I got this comment from Z-MD on my last blog which due to some glitch I couldn't publish so I am putting it here.
Your brothel story perfectly illustrates the lack of capitalism and competition in American health care. People with means will gravitate toward the more expensive product, even if the outcome is the same. Unfortunately many Americans who can't afford it still demand the expensive treatment. With government funding and insurance companies obscuring the true cost of treatments, people want nothing but the best ie/costliest care since they are not paying the full cost. If Medicare was subsidizing brothel visits (isn't sex one of life's necessities?) every old geezer would be down at the Chicken Ranch to get his $10 worth instead of paying $2 out of pocket. And if somebody's getting their $10 worth of subsidized nookie instead of paying $2, then everybody will want it, quickly bankrupting the system which is where we are today.
The point I think I made was that there is no difference between the $10 fzck and the $2 fzck and maybe the problem is not that we have "poor" people demanding $10 fzcks but rather that we offer them at all. I could give examples and maybe will some other time.
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Great Z's opinion may apply to those Californians, informed, entitled, and conscious (and bankrupt state-wise). I live in a different part of America, where roughly 15% are illiterate and we compete for the bottom of the list, if the list is of things like education, healthy behaviors, income. Obesity we rank in the top ten!! In my hospital based practice, the docs call the shots, and yes, order costly tests and procedures out the yazoo!! But the patient doesn't drive the system, they are often the helpless sick person, whose thought processes are so disrupted it is hard to believe they can give informed consent. Not to mention they really can not go on line to get the latest and push for it, ie baby boomer yuppies. I would like to see some real choice in American health care, like posting hospital infection rates on line, and RN to patient ratios, and surgeon number of cases done with results, but not likely any time soon. Oh, and Z's comment about the people polishing the spokes on his van not having health insurance, yet being able to go to the hospital and receive free all the best without paying for it, well, they can't afford to get the meds to prevent the health crisis that will force them the go to the ER sicker than most, because they had to work, no paid sick time. Great system.
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