I skimmed through the article. He argues that this would have been good, because it would stop anesthesiologists from unnecessarily prolonging procedures, and thus drive down their income.
Thus, it's not the proles who would pay for this, but the rich doctors, because uh... (he provides no explanation. Nor does he mention what would happen to the people actually requiring anesthesia and paying for it)
A slop article from some ignorant socdem.
This is just the reheated "insurers play a vital role by efficiently allocating limited resources" bullshit we've been served a million times already.
I can tell this dipshit's never met an anesthesiologist and has no idea what he's talking about. If they were gaming insurance they'd do more patients faster! And the anesthesiologists I've encountered hate nothing like they hate doing their jobs... the idea of them needlessly prolonging their time in a case is just laughable to me.
Aside from anything else, why is the argument always "it's a scarce resource, so let's embrace a soulless parasite rationing it in the name of austerity" rather than "how do we conquer the underlying scarcity?"
This time they sprinkled some fraud flakes on it right out of the oven but it's the same dish. There's no copy of Health Communism next to the cookbooks in this kitchen, all the chefs are bankers and MBAs and they don't give a fuck as long as the tab is paid
A soulless parasite rationing of it whose motives are directly adversarial to us on top of that! They say "Oh, it's more efficient this way" efficient for who? At what? Efficient for them at making money, not efficient for us to stay alive. Dead people, ruined lives, broken families: all hallmarks of great efficiency from the perspective of the parasite.
People like the author scare me. Letting people go through immense pain of not having anesthesia just to make money is some psychopath shit. Or worse, botch a procedure to save time and leave the patient permanently scarred if not dead. All for money.
I can see why people think journalists like this are in some child sex trafficking ring. I mean there really isn't much lower to go than this.
I have met someone like this in life and he would rip out your liver if it means getting a promotion. He gave me some very dangerous jobs.
I don't necessarily believe the author would condone literal pain on the operating table (or ... the other thing you said) but I don't have to because he's clearly OK with inflicting financial ruin on people. See Red Wizard's post for what I mean. That's enough for me to oppose this clown.
Yeah, sometimes I am quick to go to maliciousness as the reason; I've met some incredibly fucked people in my life and had to file a protective order recently.
I'll try to be better.
You're ok in my book, sorry you have to deal with that... and for all I know you could be right... i wonder what his opinion is on the resources chronic pain patients should recieve
He's content with appeals to egalité and indirectly supports the cost reduction (profit) of the insurance company over the income of labor aristocrat/petty bourgeois doctors.
Funny, and very liberal.
From the article:
Anesthesia services are billed partially on the basis of how long a procedure takes. This creates an incentive for anesthesiologists to err on the side of exaggerating how long their services were required during an operation. And there is evidence that some anesthesiologists may engage in overbilling by overstating the length of a procedure, or the degree of risk a patient faces in undergoing anesthesia.
[...]
Critically, contrary to Murphy’s claims, this policy would not have saddled patients with surprise bills, if their operations went over time. The burden of this cost control would have fallen on participating anesthesiologists, not patients, according to Christopher Garmon, associate professor of health administration at the University of Missouri-Kansas City’s Henry W. Bloch School of Management.“Say there is a contract between an insurance company like Anthem and an anesthesiologist,” Garmon told Vox. “What is always in that contract is a clause that says, ‘You, the provider, agree to accept the reimbursement rules in this contract as payment in full.’ That means the provider cannot then turn around and ask [the patient] for money.”
Now, In practice, how that would actually shake out I imagine is this: The insurance would only pay for the amount of "approved time", leaving a deficit for the anesthesiologist. The company that handles collecting payments for the anesthesiologist would send a bill to the patient for the difference, which will be a shocking amount, the patient will not know about this contract clause, and they will just pay it. One day, after a long time of this happening, someone with some inside knowledge will have this happen to them, they will refuse to pay it, hire a lawyer to sue the payment company the anesthesiologist uses, and have to settle this with them in court. The company will refuse to provide the language of their contract and terms with the insurance provider because it is a privileged industry secrete protected under law.
The only way I see this being remediated is through the legal system.
Agreed 100%, no matter what it's always a shell game that winds up fucking over patients and providers to the insurance company's benefit.
It’s telling that the idea that someone could spend decades specialising in a particular industry but not to do so purely for the pursuit of profits and actually out of a desire to help heal their fellow man/woman is so foreign to them that they necessarily conclude that an anaesthesiologist must be rorting the system for personal gain.
relax everybody, it's just a war between health providers and insurers with docs and patients being the ones expected to navigate the minefield they've created.
what could possibly go wrong on an operating table when life, death, and excruciating pain are on the menu?
So... wait... does this guy think that after the doctor is done sewing up a patient and scrubs out of the operating room the anesthesiologist is just left behind hanging out playing with the giggle gas to rack up billable hours?
Yes, I believe that is very close to his argument
Vox isn't sending their best
Means Morning News covered this point, but what they said was notably different. This article never once mentions the reason this was being done: to bring private insurance payouts closer into line with Medicare ones, as part of a long-running effort to improve the cost efficiency of the healthcare system. So in that sense, this policy change isn't great.
This article goes out of its way to avoid mentioning government-run health insurance though, for some reason...
(Side note: the article isn't actually wrong that US doctors make way too fucking much money. In order to realize improved healthcare costs once we have passed M4A in this country, we're going to have to cut doctor compensation down to the bone. I would imagine this would be paired with debt relief for existing doctors, and the elimination of tuition at medical schools, a la Cuba, but the fact is that doctors cannot be pulling down salaries in the six to low-seven figures under M4A if it's going to work at all.)
Physician pay only makes up 7.5% of healthcare costs in the US. So while debt relief and elimination of tuition coinciding with a reduction in physician compensation could be a reasonable reform, especially to bring specialists in line with PCPs, there will also have to be protections in place to prevent that downward pressure from creating yet more fertile ground for private equity to consume even more practices.
If we've passed M4A, I'd like to think a ban on private equity in healthcare would already be on the books, but yeah, I agree with you.
Most people think of the doctor's salary but you'd claw out your eyes looking at the administrative salaries and then remember they give themselves large bonuses every fiscal year.
That’s the whole point of single payer. If there’s only one insurance entity, the state, then doctors either take the rates the state pays or they only take patients who can pay out of pocket, which unsurprisingly is not feasible for the overwhelming majority of doctors. Which also removes bloat as a huge chunk of healthcare costs go into claims processing departments that are constantly playing back and forth with the various health insurance companies. If you compare a major urban hospital in America with a comparable one in Canada, the Canadian one will be a tiny fraction of the size of the American one.
