Wednesday, February 22, 2012

Health Care Variation And Social Costs

My posted comment to The Washington Post Ezra Klein's Wonkblog, "Why health care costs vary in one chart" by Sarah Kliff:

Source: The Washington Post
Need to adjust for cost of living differences. Going from Greece to England, analyst will use PPP (purchasing power parity) to compare country healthcare prices. Why not do the same adjustment within the US. There are significant price differences in McDonald's Big Macs in different parts of the US. Why should medicine be any different? Should we regulate McDonald's prices?

Also, social costs, such as wait time for appointment, waiting time in doctor's office, etc., are a big part of unmeasured medical costs. Some patients pay more to lower their social costs and people in some areas of the country expect quicker access. Doctors offer quicker service at a higher cost because it costs more. A doctor who can see a last minute appointment has to have left some room in his/her schedule for an unexpected patient. There is a trade off in prices between efficiency and quicker access.

It takes more MRI machines to be able to schedule a two-day appointment then it does for a three-month appointment. Per patient seen, the three-month appointment system is a lower cost medical provider than the two-day system because fewer machines are purchased. The medical outcomes may be identical, but the social cost to the patient with the injury is greater with the three-month system. It is just that the social costs, extra pain, longer time immobile, more OTC pain killers, lower work inefficiency, etc., are not included as medical costs but should be.

The study implies that the extra costs are an unnecessary excess. It may be that the extra costs are going into better daily quality of life services from the medical providers to lower patients' social costs.

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