Read what Tyler Cowen has to say, then consider possible options for the direction of health care in this Country. Tyler assumes that Medical Care in this country will be categorized by Price. I can think of a more capable system, though everyone will think it very Orwellian. I take my idea from the British system of Trial where Solicitor and Pleader are separated. I would leave diagnosis to Doctors, and medical treatment given to medical economists with the ZIP code style thrown in for good measure. Surgeons would be separated into an entirely third class, and hired by medical examiners by their record of success. Doctors would be paid a Piece rate for placing the Patient ailment in a Postal-style treatment code, medical economists would take the Postal code and assign Drug treatments or medical procedures, while Surgeons and Technicians would be brought in for curative treatments. Doctors could be chosen on the basis of success in diagnostic analysis, medical economists would be chosen on the basis of success in distribution of medical cases through the system; and Surgeons and Technicians would be picked according to their success rates. All would get what was a functional flat rate for types of medical treatment, with a bonus for each success. Patients would flow through the medical system, with basically no one concerned about how much Wealth was assembled by the Patients. My position is that it would be functionally a better performing medical system with higher success rates and lower Costs.
My rationale for the above decision is the distribution of tasks. Medical students straight out of training would get the ‘grunt work’ of medicine when they are young themselves and healthy, and could better spend their time perfecting their surgical and technical craft. Older physicians would be placed in diagnosis where their physical efforts will be less, but their experience along with Time to maintain their understanding of current medical literature would make them the best diagnosticians. Everyone could more easily be adjudged for their success rates with greater overall supervision, and medical examiners could keep the medical costs as low as possible. A series of constant Questionnaire evaluations would allow for a high degree of colleague evaluation of Peers and Subordinates without any onus being placed by such activity.
Could such a medical system be introduced?–probably far easier than is currently imagined. Part of the success of the medical system would be the simple fact that Patient and Practitioner do not possess a personal relationship, with all Patients evaluated based solely on medical condition. There are several medical clinics which show extremely high levels of success utilizing a similar system, able to capture expertise and delineation of task. It could be a real Winner! lgl