# Basic problem of for-profit medical care **URL:** \ **Category:** The BBQ Pit\ **Created:** [April 17, 2012, 3:03pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045 "2012-04-17T15:03:46Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![BigAppleBucky](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bigapplebucky/32/178_2.png) [@BigAppleBucky](https://boards.straightdope.com/u/BigAppleBucky)\ **Post date:** [April 17, 2012, 3:03pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/1 "2012-04-17T15:03:46Z")
Patterns: Doctor’s Stake in Lab Affects Biopsy Rate > **[Patterns: Doctor’s Stake in Lab Affects Biopsy Rate (Published 2012)](https://www.nytimes.com/2012/04/17/science/urologists-stake-in-laboratory-affects-number-of-prostate-biopsies.html?src=me&ref=science)** > > Doctors with a financial interest in a laboratory are more likely to send prostate samples, according to a new study, but the rate of cancer detection is no higher. Urologists with a financial interest in a laboratory send more prostate biopsies for analysis and have a lower rate of cancer detection than those who use independent labs, according to a new study. * * * Years ago my physician recommended that I start taking a certain drug. I resisted when I read about some of the side effects. A few months later I read about how the drug company was giving kickbacks to doctors who perscribed that drug. I’d guess many people have similar stories. I think this is at least part of the reason the USA spends nearly twice the proportion of GNP as most developed nations on medical care and has worse results than those same nations. (Lower life expectancy, higher infant mortality) ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [April 17, 2012, 3:11pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/2 "2012-04-17T15:11:21Z")
Another basic problem is that every dollar of profit is a dollar not spent on helping someone. Some conservatives think that non-profit health care means doctors are enslaved, but that’s another story. ---
**Author:** ![Mr.Moto](https://avatars.discourse-cdn.com/v4/letter/m/9de0a6/32.png) [@Mr.Moto](https://boards.straightdope.com/u/Mr.Moto)\ **Post date:** [April 17, 2012, 3:36pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/3 "2012-04-17T15:36:51Z")
Again, these results are skewed by a disconnect between payer and patient. This problem is inherent in government provided health care and health care paid for by a private insurer. The best way to ensure lower costs and patient involvement in health decisions is fee-for-service. Think about this the next time you hear a LASIK ad on the radio. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [April 17, 2012, 3:42pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/4 "2012-04-17T15:42:45Z")
> [@Mr.Moto](#): > > Again, these results are skewed by a disconnect between payer and patient. This problem is inherent in government provided health care and health care paid for by a private insurer. > > The best way to ensure lower costs and patient involvement in health decisions is fee-for-service. Think about this the next time you hear a LASIK ad on the radio. You’re wrong of course. Truly government run health care is cheaper, provides a higher percentage of population covered and produces better results than ours. That’s factual. ---
**Author:** ![Mr.Moto](https://avatars.discourse-cdn.com/v4/letter/m/9de0a6/32.png) [@Mr.Moto](https://boards.straightdope.com/u/Mr.Moto)\ **Post date:** [April 17, 2012, 3:50pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/5 "2012-04-17T15:50:10Z")
> [@Lobohan](#): > > You’re wrong of course. Truly government run health care is cheaper, provides a higher percentage of population covered and produces better results than ours. That’s factual. That’s because ours is not fee-for-service. Look, I am not a zealot here - I am aware that there are costs and benefits for all of these models. Most systems around the world arrive at some mixed system where government pays some portion of cost, industry another portion, with a private option available for those who want or need it. Canada in theory has no private option. In practice most Canadians live within a few hours’ drive of American hospitals that they take advantage of rather routinely. ---
**Author:** ![MichaelEmouse](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/michaelemouse/32/101_2.png) [@MichaelEmouse](https://boards.straightdope.com/u/MichaelEmouse)\ **Post date:** [April 17, 2012, 3:51pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/6 "2012-04-17T15:51:53Z")
> [@Lobohan](#): > > Another basic problem is that every dollar of profit is a dollar not spent on helping someone. Couldn’t the same be said of any industry? Every dollar of profit in agriculture is a dollar not spent on feeding someone. Every dollar of profit in the clothing industry is a dollar not spent on clothing someone. You can do this with every industry. > [@Lobohan](#): > > You’re wrong of course. Truly government run health care is cheaper, provides a higher percentage of population covered and produces better results than ours. That’s factual. What did Moto say? Did he deny that gov’t run health care is cheaper, covers more and gives better results than the current US system? Did he say he was in favor of the US health care system? He recommended fee-for-service as opposed to the two previous options. ---
