re: #237 PT Barnum

The problem is that everyone seems to confuse the paying for health care with the actual providing of healthcare. There is a difference.

One of the biggest issues is that Medicare pays by procedure rather than based on patient or outcome.

There needs to be movement away from paying by procedure so that 1) Doctors don’t have any incentive to perform tests that aren’t needed. 2) Billing is simplified. 3) We remove the profit motive from paying for healthcare while retaining it in the actual delivery.

I agree about the confusion. Part of that is intentional on the part of the supporters of this legislation. Note that it is always referred to a health “care” reform, when that’s not even a component. This is a massive overhaul of the health “insurance” system in America. So you’re right, people are confusing paying (“insurance”) with delivery (“care”).

Your other points are interesting as well. Doctors generally don’t perform tests that aren’t needed. They may not be medically critical, but unless there is tort reform (not even addressed in this bill), those tests may be damn well critical when the lawsuit paperwork arrives. Billing being simplified is a great idea, but if it’s simply automating records while still requiring two or three people to file, follow-up, argue, refile, re-follow-up and so on, we’re still in trouble.

I’m not sure I understand your last point - about profit.