nos-trum. pronunciation: \nos'-trum\. noun. Etymology: Latin, neuter of noster our, ours.
1. a medicine of secret composition recommended by its preparer but usually without scientific proof of its effectiveness.
2. a usually questionable remedy or scheme.
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Saturday, April 23, 2011

Health Care Incentives: Are We "Consumers?"

Argument among columnists and politicians:  are we "consumers" of health care that can make good choices or not?

Liberal economist Paul Krugman says (New York Times Op-Ed, Apr 21) we can't because it requires too much specialized knowledge for us to decide whether we really need health care or not.

Others say (WSJ Health Blog, Apr 22) that if we ask people to pay some of their own money for health care, it will make them more circumspect.  Conversely, where they pay nothing, there's no incentive to not abuse the system for unneeded care.

Both arguments have their points.  But I would tell Mr. Krugman that our health care decisions are already consumer-based.  We just have to consult a doctor we get the pertinent information to make that call.

We're not helpless because we aren't experts at everything.  We use experts to buy cars and other appliances (e.g., Consumer Reports), because we haven't studied refrigeration repair for several years.

And having to put in some of your blood and sweat usually makes you think before acting, at a minimum.

Those who can't afford much should pay little, that's just common sense.  But our system of government subsidies is abused.  Every doctor I know who sees Medicaid patients is aware that seem pretty well off (late model Cadillac Escalade, iPhone, expensive jewelry, etc) but see their free medical care as their right. Either they have other undeclared income, or somehow they've become qualified for the program.

Some of our other patients who are struggling to pay bills, but don't have as much material wealth, are very angry that they pay the taxes that get these folks their free care.

In any case, this is not about the broken system.  It's about personal freedom and responsibility.  I come down mostly against Mr. Krugman. 

My experience as an adult is that people value only what they earn, not what they are given.

Doc D

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