**Author:** ![Anne\_Neville](https://avatars.discourse-cdn.com/v4/letter/a/b9e5f3/32.png) [@Anne\_Neville](https://boards.straightdope.com/u/Anne_Neville)\ **Post date:** [April 17, 2012, 3:58pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/7 "2012-04-17T15:58:46Z")
> [@Lobohan](#): > > You’re wrong of course. Truly government run health care is cheaper, provides a higher percentage of population covered and produces better results than ours. That’s factual. Maybe optional things like Lasik and plastic surgery could be done on a fee-for-service basis, and stuff that’s actually necessary for survival could be paid for by the government. People can make a rational, non-emotional decision about whether they want Lasik or not. They can’t always do the same thing about bypass surgery or chemotherapy. Desperate people don’t always make rational decisions. The fact that people are going to find it hard to refuse lifesaving care opens the door to jacking up the prices on the necessary stuff. It might be better to let someone with no emotional investment make the decisions on how much to pay for bypass surgery. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [April 17, 2012, 4:03pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/8 "2012-04-17T16:03:08Z")
> [@MichaelEmouse](#): > > Couldn’t the same be said of any industry? Every dollar of profit in agriculture is a dollar not spent on feeding someone. Every dollar of profit in the clothing industry is a dollar not spent on clothing someone. You can do this with every industry. And medical care is different. It is something everyone needs and it, because our system is rubbish, priced out of reach of much of the country. On a purely practical level, the cost of agriculture isn’t growing much faster than inflation. Other countries have a solution that works much, much better than our system. There is something uniquely pathetic about the US where we demand that we are the best, when we pay twice as much and aren’t in the top thirty. > [@](#): > > What did Moto say? Did he deny that gov’t run health care is cheaper, covers more and gives better results than the current US system? Did he say he was in favor of the US health care system? He recommended fee-for-service as opposed to the two previous options. Fee for service works okay for lasik and dental, but in each of those there aren’t huge cost possibilities. Fee for service and no insurance means that people just won’t get heart bypasses. ---
**Author:** ![Rhythmdvl](https://avatars.discourse-cdn.com/v4/letter/r/85f322/32.png) [@Rhythmdvl](https://boards.straightdope.com/u/Rhythmdvl)\ **Post date:** [April 17, 2012, 4:03pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/9 "2012-04-17T16:03:26Z")
Wouldn’t avoiding the OP entail the complete nationalization of health care, from doctor offices to labs? As long as a private lab gets paid, there is an incentive to provide doctors with kickbacks. That’s a far cry from a single-payer system. ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [April 17, 2012, 4:10pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/10 "2012-04-17T16:10:59Z")
> [@Mr.Moto](#): > > That’s because ours is not fee-for-service. > > Look, I am not a zealot here - I am aware that there are costs and benefits for all of these models. Most systems around the world arrive at some mixed system where government pays some portion of cost, industry another portion, with a private option available for those who want or need it. > > Canada in theory has no private option. In practice most Canadians live within a few hours’ drive of American hospitals that they take advantage of rather routinely. That’s a little misleading:[ > [@Wiki](#): > > Some residents of Canada travel to the United States because it provides the nearest facility for their needs. Some do so on quality grounds or because of easier access. A study by Barer, et al., indicates that the majority of Canadians who seek health care in the U.S. are already there for other reasons, including business travel or vacations. A smaller proportion seek care in the U.S. for reasons of confidentiality, including abortions, mental illness, substance abuse, and other problems that they may not wish to divulge to their local physician, family, or employer. ]([Healthcare in Canada - Wikipedia](http://en.wikipedia.org/wiki/Health_care_in_Canada)) ---
