UnitedHealth CEO shot

efil4stnias said
the medical industry web is so interwoven -from medical school to employment to internal groups and outsourced labs ( and im sure im missing other facets like pharmacy/prosthetics/equipment etc ) - its hard to know where to even start re: price controls.

If we institute controls on the services, will medical schools lower tuition? Thereby reducing the debt physicians enter the workforce with? If not, price control wont work. Is that where we start? Or do we start at the service level and hope med schools follow suit?

And if a med school is forced to lower tuition, do the instructors/teachers/professors take a pay cut and stay on or bolt? Does the level of education drop?

I personally believe it must start at the medical school level. The cost of getting a degree in medicine is outrageous. There is no reason a 28 yr old general practitioner should have $200,000+ in debt to start his/her career in medicine. The lone driving factor for them seeking employment will always be maximum income.

But then i start to think about medical equipment- for instance an MRI machine that can cost anywhere from $1,000,000 to $3,000,000 per machine.

Here is what it cost for CT scanner : ( i had no idea that there were 4 different levels - 16 to 256 slice ( slides ) ) so do you go with the 16 to save money but lose out on resolution?
https://www.excedr.com/blog/ct-scanner-cost

meh i gotta get off this thread. im making my brain hurt and lawd knows i cannot afford a CT scan today. ;) I truly dont know where you start to get a handle on this issue.

It's a multi-faceted problem. Medical school debt is certainly part of it. Also, your equipment issue is interesting as well... I've often thought about the idea of competition vs excess capacity in the medical field. How many MRI's do you really need in a particular geographic area? Probably fewer than you already have in high population areas, but more in less populated areas... which means there's probably added costs from redundant systems (where you can get it). Not sure if that makes sense - if you have 3 $3million dollar MRI machines in an area where the demand can be fully serviced by 1, then you have a ton of excess capacity which gets passed on as per use cost to each consumer. But how do you solve that? In Norway, it's centrally controlled, which reduces the costs dramatically -- but also leads to a multiple hour drive to get to the equipment for the remote consumer.

How do you address the profit motive tied to a discrepancy in knowledge and an inelastic demand. If I have cancer, I have to get some kind of service to live - so it's not like I can opt out like I can with a cell phone service or avocado toast.... but I don't know as much as the doctor (or the insurer), who both have differing financial incentives (the doctor has an incentive to spend as much as possible both to increase profit, but also to minimize the risk of being sued for not doing enough to save someone), and the insurer to minimize costs (while still providing enough service to prevent customers from fleeing.

I'm good at asking questions... not so good at providing the solutions. But I do believe we need to dramatically the change we do things.