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Author: Lokicious Big gold star, 5000 posts Feste Award Nominee! Old School Fool Add to my Favorite Fools Ignore this person (you won't see their posts anymore) Number: of 35392  
Subject: Re: Bank failed need some answers... Date: 2/13/2009 1:09 PM
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And, again, to the greater question - would you also want to apply this principle to other essential things whose costs have zoomed up over the last generation?

I'm not sure what other essentials fall under the same conflict of interests/direct advertising parameters. I think short term capital gains should be taxed through the roof to try to eliminate the speculation component in food and energy prices, and I favor government fuel efficiency standards for many reasons—we could argue that people driving Hummers drove up my driving costs. But I think health care is really unique in that direct consumer advertising is intended to undermine decision making by qualified professionals.

I'd buy that, but what about the rest of the definition, like what is "advertising"? Would it include a website with information? Would it include getting links to that website? If no website is permitted, then how can customers, not to mention doctors, ever get any timely information.

I'm all in favor of informed consumers. There can be guidelines about what qualifies as product information and what is a sales pitch. It was never possible, even when ads were banned, to keep some patients from self-diagnosing and self-prescribing and pressuring doctors. But aggressive consumer advertising has made the "informed" patient much more of a problem.

For evidenced-based medicine to drive down costs, conflicts of interests for physicians need to be eliminated, as well as for the health care industry (and law suits against those who practice by the guidelines need to be eliminated). As to who sets standard of care guidelines, right now most health insurers already do this (I have a much larger co-pay for choosing a name brand when a generic will suffice, for example). But it's pretty muddy, which is why when some patients insist on unnecessary or overpriced options (even that higher co-pay still doesn't cover the full difference) it affects everybody. And, we're still trying to get past the HMO fiasco. The problem was that the HMOs were refusing to pay for some treatments that were justifiable and decisions were being made by unqualified bean-counters. In fact, many of the most publicized refusals probably should have been refused from an evidence-based perspective. We won't be able to control health care costs if "I have a right to try everything however unlikely to produce results and have someone else pay the costs" remains the norm. But it is precisely this wing and a prayer stuff that provides the best money for the health care industry (other than insurers—there is a real conflict of interest between insurers and the rest of the health care industry that I would love to see turn into a blood bath).
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