**Author:** ![Hbns](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hbns](https://boards.straightdope.com/u/Hbns)\ **Post date:** [April 17, 2012, 4:12pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/11 "2012-04-17T16:12:00Z")
> [@BigAppleBucky](#): > > Basic problem of for-profit medical care I think this is more a regulation problem than a profit problem. When industries were small and markets had numerous independent choices, free market principals worked in the consumers favor. As industries have become more and more consolidated and intertwined and true competition has all but disappeared, more and more the market works against the consumer. Maybe it is time to treat health care in America a little more like we treat electric utilities. ---
**Author:** ![Imago](https://avatars.discourse-cdn.com/v4/letter/i/85e7bf/32.png) [@Imago](https://boards.straightdope.com/u/Imago)\ **Post date:** [April 17, 2012, 4:24pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/12 "2012-04-17T16:24:42Z")
> [@Mr.Moto](#): > > Canada in theory has no private option. In practice most Canadians live within a few hours’ drive of American hospitals that they take advantage of rather routinely. Are you _joking?_ ---
**Author:** ![Giraffe](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/giraffe/32/129_2.png) [@Giraffe](https://boards.straightdope.com/u/Giraffe)\ **Post date:** [April 17, 2012, 4:30pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/13 "2012-04-17T16:30:43Z")
> [@Mr.Moto](#): > > Again, these results are skewed by a disconnect between payer and patient. This problem is inherent in government provided health care and health care paid for by a private insurer. > > The best way to ensure lower costs and patient involvement in health decisions is fee-for-service. Think about this the next time you hear a LASIK ad on the radio. You’re half right. Many people support the current system on the grounds that the free market is more efficient than the government. These people are retards. Our medical system is about as far from free market as you can get: prices are not set competitively, most people have little to no choice over which large company’s plan will determine what they can and can’t do and how much they’ll pay for it, and said large companies siphon a big chunk of cash out of the system at every turn. So if you’re going to support private health care, it’s logical to push for truly private health care, where every service is a standalone product. At least then the free market has a chance to drive some costs down. The problem is that health care isn’t like toothpaste or automobiles: consumers don’t know in advance if/when they’ll need a particular medical service, and would rarely be able to shop around for it or walk away if the market’s prices are too high. And no one can afford the rare catastrophic situations, that’s why we share our risk in the first place. Same as with firefighting, police, and national defense. What it comes down to is that the free market is very good at doing what it is designed to do: maximize the profits of whichever company can deliver good and services to consumers as efficiently as possible. It’s not good at maximizing the overall health of a populace as inexpensively as possible. That’s just not what it is designed to do. Profits, yes. So you end up with insurance companies who know how to structure plans to give the best appearance of coverage to the healthy, while not screwing over the sick so badly that future people don’t sign up for them. Take them out of the equation and you have a chance at doing the cheap stuff a lot better (e.g. preventative care) so you don’t end up treating expensive stuff via the emergency room. ---
**Author:** ![Euphonious\_Polemic](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/euphonious_polemic/32/3002_2.png) [@Euphonious\_Polemic](https://boards.straightdope.com/u/Euphonious_Polemic)\ **Post date:** [April 17, 2012, 4:58pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/14 "2012-04-17T16:58:33Z")
> [@Mr.Moto](#): > > Canada in theory has no private option. In practice most Canadians live within a few hours’ drive of American hospitals that they take advantage of rather routinely. Ha ha ha ha ha! You are wrong of course. > [@](#): > > In a [Canadian National Population Health Survey](http://en.wikipedia.org/wiki/Health_care_in_Canada#Cross-border_health_care) of 17,276 Canadian residents, it was reported that only 0.5% sought medical care in the US in the previous year. Of these, less than a quarter had traveled to the U.S. expressly to get that care So that would be 0.125% of Canadians traveled to the US expressly for healthcare. Rather routinely you say? Bullshit I say. This is one of the things about the healthcare debate that pisses me off. Folks routinely pull a nugget of crap out of their asses, and try to pass it off as fact. Then when the actual data is pointed out to them, they frequently disappear and all you hear is crickets. Wait a while though, and they reappear and post the same bullshit again. It’s like playing whack a mole. ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [April 17, 2012, 5:05pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/15 "2012-04-17T17:05:36Z")
