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The Medical Procedure That Keeps Getting Cheaper

Discussions related to the physiological and psychological effects of peak oil on our members and future generations.

The Medical Procedure That Keeps Getting Cheaper

Unread postby mattduke » Sun 20 Sep 2009, 17:18:12

$this->bbcode_second_pass_quote('', 'L')aser eye surgery has the highest patient satisfaction ratings of any surgery, it has been performed more than 3 million times in the past decade, it is new, it is high-tech, it has gotten better over time and... laser eye surgery has fallen in price. In 1998 the average price of laser eye surgery was about $2200 per eye. Today the average price is $1350, that's a decline of 38 percent in nominal terms and slightly more than that after taking into account inflation.


$this->bbcode_second_pass_quote('', '[')b]Why the price decline in this market and not others? Could it have something to do with the fact that laser eye surgery is not covered by insurance, not covered by Medicaid or Medicare, and not heavily regulated? Laser eye surgery is one of the few health procedures sold in a free market with price advertising, competition and consumer driven purchases. I'm seeing things more clearly already.

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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby Pops » Sun 20 Sep 2009, 18:00:58

Yea too bad I couldn't look in the phone book for a big ad when I was about to go into a diabetic coma!

But hey, cheer up, that's exactly how prescription drugs are sold and we all know how great that's working.
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby smallpoxgirl » Sun 20 Sep 2009, 18:33:03

$this->bbcode_second_pass_quote('Pops', 'B')ut hey, cheer up, that's exactly how prescription drugs are sold and we all know how great that's working.


Not exactly. I believe it's generally considered an ethics violation by state boards of pharmacy for pharmacists to advertise prices for prescription drugs, and third party payers are neck deep in prescription drug payment.
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby Pops » Sun 20 Sep 2009, 18:48:59

I was thinking about the drug companies' advertising and the "notepads" and other promotional items given to docs as well as the New and Improved copycat drugs that are neither.

Free trade and the open market don't seem to be hindering them much.
The legitimate object of government, is to do for a community of people, whatever they need to have done, but can not do, at all, or can not, so well do, for themselves -- in their separate, and individual capacities.
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby smallpoxgirl » Sun 20 Sep 2009, 22:48:35

$this->bbcode_second_pass_quote('Pops', 'I') was thinking about the drug companies' advertising and the "notepads" and other promotional items given to docs as well as the New and Improved copycat drugs that are neither.

Free trade and the open market don't seem to be hindering them much.


A lot of the drug shenanigans is driven precisely by the absence of open markets. Because of third party payment, there is little financial pressure on patients to keep their med costs down, so consequently there is little pressure on doctors to prescribe the cheapest effective medication. When cost is an issue, clever use of samples by the drug companies frequently creates incentives to start the patient on the most expensive med rather than the least expensive.
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby rangerone314 » Mon 21 Sep 2009, 08:48:47

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('Pops', 'I') was thinking about the drug companies' advertising and the "notepads" and other promotional items given to docs as well as the New and Improved copycat drugs that are neither.

Free trade and the open market don't seem to be hindering them much.


A lot of the drug shenanigans is driven precisely by the absence of open markets. Because of third party payment, there is little financial pressure on patients to keep their med costs down, so consequently there is little pressure on doctors to prescribe the cheapest effective medication. When cost is an issue, clever use of samples by the drug companies frequently creates incentives to start the patient on the most expensive med rather than the least expensive.

Kinda reminds me of the technique drug dealers in public schools use by giving sample drugs to kids to get them hooked.
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby americandream » Mon 21 Sep 2009, 17:28:16

The free markets to the rescue! Why, do you think we could get some of those tree hugging, price inefficient tribals in the Amazon to subscribe to the efficient price mechanism?

:lol:
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby smallpoxgirl » Tue 22 Sep 2009, 18:48:36

$this->bbcode_second_pass_quote('rangerone314', 'K')inda reminds me of the technique drug dealers in public schools use by giving sample drugs to kids to get them hooked.


Yep. IMHO samples work exactly the same whether it's legal or illegal drugs. If somebody really wants to give it to you, it's probably because it's something that it's not in your best interest to take.
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby americandream » Tue 22 Sep 2009, 19:00:00

One could say this of all forms of advertising and marketing. After all, the intent is to create loyalty. One's interest seldom figures I should imagine.

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('rangerone314', 'K')inda reminds me of the technique drug dealers in public schools use by giving sample drugs to kids to get them hooked.


Yep. IMHO samples work exactly the same whether it's legal or illegal drugs. If somebody really wants to give it to you, it's probably because it's something that it's not in your best interest to take.
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby mattduke » Tue 22 Sep 2009, 20:05:12

Image
Now here is a wonderful product that has improved my life!
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby smallpoxgirl » Tue 22 Sep 2009, 20:42:07

$this->bbcode_second_pass_quote('americandream', 'O')ne could say this of all forms of advertising and marketing. After all, the intent is to create loyalty. One's interest seldom figures I should imagine.


