
Go read John Edgell on the "nudge" theories currently fashionable in the Formerly Known as Democratic Party:
Orszag makes a convincing case that significant cost savings can be deployed through “comparative effectiveness research” where health care providers and procedures are tracked for efficiencies and outcomes. Included in the $787 economic recovery package (PL 111-5) was $1.1 billion to compare the outcomes on patient health care from medicines, medical devices, surgical procedures and treatments.
Perhaps it’s the embracing and funding of outcomes research, coupled with a Democratic Congress and the White House with a firm commitment to revamping health care, that has kept health care players such as insurance companies, drug firms, for-profit hospitals, specialty physicians, and medical device makers — in other words those with the most to lose financially from any large-scale system-wide changes — from joining together in opposition. This too may be the reasoning behind the effort to find $2 trillion in voluntary cost savings.
What may be at play also is what’s known as “Nash Equilibrium,” a key concept in game theory where competitors are fully cognizant of each others’ strategies, creating an eventual greater risk should they choose to alter their strategies. With outcomes better identified, and greater transparency and efficiencies driving overall spending decisions — for example, where expanded patient drug coverage derives considerable savings on future hospitalizations — what may also be in play is “prisoner’s dilemma,” another key concept of game theory. Or what may also be in play here is a fear of being on the wrong side of a “Pareto Efficiency,” a game theory where someone else gains at your expense.
Yadda, yadda, yadda. I left a comment (go and do likewise):
Isn't all this a lot of fancy language to disguise the essential dynamic that's in play here -- that is, keeping the health insurance companies in business? I understand why a lot of fancy footwork would be needed to do that, since single payer has 3% administrative costs, vs. the 30% that goes to executive compensation, profit, and the apparatus needed to deny people care under the health-care-for-profit model, meaning that single payer saves $350 billion a year, covering the uninsured easily without raising taxes on health benefits.
For example, you write of the Nash equilibrium, where "competitors are fully cognizant of each others’ strategies." However, since all "competitors" -- except the people -- have excluded single payer from the table and censored its advocates, clearly other forces than "nudging" are at play.
Let's hope the Democrats come to their senses and do the right thing by August -- with all the players represented in this so-called "open" and "transparent" process.
Comments seem to be moderated, since mine does not appear right away. So much the better -- force them to read what you say.
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problem: American health care is too bureaucratic
solution: more bureaucracy
a uniquely American solution
Should first line end with "FKD"? Even better, "the FKD Party"?
Also, when using the article "the" precedes FKD shouldn't "Party" be used as well?
Since the initials stand for "Formerly Known as Democratic" wouldn't "the FKD Party" make more sense? And be more easily sussed ut by readers? When referring to members of the FKD Party, then writing about "the FKDs" would work, right?
Since this a really neat new acronym/criticism of the Dems, presenting it to make the most sense makes it more powerful. For drop in readers, hard to make out what it stands for, imho. (And I keep mentally putting "Party" in when reading it....)
Outcome comparisons may be way to achieve better outcomes, BUT
since humans vary to greater and lesser degrees, the "best" outcome for a majority of patients might not lead to a good outcome for a single human whose genetic makeup or other conditions preclude that approach from working well for that individual.
To insist that every patient must be treated with something which statistically works for the greatest number of patients may well lead to higher mortality rates or lesser well-being for a minority of patients.
Medicine is based on science, but it is called the "practice of medicine" for good reason. There is much trial and error involved in treatments and diagnoses.
Even with something which seems as clear cut as replacing/augmenting natural thyroid hormones, it turns out some people have adverse reactions to fillers in the so-called inert ingredients which bind the active ingredient in the pills or just don't do well on the best selling/most prescribed synthetic thyroid hormones.
Economists declaring best methods? Scary to me.
A very good point
I have found that most synthetic drugs don't agree with me very well. I tend to have the "side effects" they talk about. I was like that with the synthetic hormones, with a completely different reaction to the bioidentical ones. One doctor insisted the synthetics were the same, but I can tell you they weren't for me!
It's like the synthetic chemicals they put into processed foods. It seems like most people don't feel bad from them, but I do. I had to learn to cook (which I really don't like doing) because most of the processed foods just don't agree with me at all. I have to start with real food, or find foods that don't have all kinds of things I can't pronounce, which is uncommon these days.
"A little knowledge is a dangerous thing. So is a lot." - Albert Einstein