Thursday, August 20, 2009

But Plastic Surgery is competitive!

One of the other comments made at the town hall the other night was that "Laser Surgery costs have come down in the last decade. This is proof that medical care, when not funded by or interfered with by the gov't can work well using just the free market".

Thom Hartmann was reading my mind this morning when he responded to a similar question at the town hall he was holding on his radio show. The question is, "but costs for plastic surgery have remained stable or gone down in recent years. Doesn't this prove that gov't only fucks things up when they get involved?"

Ummm..... no.

First, as no health insurance policy in the world will cover elective, cosmetic procedures like facelifts and LASIK I'd say it's a much better indication of how well things can work when there aren't any insurance companies involved. Because even though the Gov't doesn't pay for elective, cosmetic procedures any more than insurance does... they are still very much "involved" in these industries in a regulatory manner. The FDA approves what drugs/treatments they can use. The states license the doctors of course and dictate standards of care/sterility, etc.

Second - what part of "ELECTIVE" do you not understand??? Nobody dies if they don't get that facelift or LASIK surgery (unless, you know you lose your glasses and inadvertently step in front of a moving bus). People DO die, every day from not being able to afford cancer treatment, or brain surgery. A free market only works if one of your options is "none of the above- thanks I can live without it after all". In the case of health care, "None of the Above" = a death sentence. In other words, you're making your "choice" with a gun to your head. That's not free enterprise, it's extortion.

Third - I'm sure one of the reasons there's more competition in the world of cosmetic surgery is because so many doctors are getting tired of dealing with all the crap (insurance and gov't alike) and are saying no to primary care and becoming specialists. This is NOT a good thing, and is one of the reasons most bills on the table include funding/ incentives for doctors to go back to or get into primary health.

Fourth - You can't very well ask for bids/quotes from different hospitals/ ambulance services, etc. when you or a loved one are lying bloody and unconscious in the middle of the street; or in that "golden three hour" window while suffering a stroke when medical treatment might actually save your life. Even if you had any clue, whatsoever as to WHAT specific tests, procedures, drugs etc. you might need at that point.

Well, you night say - nobody expects people to bargain shop in the middle of a crisis. What insurance companies want is for consumers to do their comparison shopping *ahead* of time, and for chronic conditions to help keep down costs. Because we don't have anything better to do than to spend hours out of our days calling up various hospitals, doctors, clinics, labs and pharmacies to find out what they charge for everything from office visits to urine tests to enemas.


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