> Dana wrote:
> fair enough. But based on my experience (perhaps skewed by it) they
> start with a protocol and then if they see a lot of patients with a
> given condition, may satrt to consider how to improve it. But the
> protocol and the consensus are important.
>

That's not true.  Consider that there are 3 events in health care,
ignoring who pays for them:

(1.) Preventative "maintenance": good lifestyle choices (incl job),
routine check ups, metrics-based monitoring.
In general this going to determine your relative disease burden, and
thus your cost to the system.  Any system that doesn't include
penalties for bad choices (and incentives for good ones) is going to
VERY expensive.


(2.) Care methodology once ill or with symptoms.
Are tests ordered?  If you have chest pains are they from that new
workout routine or do we jump right into $200k worth of tests?

"...by reimbursing providers for the effectiveness of treatment — and
not just the volume of tests and office visits — costs can be
controlled without cutting the quality or availability of care."

"The Dartmouth researchers also identified incentives in the current
fee-for-service payment system that can create big differences in cost
with little difference in outcomes. For example, a hospital that buys
the latest imaging technology has to look for ways to keep the machine
busy to pay for it. If the hospital does not buy the machine, it risks
losing business to a neighboring hospital."
http://www.msnbc.msn.com/id/31427909/ns/business-personal_finance/


(3.) Behavior post treatment.  Do you follow doctor's orders?  Do you
take your medicine?  Do you change bad habits?
http://www.wwtdd.com/2009/06/christina-applegate-is-easily-relaxe

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