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Wednesday, March 15. 2017
Medicine has a long history of unproven and dubious treatments, but it is discouraging to see it approached deliberately. A quote: “[Hospital executives] talk of patients as customers. Customers have demands. Your job is to sell them what they want.”"
No it's not. It's to give them your best opinion on what is best for them, with maybe some choices or maybe not.
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Actually, yes it is, sort of.
What the customer wants is to be healthy and free of pain with as little effort as possible.
This doesn't mean that you have to sell them *what they ask for*, just what they want/need.
Back in the 60s my father was a medical instrument salesman, and one of the doctors he called on needed some sort of motorized whatsit (I can't remember) for his surgical suite. The whatsit came in two types, one for use in suites that used supplemental oxygen and one for those that didn't (meaning that one was sealed against sparking etc. which could be A Bad Thing if the oxygen/nitrogen balance in the room is out of whack).
Doctor didn't want to spend the extra dosh on the sealed unit. My father wouldn't sell him the unsealed unit.
This is called "ethics" and too few people these days have it. That hospital is run by people who do not have it, and should be called on it.
Wants vs Needs
When you say "wants", it's fairly obvious that this is something determined by the patient based on what he subjectively values.
However, when you refer to "needs" and imply (by your sentence structure) that these may be equivalent or related to "wants", you're stretching it. I suspect you realize that. Who gets to determine what the patient "needs"? The patient? The doctor? The hospital administrator? The insurance company? Some government agency? Some scientific study?
"Need" is a term favored by the left because it implies that something is not merely desired for one's relative pleasure, but necessary for one's existence. In a world of endless wants and finite resources, this is a crucial distinction.
Back to your point - it's not necessarily unethical for a hospital administrator to provide "unnecessary" services to patients who want and demand (in an economic sense) those services. What is unethical is to advertise them as necessary (make false claims about their virtues or values). I'm sure you would have no problem with a hospital providing a luxury suite, lavish meals, private nursing, valet parking, etc. for some patients and bare bones accommodations for others - provided each group was charged an amount agreed to for the level of services.
In many nations, the room and board items that we consider as "needs" are not routinely supplied. Instead, families are expected to supply the patient's food, clean sheets, etc. Only the medical services are deemed to be included. What can properly be called "hotel and restaurant services" are not.
The problem is that the federal government has intervened and determined what we "need" and they dictate what gets delivered and what gets paid. That's beyond the intellectual abilities of the people actually delivering or receiving medical care.
I see pharmacies now carrying a lot of "alternative medicine" products which I assume are more profitable than ethical drugs.
The local medical school got a big donation from the space cadet wife of a local billionaire and, sure enough, it now has an "alternative Medicine Center."
Reminds me of the old song "My sister sells sex on the corner."
Urologist in a large practice: We now carry a full line of natural alternative products.
Me: Do they work ?
Urologist: Lot's of people use them.
Me: Do they work ?
I don't have a problem with alternative medicine as a informed choice or as a scientific experiment/study to determine efficacy. But I do not think medical insurance should pay/subsidize it.
Did you read about the Husband who shot his wife's doctor after she died from cancer? The doctor had talked her into an alternative treatment instead of chemotherapy.
Insurance companies and their customers SHOULD be free to enter into any insurance contract that is mutually agreeable - but the federal government won't allow this (we're not smart enough). That would allow the insurance company to tailor a policy to fit what you want AND are willing to pay for, i.e. you want more extras, coverage, lower deductible, etc.->you pay higher premiums (this ain't rocket science).
Much of ObamaCare was about mandating that insurance companies include coverage for certain things in ALL policies (such as maternity care or contraceptives for 60 year olds....or nuns). The purpose wasn't to protect customers. It was to transfer wealth from certain taxpayers to special interest groups beholden to the Democrats (in exchange for votes).
As for alternative medicine specifically, the lobbyists for these groups (chiropractors, etc.) have led congress and federal agencies to force insurance companies to cover their services under ALL policies. The government should allow my insurance company to sell me a policy that does not cover services I don't want.....and to charge me less for such a policy. But the lobbyists say that's not fair.
I agree that insurance companies should be able to write any insurance contract they want including quacks and medicine men. However to the extent that it is covered by government regulation and/or subsidized by taxpayers health insurance should only cover legitimate treatment. If Lloyds of London wants to insure for laetrile treatments or witch doctors chanting I'm OK with that. But not the regulated health insurance and most certainly not health insurance that is subsidized by the taxpayers. The problem is that already too many people believe in fakirs and quacks so I don't want to institutionalize it. If you or anyone wants to pay for the laying on of hands or cutting a chickens head off and covering you with it's blood please be my guest. Put it on youtube if you like. Just don't make me pay for it or make the government pretend it is legitimate.
As soon as you throw in "government", your argument vanishes by virtue of the demonstrable fact that when somebody other than the insurer and the insured get to decide what's legitimate, virtually anything can be deemed legitimate or not.
Chiropractic pseudoscience wasn't always covered by Medicare, but cheese (a.k.a. $$$) attracts rats and the chiro lobby persuaded (translation: $$$$$) the federal government to pay for this crap (translation: transfer your tax dollars to quacks). So, now certain chiro manipulations are deemed "legitimate."
