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  #11  
Old 08-27-2009, 10:05 PM
Namazu Namazu is offline
 
Join Date: Jan 2007
Posts: 185
Default Re: Thaler

Quote:
Originally Posted by claymisher View Post
Some takes:
[snip]
Thanks for the links. I didn't find the arguments persuasive, though. A couple of common threads:

- small opportunity from tort reform: actually, a KPMG study claims $210B/yr in defensive medicine costs
- advantages to scale: not really obvious in healthcare delivery, and at some point we're talking about a public non-option, and the monopsony problem has huge consequences for innovation
- government competency: key question is whose government? We're not Sweden, and we're probably not even the UK--which, by the way, has a system Americans would find totally unacceptable

What seems to work well here are tightly-integrated payer/provider networks, and there are good examples of both profit and not-for-profit. Perhaps in combination with government-provided catastrophic reinsurance or risk-weighted reimbursement to avoid denial-of-coverage/adverse selection problems. And figuring out how to have more Kaiser Permanentes. Incidentally, by state, the lowest satisfaction correlates with the least competition (as you might expect), but the worst states tend to be the ones dominated by the Baby Blues.
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