> [@Lobohan](#): > > And medical care is different. Different than agriculture? Everyone doesn’t need food? ---
**Author:** ![Lobohan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lobohan/32/79_2.png) [@Lobohan](https://boards.straightdope.com/u/Lobohan)\ **Post date:** [April 17, 2012, 5:10pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/16 "2012-04-17T17:10:24Z")
> [@John\_Mace](#): > > Different than agriculture? Everyone doesn’t need food? Having trouble with the reading? You don’t suddenly need $500k worth of food or you’ll die. Do you really not understand this, or is this an ideological thing? ---
**Author:** ![Great\_Antibob](https://avatars.discourse-cdn.com/v4/letter/g/e47c2d/32.png) [@Great\_Antibob](https://boards.straightdope.com/u/Great_Antibob)\ **Post date:** [April 17, 2012, 5:14pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/17 "2012-04-17T17:14:32Z")
> [@John\_Mace](#): > > Different than agriculture? Everyone doesn’t need food? Technically, yeah. With a bit of work and not too much expertise, you can grow at least some of your own food, even if it’s probably going to be limited to a few vegetables or something. And if you were gung-ho about it and had some resources, you could become a full time farmer or at least nearly self-sufficient, food wise. There’s a vanishingly small probability that Joe Average could get enough training to be self-sufficient in terms of medical care, no matter how much effort or money was tossed into the attempt. ---
**Author:** ![John\_Mace](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/john_mace/32/185_2.png) [@John\_Mace](https://boards.straightdope.com/u/John_Mace)\ **Post date:** [April 17, 2012, 5:14pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/18 "2012-04-17T17:14:41Z")
> [@Lobohan](#): > > Having trouble with the reading? You don’t suddenly need $500k worth of food or you’ll die. > > Do you really not understand this, or is this an ideological thing? No, I think you’re having trouble remembering what you argument was. You said: > [@](#): > > Another basic problem is that every dollar of profit is a dollar not spent on helping someone. Someone asked you how this differs from other industries, like agriculture. You still haven’t told us how that is different from saying that every dollar of profit made in agriculture is a dollar not spent on feeding someone. ---
**Author:** ![Giraffe](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/giraffe/32/129_2.png) [@Giraffe](https://boards.straightdope.com/u/Giraffe)\ **Post date:** [April 17, 2012, 5:16pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/19 "2012-04-17T17:16:38Z")
> [@John\_Mace](#): > > Someone asked you how this differs from other industries, like agriculture. You still haven’t told us how that is different from saying that every dollar of profit made in agriculture is a dollar not spent on feeding someone. Rather than nitpicking the exact wording one poster used, how about replying to the sentiment behind it, e.g. [QUOTE=Giraffe] What it comes down to is that the free market is very good at doing what it is designed to do: maximize the profits of whichever company can deliver good and services to consumers as efficiently as possible. It’s not good at maximizing the overall health of a populace as inexpensively as possible. That’s just not what it is designed to do. [/QUOTE] Wouldn’t that be more useful and interesting than playing gotcha? ---
**Author:** ![Typo\_Negative](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/typo_negative/32/484_2.png) [@Typo\_Negative](https://boards.straightdope.com/u/Typo_Negative)\ **Post date:** [April 17, 2012, 5:16pm UTC](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045/20 "2012-04-17T17:16:44Z")
> [@Euphonious\_Polemic](#): > > Ha ha ha ha ha! > > You are wrong of course. > > So that would be 0.125% of Canadians traveled to the US expressly for healthcare. > > Rather routinely you say? Bullshit I say. > > This is one of the things about the healthcare debate that pisses me off. Folks routinely pull a nugget of crap out of their asses, and try to pass it off as fact. Then when the actual data is pointed out to them, they frequently disappear and all you hear is crickets. Wait a while though, and they reappear and post the same bullshit again. It’s like playing whack a mole. Would you happen to have any data on how many Americans attempt to go to Canada for health care? [Next page](https://boards.straightdope.com/t/basic-problem-of-for-profit-medical-care/619045.md?page=2)