this scenario of free market the amount of doctors trained is not restricted? Have you run this past the AMA?
                              yeah i spoke with them yesterday. they gave me the thumbs up so we're all systems go.
                              Originally posted by Friedrich Hayek
                              "The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design."

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