What an Unexpected Conclusion

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Chartreuse Wombat

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It's an interesting debate that will certainly come to forefront in the coming years: is it better to incentivize doctors to offer the most expensive treatment or the least expensive treatment? Ideally we would want to incentivize providing the best AND most cost-effective treatment, but that would require oncologists to agree on exactly what that is
 
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Keep your eyes on the prize. Misaligned incentivization is attention grabbing and "sexy", and intuitively might seem that it leads to increased utilization which drives up health care costs. Unfortunately, there is not much macroscopic evidence of globally increased health care utilization in America compared to other countries. Most academics feel our excessive costs in health care are mostly due to higher prices. The dirty radiation oncologist treating PSA 3 G6 prostate ca in 95years old with alzheimer is not the problem, the large regional medical center with monoplistic pricing leverage with insurance companies due to presence/geography or academic reputation is. Please keep this in mind when you hear about Choosing Wisely and hypofractionation from ASTRO, as it is a distraction from the underlying problem.

California sues Sutter Health, alleging the hospital system unfairly inflated costs for patients

Why the U.S. Spends So Much More Than Other Nations on Health Care

The Astonishingly High Administrative Costs of U.S. Health Care

Health Care Spending in the United States and Other High-Income Countries

https://www.washingtonpost.com/news...yre-mostly-nonprofits/?utm_term=.b0f0c6c412ff
 
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Bundles (site agnostic) would address all of the above, from an RO standpoint . Not for MO though

Would it though? I’d think the prices would be pegged to peers, in which case they’d still get paid more.
 
Would it though? I’d think the prices would be pegged to peers, in which case they’d still get paid more.
Hospital - based peers can't charge more than their freestanding counterparts... We will be lucky if that happens though .. I don't think hospital lobbyists will ever let site neutrality come to pass, even if bundles do eventually go mainstream
 

Thanks, the notion of higher prices is really the dogma now. Price gouging and expanded residencies are linked in many ways.



U.S.

Why Americans Spend So Much on Health Care—In 12 Charts
Prices are hidden behind insurance deals, hospital consolidation pushes up costs and the health sector is a growing power in the economy
STUART BRIERS


By
Joseph Walker
| Graphics by Angela Calderon
July 31, 2018 10:27 a.m. ET
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The U.S. spends more per capita on health care than any other developed nation. It will soon spend close to 20% of its GDP on health—significantly more than the percentage spent by major Organization for Economic Cooperation and Development nations.

What is driving costs so high? As this series of charts shows, Americans aren’t buying more health care overall than other countries. But what they are buying is increasingly expensive. Among the reasons is the troubling fact that few people in health care, from consumers to doctors to hospitals to insurers, know the true cost of what they are buying and selling.


Providers, manufacturers and middlemen operate in an opaque market that can mask their role and their cut of the revenue. Mergers give some players more heft to enlarge their piece of the pie.

Consumers, meanwhile, buoyed by insurance and tax breaks, have little idea how much they are really spending and little incentive to know underlying costs.


Note: Average is of 15 OECD nations with the largest per capita GDP for which data were available in all years.

Source: OECD

A big part of the problem in analyzing health spending is the opacity of the industry.

The bulk of consumers’ health spending now goes to paying for health insurance, a shift from when patients paid directly for health services. Since insurers negotiate prices with providers, it is hard for individuals to judge health costs and make more informed choices.

Hospitals are becoming more consolidated and are using their market clout to negotiate higher prices from insurers.
 
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