Obama Care

[firstdown]

Originally Posted by Schneed10

I'm not quite sure which portion of my comment your question is directed at, but...

The biggest change with healthcare reform is that eventually providers will be reimbursed for episodes of care, rather than for encounters or procedures performed.

Let's say you fall and break your leg. Right now, every time you come to the hospital for an X-Ray we get $90, every time you come for an outpatient surgery we get $1500, every time you come for an inpatient admission we get $7000. I'm making up numbers and oversimplifying, but you get the picture. You can clearly see that the more we see you, the more we get paid. So there's an incentive to see you over and over. Lots of doctors order unnecessary tests because of this.

Under healthcare reform though, if you fall and break your leg we'll get paid a lump sum $8000 to take complete care of you, from the first time you see us to when you're either healed or the year ends. So then it's up to the doctor to decide when ordering a test is really necessary, which he'll be incented to do to watch his bottom line.

Now, before you freak out about a doctor withholding tests in the name of his (or his hospital's) bottom line, malpractice and licensing issues still are strong incentives to keep them from rationing care.

But it's easy to see; why order 4 x-rays on the leg when all you need is 2? It will reduce redundant tests, which reduces costs to the consumer in the long run.

So clearly testing volume will drop at hospitals, so competition will become more fierce. If testing levels drop enough, some hospitals may not be able to support themselves and may have to close. But that just speaks to the excess capacity of healthcare facilities and equipment that we have in SOME parts of the country. Closing those facilities will be a good thing in the long run, it's a market force that will bring capacity more in line with patient demand.

Lots of doctors order unnessary test so they don't get sued. A good portion of those test are done by specialist and the doctor ordering them makes nothing of them.