If colleges worked like health care

[Airhog]

If Colleges Worked Like Health Care - Economix Blog - NYTimes.com (http://economix.blogs.nytimes.com/2010/02/05/if-colleges-worked-like-health-care/)

[albionmoonlight]

If health care worked like college, I think that we'd probably have a lot more advances in the medical marijuana area and doctor's offices would be open from 2:00 in the afternoon until 4:00 in the morning.

[digamma]

Well, there would be morning clinics, but they would be sparsely attended.

[sterlingice]

That's kindof stacking up one dysfunctional model versus another.

SI

[Passacaglia]

What if apples grew like tomatoes? That would be weird, too.

[gstelmack]

Correctly viewed, a modern university is a prepaid, staff-model, pedagogic group practice – the educational analogue of a staff-model health maintenance organization, or H.M.O., like the Kaiser Permanente Health Plan. Like H.M.O.’s, which are prepaid an annual capitation (http://www.health-insurance-carriers.com/kaiser.html?source=google&grp=kaiserpermanente) for all of an insured person’s medically needed services, universities are prepaid one annual tuition fee for all the pedagogic services going into the education of the student.

Well, first off HMO's suck because they take your money and have a huge incentive to NOT treat you when you are sick. That's how they make a profit. I had ONE experience with an HMO and it was NOT pretty.

Second, colleges are NOT that model. You pay tuition per class, room & board is separate, meals are separate, books are separate. I can control costs based on how many hours I attend, what I choose to eat, and where I choose to live. College is more like how BCBS NC handles pregnancy - one copay per "illness", which means we paid once at the start of the pregnancy and not another dime throughout it. Get sick with something else, you pay for that separately.

But yes, doctors charging for every little thing they see you for rather than for their time leads to a lot of the insane billing we have now. I don't know if that is the fault of the doctors or the insurance companies.

[flere-imsaho]

But yes, doctors charging for every little thing they see you for rather than for their time leads to a lot of the insane billing we have now. I don't know if that is the fault of the doctors or the insurance companies.

I'm pretty sure the fault lies with the insurance companies. Since doctors pretty much universally hate paperwork I can't imagine they'd really be into nickel-and-dimeing their patients.

I'd restate the question by asking if this bill-by-item approach is done on purpose by insurance companies (i.e. generate revenue through nickel-and-dimeing), or if it's just a consequence of how they have to do business.

I would imagine that, to an insurance company, insanely detailed billing is preferable to, say, time-based or outcome-based payments because it's black-and-white. If a doctor did X, Y and Z, they pay for X, Y and Z. If he sees patients for 8 hours, did he do it well?

I also suspect that itemizing also allows insurance companies to dictate certain courses of treatment and/or uses of equipment, so as to save costs, and that this is appealing to them (for obvious reasons).

[Noop]

College is a scam.