tag:blogger.com,1999:blog-10235575.post114287643510237629..comments2024-02-04T15:48:48.193-05:00Comments on Adventures in Applied Math: Pareto-Optimal HealthcareRebeccahttp://www.blogger.com/profile/06927630155994067676noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-10235575.post-1143570448590041872006-03-28T13:27:00.000-05:002006-03-28T13:27:00.000-05:00Oh, and there really are black helicopters ;)Just...Oh, and there really are black helicopters ;)<BR/><BR/>Just reread my post and seems grim, but it is what those of us on the ground are seeing.kerokhttps://www.blogger.com/profile/05002995923419689441noreply@blogger.comtag:blogger.com,1999:blog-10235575.post-1143570357192104082006-03-28T13:25:00.000-05:002006-03-28T13:25:00.000-05:00My own view is that a single-payor plan is best, b...My own view is that a single-payor plan is best, but it will be unacceptable to many. Why? Because it will only pay for things they NEED, and not for what they WANT or the time in which they want to have it (NOW!).<BR/><BR/>A good model for a plan that paid according to outcome is (was?) the Oregon Medicaid experiment. Treaments/services were ranked in order of return on money spent. (Prenatal care saves 5 dollars for every dollar spent so goes near the top of the list.) Every year they would figure out how much money they had to spend, and a line would be drawn somewhere on the list below which those procedures/treatments/services would not be covered. This drew ire from those advocating expensive/quasi-experimental/poor-outcome-anyway treatments for catastrophic diseases, because they didn't fit into the queue.<BR/><BR/>We could build an entirely rational plan, but people would have to change their behavior and expectations. With situations like the drug companies exhorting viewers to "ask your doctor about X," in order to increase the users of the medication we are heading further down the path of demand-based healthcare. This is incompatible with outcome-based care. <BR/><BR/>I won't even start on how medical liability fits into all this. <BR/><BR/>My belief is that, because all of these (and other) issues are inextricably intertwined it will take a meltdown of the system before they can be simultaneously re-engineered. Too many vested interests are resisting change. We should be preparing now for this eventuality. Many of my colleagues on the front-lines think that the meltdown is coming...soon.kerokhttps://www.blogger.com/profile/05002995923419689441noreply@blogger.comtag:blogger.com,1999:blog-10235575.post-1143165960490278592006-03-23T21:06:00.000-05:002006-03-23T21:06:00.000-05:00Beanie Baby,I'm glad you liked my post. I can thi...Beanie Baby,<BR/><BR/>I'm glad you liked my post. I can think of at least two other, more expressive locations upon which you might consider tattooing this post! >:)Rebeccahttps://www.blogger.com/profile/06927630155994067676noreply@blogger.comtag:blogger.com,1999:blog-10235575.post-1143052608304731172006-03-22T13:36:00.000-05:002006-03-22T13:36:00.000-05:00The frustrating thing for me, as a Canadian, is th...The frustrating thing for me, as a Canadian, is that so many ofm y fellow Canadians are so ignorant of these facts and so convinced that a private health care model would somehow serve them better. Maybe I should just tattoo this post on my arm; then I could stop making the argument.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-10235575.post-1142950273081533942006-03-21T09:11:00.000-05:002006-03-21T09:11:00.000-05:00Hi David,Thanks for your comment. I completely ag...Hi David,<BR/><BR/>Thanks for your comment. I completely agree that the decision-making process does not value morality. Corporations aren't going to change on their own, because they have no reason to value social responsibility over profit. The system needs a major overhaul, and the only realistic solution I see is to legislate the change. My goal was to describe what is wrong with the system, not to propose a method of solution.<BR/><BR/>This single blog entry is only the tip of the iceberg and I focused only on what I know, which is math, not political science. :)Rebeccahttps://www.blogger.com/profile/06927630155994067676noreply@blogger.comtag:blogger.com,1999:blog-10235575.post-1142877650547199142006-03-20T13:00:00.000-05:002006-03-20T13:00:00.000-05:00Preach it, sister! I agree. Very good points. Anne...Preach it, sister! I agree. Very good points. Anne (who works in a psych clinic and wrestles with health insurance daily) says that almost nobody who actually works in health care is opposed to a single-payer system. The way it is now is too horrible and inefficient. (Funny, because market-solutions to problems are, supposedly, the most efficient way to go.)<BR/><BR/>I can't believe you were counting sheep by 17's. You are such a nutcase! :-)Laurahttps://www.blogger.com/profile/05276809374974996981noreply@blogger.com