should all healthcare adopt Kaiser's system?

[brainhulk]

I was just speaking with my friend who is a cardiologist at Kaiser. He said he doesn't get paid per procedure, instead he gets paid a fixed salary per year. He said he had to attend "Kaiser University" so he can learn their philosophy in preventative medicine. They spend their money on preventative screenings and therapy up front in the hope of preventing expensive complications down the road.

He mentions the private system as it stands now just waits for shit to happen and encourages profiteering off procedures.

 

[preslove]

Yes, we should adopt universal healthcare and one of the many, many, many efficiencies it would create is more preventative medicine leading to fewer costly complications down the road.

 

[cbrunny]

Yeah, it's called single payer universal. That's what modern countries do.

Should update thread - remove "Kaiser" replace with "single payer universal"

edit: some systems do pay-per-visit or pay-per-patient, but I've not heard of pay-per-procedure as a method. I suppose it is possible for it to exist in a single payer universal though. More likely there's some kind of hybrid approach.

 

[vi edit]

There's several things buried in the OP.

1) Yes, I do think we should remove the incentive of pay for service. Healthcare should not be a business with profit in mind. It should be a business with outcomes in mind. Getting paid by service instead of paid for results puts the wrong emphasis on why providers may elect to do a particular procedure. Making them salaried removes the incentive model of pushing particular procedures. Also making them salaried under the hospital instead of operating from and independent practice groups removes some of the power struggle and billing confusion in the mixed models.

2) Basic access to healthcare should be a public utility. Well checks, basic diagnosis and treatment, ect should be something offered by high functioning 1st world country. Emergent care (traumatic injury, heart attack, ect) and chronic/terminal health issues (cancer)is a trickier thing that is much harder to build into a risk pool. But it's something that a non-partisan and smart committee should be able to come up with a well reasoned option to support.

3) Yes, preventative medicine should be the approach. It's hard to tell how effective it really is though. People are cheap, stubborn, and stupid. Option 2 above can help offset the cheap part if access is free. Option 1 can somewhat help the stubborn part if the check up is reasonable and not a billion lab draws and other services there there to cook up the bill. Hell, even something like a traveling nurse can hit up a pile of homes in a day to do check ins on people that can't drive or do not have access to transportation. But the stupid thing is hard to overcome. You can put piles of info in front of people. But if they don't want to change, they aren't going to. And they will just end up being a drain on your risk pool.

 

[zinfamous]

Kaiser is a great model. Mayo is better, but they are both similar (same idea with salaried physicians and preventative care focus--Mayo just happens to be highly specialized in most areas. Basically--those clinics are far more comprehensive and not all that expensive, comparatively).

Universal healthcare in the US, I think, should look something like Kaiser and Mayo clinic.

 

[tynopik]

more importantly, should this post be in P&N?

 

[IronWing]

Healthcare just encourages weakness. We should be tougher.

 

[Ns1]

as a customer, kaiser was fucking awesome. as long as you're a reasonably healthy individual and get along with all the providers in their network. their system is truly amazing.

after a few years of getting bounced around terrible PPO doctor offices, I finally found a PPO provider group that's basically kaiser (ie provides similar level of online functionality), but PPO + better doctors.

 

[BudAshes]

My work just switched over. Sadly as I'm in Az it is useless for me.

 

[Capt Caveman]

Kaiser is not the only healthcare system that practices this.

 

[AgentUnknown]

The same kaiser that the waiting room is a meat market?

 

[elitejp]

Vi edit
I see what you are saying about healthcare services should be about getting people healthy and not about profit but i dont see how that is reasonable when all the employees are looking at getting paid well and in time through hard work and the value they have created expect a raise.

 

[TwiceOver]

Something has to "give". Every year my employer insurance coverage gets worse while the deductibles and premiums increase. I'm not saying single payer is the solution but the average person can't live with insurance like this. Last year it cost my employer just shy of $8000 for me to visit the doctor once and get one prescription.

 

[Murloc]

hospitals still need to be paid per performance because surgery simply costs more money.

It's an issue that requires attention anyway because there are surgery-happy doctors, especially when it comes to joints and c-sections.

 

[vi edit]

Vi edit
I see what you are saying about healthcare services should be about getting people healthy and not about profit but i dont see how that is reasonable when all the employees are looking at getting paid well and in time through hard work and the value they have created expect a raise.

How do we handle other "civil servant" positions like firefighters, cops, and teachers?

 

[zinfamous]

The same kaiser that the waiting room is a meat market?

what waiting room? Urgent Care, Clinic, ER?

The ER is a meat market in any hospital...except Kaiser, where, ime, they hustle you through if you are a member (not that I agree with this).

 

[Ruptga]

How do we handle other "civil servant" positions like firefighters, cops, and teachers?

Pay them nothing then bitch when their unions demand raises?

 

[NutBucket]

as a customer, kaiser was fucking awesome. as long as you're a reasonably healthy individual and get along with all the providers in their network. their system is truly amazing.

after a few years of getting bounced around terrible PPO doctor offices, I finally found a PPO provider group that's basically kaiser (ie provides similar level of online functionality), but PPO + better doctors.

Just curious about your comment "getting bounced around terrible PPO doctor offices". Makes it sound like they were doing the bouncing when you have "unlimited" choice in providers?

 

[Ns1]

Makes it sound like they were doing the bouncing when you have "unlimited" choice in providers?

Yes, we voluntarily left all those doctors because all those doctors had terrible back-office practices that couldn't hold a candle to Kaiser. There were countless "great" doctors who would schedule appointments at 2 but fail to see my wife until 2-3 hours later. And then they wouldn't email or send you the test results w/o follow-up.

Compared to my current medical group (and Kaiser), you get an email saying your medical info has been updated online, with a link to said results.

 

[NutBucket]

Gotcha.