@petersuber

Much of this is due to #feeforservice billing paradigm and prepaying for routine care via #healthinsurance

For #primarycare, it's simpler to dump both. That makes primary care efficient enough that we can provide it (and free phone calls and messages) for $44 to $99/month when the hospital clinic down the street is charging $173 to $351 per visit.

Save the insurance for big , expensive problems.

#costsofcare #directprimarycare #dpc #healthreform

@jeffjarvis

All those false positives ("indidentalomas") from full body #MRI will get expensive workups and then follow up studies that will be paid by the rest of us via higher insurance premiums and taxes.

Get some data first please. Failing that, add a special tax on these to cover the extra workups upfront instead of socializing their false positive costs to everyone.

#medmastodon #costsofcare #radiology #evidencebasedmedicine #ebm #sbm #sciencebasedmedicine

@brittanytrang @STAT

4. #maine is one of many states that still have Certificate of Need laws that had the goal of reducing oversupply/use of services but now protect hospital networks (mostly regional monopolies) from lower priced competitors.
It's not rare for me to send patients out of state for cheaper studies, procedures, etc. The price savings are often big enough to make the trips worthwhile for them. The shorter wait for consults are a bonus.

#costsofcare

https://www.pressherald.com/2021/04/07/board-wont-recommend-central-maine-healthcares-proposed-topsham-surgical-center/

@brittanytrang @STAT

2. A large proportion, if not most, of medical care is routine, non-urgent and potentially 'shoppable' but we prepay for it with the same mechanisms we use for ER visits and big inpatient stays causing great harm. It's like using auto insurance for oil changes or homeowner's to have the plumber fix the toilet.

Yes, I'm biased as a #directprimarycare doc but this realization was a big part of why I left #insurance paid practice eight years ago.
#dpc
#costsofcare