There certainly is cost shifting to private pay as a result of low Medicaid, Medicare (and of course charity care) reimbursement. "Costs" are also inflated to allow for more bad debt to be written off. Remember, no one ever pays charges. But I don't think our issue with costs can solely be attributed to govt programs or a lack of supply of docs. If so, why are prescription drugs so expensive? We have lots of competition there. There are more drug stores than McDonalds in the US.
But, lets remember, Medicare is single payer in the US and even with this model, we spend more on Srs than any other country with single payer. We get so caught up on price per unit/drug/procedure that we lose focus on increases as a result of the amount of care we consume. Again, our single payer system is more expensive than the rest of the world. Why is this? Id argue our reimbursement model to pay docs is so flawed. We pay on a per unit FFS basis. Plus all docs get the same $. Good, bad or horrible. Everyone gets paid the same. Thats a flawed model.
I agree a part of this is how far removed the patient (and provider) are from what things costs which only drives utilization. Im a huge fan of mandating fee schedules being posted for everything along with requiring there to be cost share on every service, even if its modest. Im also for paying base don outcomes that look at the total cost of care.
Im just a shill though.
But, lets remember, Medicare is single payer in the US and even with this model, we spend more on Srs than any other country with single payer. We get so caught up on price per unit/drug/procedure that we lose focus on increases as a result of the amount of care we consume. Again, our single payer system is more expensive than the rest of the world. Why is this? Id argue our reimbursement model to pay docs is so flawed. We pay on a per unit FFS basis. Plus all docs get the same $. Good, bad or horrible. Everyone gets paid the same. Thats a flawed model.
I agree a part of this is how far removed the patient (and provider) are from what things costs which only drives utilization. Im a huge fan of mandating fee schedules being posted for everything along with requiring there to be cost share on every service, even if its modest. Im also for paying base don outcomes that look at the total cost of care.
Im just a shill though.