Yeah. I just think that advertising becomes especially pernicious when one person is getting the supposed benefit and another is paying the cost. In that setting, it doesn't take much encouragement to get people wanting the more expensive product. I deal with this with freaking Yaz several times a week. Patients come in wanting Yaz when a generic pill would do just as well at 1/5th the cost. I have to have this long discussion and they usually end up acting like I'm stiffing them somehow. After all...what do they care how much it costs. Their insurance is going to cover it anyway, and those people on the Yaz commercial look so damn happy and enlightened.

Believe it or not, even the name of Yaz is a slick marketing ploy to doctors. All things being equal, which would you rather write twenty times in a day? "Yaz" or "Orthotricyclen Lo"? The three letter name is brilliant. I don't get writer's cramp, the patient gets to feel hip and trendy. The insurance company gets screwed, but what do we care?
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby mattduke » Tue 22 Sep 2009, 20:47:09

Image
Here is all the information you need. Do you advertise yourself in the best light SPG?
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby smallpoxgirl » Tue 22 Sep 2009, 20:49:07

$this->bbcode_second_pass_quote('mattduke', 'H')ere is all the information you need.


Ibuprofen

Short for Isobutyl, propyl, phenol

Unfortunately that's about the only drug I could ID from it's structure.

$this->bbcode_second_pass_quote('', 'D')o you advertise yourself in the best light SPG?


Sort of. My clinic in Montana went belly up. I just work for other people now, so I'm not directly involved in the advertising. The thing is A: most of my patients are directly paying for their own care and B: our prices are very low. If you went to a hospital and received the same procedure that we do, it would cost somewhere between $3000 and $5000. We charge $485 as long as we don't have to mess with insurance. Plus if you have problems and need additional visits or a reaspiration in our clinic that's included in the cash price. In a hospital setting you'd pay extra for all that. Actually, in keeping with the topic of this thread, I would say that abortion is another situation where most of the care is self pay by patients and we've had a big incentive to get more efficient, cheaper (and safer) over the years. The big problem we're staring at right now is that the state board of health is threatening to pass a bunch of restrictions on what pain meds we can give for the procedure. Mind you there hasn't been a single documented problem anywhere in Washington State. They just feel the need to meddle to justify their salary. I assume it's probably going to either force us to charge more or provide lesser quality pain control. I'm pretty upset about it.
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby americandream » Tue 22 Sep 2009, 21:15:47

Welcome to my world. Financial advising has its own subgroup of market profiling, invariably driven by houses intent on pushing their structures and clients who will not listen to objective advice; ethics and cost opportunities be damned. I'ld rather we towed the advertising industry out into the deep blue and left them to fend for themselves.

Seriously though, I don't know how you deal with this growing impasse in the misuse of resourcing worldwide (health, infrastructure, etc, etc) other than to scuttle this whole, nasty tub. On a more realistic note given the nature of the status quo and the fact that the sun is not about to rise on a brave new world of socialism, I'm rather leery of anymore privatisation (cost rationalisation) having seen British Rail, to name one example, reduced from a less than efficient public service to a for-profit shell of its former self.

$this->bbcode_second_pass_quote('smallpoxgirl', '')$this->bbcode_second_pass_quote('americandream', 'O')ne could say this of all forms of advertising and marketing. After all, the intent is to create loyalty. One's interest seldom figures I should imagine.


Yeah. I just think that advertising becomes especially pernicious when one person is getting the supposed benefit and another is paying the cost. In that setting, it doesn't take much encouragement to get people wanting the more expensive product. I deal with this with freaking Yaz several times a week. Patients come in wanting Yaz when a generic pill would do just as well at 1/5th the cost. I have to have this long discussion and they usually end up acting like I'm stiffing them somehow. After all...what do they care how much it costs. Their insurance is going to cover it anyway, and those people on the Yaz commercial look so damn happy and enlightened.

Believe it or not, even the name of Yaz is a slick marketing ploy to doctors. All things being equal, which would you rather write twenty times in a day? "Yaz" or "Orthotricyclen Lo"? The three letter name is brilliant. I don't get writer's cramp, the patient gets to feel hip and trendy. The insurance company gets screwed, but what do we care?
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Re: The Medical Procedure That Keeps Getting Cheaper

Unread postby frankthetank » Fri 09 Oct 2009, 11:48:57

I know some guys that work with my brother who went to Chicago and had eye surgery done for $500/eye and that was a good 5 years ago. My sister, my brother, my sister in law have all had LASIK but they did it at the local clinic and paid a lot for it... I'm thinking it was $1500/eye or more. None of them have had problems and they had it done probably close to 10 years now, although my brother said his night vision is not that great.
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