Let me make my point again - I re-read my post and I can see didn't emphasize this: The federal government has NO business in healthcare insurance. Wherever and whenever the federal government meddles in healthcare insurance, the costs go up, the quality goes down and the access becomes limited and/or delayed.
You are right and I'm not denying it. But government does exist and there are clearly some things that the government must and should do. Without government we would still have incompatible fire fighting equipment, incompatible nuts and bolts and progress and safety would be stifled. Government's job as it pertains to insurance is standardization and efficacy. We should not allow and by our inaction encourage outright fraud and dishonesty. I cannot read all the fine print on my insurance and neither can 99% of Americans. We expect and deserve that our insurance companies (and all companies) follow certain standards and avoid intentionally defrauding their customers. Only a federal government can enforce this across the 50 states. It is a necessity that someone does it or we would have anarchy. The trick is to balance what must be done while avoiding what should not be done. Your insurance policy is essentially a contract a huge complicated contract with lots of small print and exceptions. Most of us never even see the contract never mind read it. The only reason that this can be true and the insurance companies still don't have all our assets and have enslaved us is because of regulation. Like it or not it is necessary.
Modern medicine has turned into one huge con job. The system exists to suck maximum cash out of clients, with no more regard for the patient than that exhibited by nursing homes. Offering alternative therapies is simply a way to avoid leaving cash on the table.
“Yes, as scientists, we want to be rigid. But me, as a physician, I want to find what’s best for a patient. Who am I to say that’s hogwash?” said Dr. Linda Lee.
Who are you to say that's hogwash? Well, you're a trained physician, aren't you? The purpose of examining evidence is so that you can reach a factual conclusion, not merely so that you can appreciate alternative points of view about what the truth is. While it's good to be open-minded, you shouldn't be so open-minded your brains fall out. If there's no possible causal link between the treatment and the result, there's no science involved.
Now, if you'll excuse me, my arthritis is acting up so I've got to go find a black cat and pluck three hairs off of its tail to put under the porch step.
Let's e a bit more precise: Big Pharma s a big reason costs have shot up. And they too, are not above pressing for sale of drugs that do little more than what the patients want.
Also, too many doctors "continuing education" of what truly works, comes not from courses taught by "scientists" or other physicians, but from Big Pharma's "detail men", the sales guys (or often attractive young women!!!) who give the old snake-oil pitch for their company's products and leave tons of free samples with all the docs.
Prozac became one of the top-prescribed and sold drugs of all time for "everything what ails ya" as a result, despite the fact that it barely passed every placebo test ever employed by the FDA or the industry.
There is "some" truth in what you are saying but it is far from universal. My siblings and I were born at home (in the 30's and 40's) with a family doctor attending. I had my tonsils taken out on our kitchen table by our family doctor. When I was 8 years old I went into convulsions and collapsed from a allergic reaction. My mother called the family doctor who left his office so quickly to drive to our house that he didn't even hang up the phone. My mother was still holding it when he came in. He gave me an adrenaline shot directly into my heart to restart it (or so I was told). I have only good feelings about my doctors and nurses. Our family doctor would often provide my mother with free medicine that had been given to him by big pharma's sales guys. Our doctor was a kind old man who knew us all by our first names and made house calls and now even 50 years after he passed away I remember him fondly like an uncle or grandfather. That is how I see the doctors today even though a lot of them look like High School kids to me and not like a grandfather. I love my doctors and nurses and only wish there was something more I could do for them. I do bring the surgeons candy (but only if the surgery is successful :>) I wish them all well and they have my full respect.
Spoken like a true Bernie Sanders useful idiot.
Pharmaceutic companies are behaving rationally in response to government subsidies for their drugs.
When the government provides insurance (Medicare and Medicaid) at below market cost, patients have an incentive to seek more goods (drugs) and services than they would if they were bearing the true cost of these goods and services. As a result, drug companies - acting rationally and responsibly in the interest of their shareholders (that may include you) - increase the price and availability of their drugs.
The same thing happens when (vis government tax laws that favor employer paid medical insurance) insurance is furnished by an employer. Insurance purchased with pre-tax dollars results in higher prices for medical goods and services, i.e. the employee doesn't end up pocketing any savings. The benefit ends up in the hands of the service provider. This is ECON 101.
But the liberal politicians need you to think you're a VICTIM of some rich corporation (run by angry old white Republican men) and that if you vote for them, your problems will be solved. Instead, they create plans and give them bogus names - like Affordable Care Act - that are aimed at creating and illusion of helping you, but which actually make the problems worse or create a new set of problems worse than the original.
I can't tell you how dismayed I was when my niece told me that nursing schools are actively promoting this kind of junk medicine as something nurses can do. The nursing profession has their own list of diagnoses they can make, one of them being "disturbed energy field" as my niece showed me in her textbook. The treatment is waving hands over the victim, I mean "patient", to restore the energy field in the best revival tent huckster healer tradition. I wonder how much that will cost on the final hospital bill.