[the_d3f4ult]

This is an uninformed take. A relatively small fraction of our healthcare dollars (~7%) are going to ‘providers’ i.e. doctors and nurse practitioners. I don’t have a source handy but this is easily searchable.

Most of the spiraling healthcare costs are attributable to administrative bloat, hospital profits, insurance companies and pharmaceutical profits. What you’re suggesting would just result in lower quality care in general and has effectively already been implemented with the rise of ‘supervised’ and unsupervised mid-level providers. I.e. NPs, PAs, CRNAs etc. It hasn’t resulted in any decrease in healthcare costs for the patient.

Let me give you some context for insight. If I see a patient in clinic for an intravitreal injection my fee will be $150-250 before overhead, the pharmaceutical company will be paid by medicare or private insurance around ~ $2000 for the drug that I inject. Double that for a bilateral injection.

If I operate at a hospital, my fee is $5-600. The hospital bills medicare a $4000 facilities fee plus additional fees for anesthesia, consumables etc. to the tune of over $10000 per eye.

If you want to lower healthcare costs a good start would be negotiating drug prices, repealing the clause in the ACA that bans physicians from owning hospitals, banning non-competes for healthcare professionals and getting rid of certificates of need that make it unnecessarily difficult to build outpatient surgery centers. In short, ideas that require a more nuanced understanding of our healthcare system.

[bad_haircut72]

Thank you for the reply. As in all things, I'm prepared to be wrong, if that 7% is indeed even ballpark accurate.

btw I appreciate being called uninformed (which I dont dispute and find no offence in) rather than stupid or pigheaded or whatever. The point of talking about things is to share and increase our understanding.

[bad_haircut72]

For what its worth I did check this today and it seems to be more like 20% of healthcare is going to providers, not 7%.

However in the grand scheme of things this still isnt that bad, and I do think doctors/nurses deserve a good compensation, so given the problems associated, maybe we dont go with removing medical licences as a solution to healthcare costs

[Tostino]

Hey, good attitude to have. I've been seeing this type of exchange less and less on HN, but agree completely that it's (reassessing their positions) something more people should be doing / willing to do.