On a cash only basis, a primary care physician can provide continuity of care and routine maintenance for about $40 a visit. That’s under a day’s wage at the federal minimum wage. Is devoting two days of your labor a year (as the absolute worst case) to do routine checkups an unreasonable expectation? I do not believe so.
And for the very small minority where it’s the case, yes, there are doctors willing to provide free care if they know that they are not being taken advantage of. Just don’t expect to drive to the clinic in a car worth more than your doctor’s, with a cell phone that’s better than your doctor’s and expect the free care option.
What specific vaccinations are a problem? I just looked up the CDC’s posted price list and most of them are a buck or two a dose. The most expensive seem to be the zoster and HPV vaccines and those are under $15 each. Vaccines are one time expenses, not recurring, and many of them can be gotten for free from your local county because maintaining herd immunity is worth the expense of providing free vaccinations.
Speaking as someone who has had to juggle credit cards to pay for cancer care (a relative’s, not my own), I can feel your pain. But you’re missing some of the most important parts of the problem.
Sunday, February 19, 2012
Letters to the Editor
A little something I wrote in response to somebody who claimed that the lack of preventative care is what makes US medicine so expensive.
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The US medical system, among the most expensive in the first world, is that way because it is a "for profit" system.
ReplyDeleteI don't believe there is another first world country that operates this way so it's no surprise yours is the most expensive system.
Actually, the US is a mixed system but you bring up a good point that needs addressing, though I doubt you'll agree with my view.
ReplyDeleteAt any one moment in time, it is always possible to destroy a profit system and replace it with a non-profit system that costs less. That doesn't mean that when such measures are taken that you actually get such an improvement but if done at the best competence levels, it is possible to achieve this. What simultaneously happens though is that the incentive to further lower costs is significantly lessened so that the pace of improvement slows whenever such a change happens.
Over time, the "more expensive" for profit system creates lower costs for society and is actually cheaper on a total cost over time basis for any societal level of competence. The effect is magnified because those who tend to be very competent also tend to drift towards sectors that are for profit because they personally benefit from the enhanced compensation structure.