Tuesday, August 22, 2006

All of a sudden

After opening with his customary fart joke, Bush gave a talk about “health transparency” today. I would say if you’re transparent, you should definitely see a health care professional immediately. Maybe one of those Gray’s Anatomy chicks in the shower (cause you’re transparent, see, try to keep up). He said, “I think the new trend in medicine is going to be to encourage transparency in pricing, as well as transparency in quality. ... How do we encourage consumerism.” As I’ve said before, the language of consumer choice disguises, and not very well I’d have thought, that he wants to “empower” patients to make decisions based on cost rather than health. Nowhere does he suggest any way in which doctors posting their prices would improve medical care, although he does mean to give the impression that it would. He even made an interesting slip, which I’ll highlight:
Think about the system today as a third-party payer, how many of you have got insurance and you never really cared about the cost because somebody else is paying the bill, right? You don’t really care about the quality, because some person in an office somewhere is paying the bill on your behalf.
Said quality, meant cost.

The new focus on “transparency” leaves out any mention of the mechanism of change, which is more or less magical.
And if we can get a system down where people are able to have a good program, a good product, good insurance, but where the consumer has more to say with what’s purchased or not, all of a sudden the dynamic begins to change, and costs begin to go down. ... if consumers have more information from which to make decisions, all of a sudden, costs begin to become less of a burden on the system
He brings up his favorite, because untypical of most medical decisions, example, Lasik surgery, whose cost has also dropped... wait for it... “all of a sudden.” The mechanism of change hidden in all this suddenness is the imposition of economic penalties on sick people who choose to seek medical care. If you’re the sort of person fooled by that sort of vocabulary, you might find the sight of someone signing their name a great source of fascination and entertainment.
Oh, wait a minute, now I’m going to sign an executive order. And I think you’ll find this interesting. It doesn’t take very long, and we usually have people stand behind me when I do it.

“Can I see a price list for pulling this cadace... coodace... wingy snakey thing out of my head?”

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