What about people who may be 'genetically pre-disposed' for certain
diseases, such as cancer.  Should they be penalized because of their genetic
makeup?

On Sun, Jun 21, 2009 at 2:56 PM, Gruss Gott <[email protected]> wrote:

>
> > 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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