U.S. Health Care Costs

One thing that would really help: limit hospital births to high risk mothers/babies. Hospitalization is overkill for most births.

I'm all for spending less money at the end of life, but how do you know when the end of life is without spending a lot of money trying to prevent it? It's like the famous quote in the marketing industry: "Half of all the money I spend on advertising is wasted. I just don't know which half."

Parkland's baby delivery system (the largest in the country, I believe) is efficient and of high quality precisely because none of the women are insured. That means Parkland can ignore Medicaid rules, private insurance perverse incentives to overspend and state and federal regulation of private insurance.

It's amazing what can be done if the bureaucracies don't interfere.

And Steve wins the thread. You cannot reduce total costs by restricting the market, if you want to reduce total costs we need better knowledge of the future in the market. But instead of allowing for that (genetic testing etc) they are making it hard to gain the knowledge.

All of that and Parkland is a government run facility. Of course, they still follow government set guidelines for care. You should also realize that Parkland is a teaching hospital. I would wager that their 79 residents provide a lot of that care. I am not sure that is applicable to non-teaching hospitals.

"That means Parkland can ignore Medicaid rules"

This puzzles me. Granted, we do only 3000 deliveries, but we do a large percentage of Medicaid patients. What rules would those be?

Steve

I care about our culture re health care. It costs me an ungodly fortune in insurance I don't use. If insurance companies could look into my motivations and see that I've really got no interest whatever in a bunch of poor procedures, I'd probably save quite a bit of money.

Steve:

"Prenatal care delivered by nurses rather than doctors might not be allowed under many states’ Medicaid rules. Ditto for deliveries performed by midwives. And under typical state insurance regulations, patients with private coverage would be encouraged to see OBGYNs (because of zero patient cost sharing), where the cost would be higher and the overall quality of the pregnancy/delivery episode might not be as good (because of fragmented care).

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