home *** CD-ROM | disk | FTP | other *** search
- Path: sparky!uunet!spool.mu.edu!yale.edu!qt.cs.utexas.edu!cs.utexas.edu!news-is-not-mail
- From: turpin@cs.utexas.edu (Russell Turpin)
- Newsgroups: sci.med
- Subject: No free market in medicine (was: reliability engineering...)
- Date: 26 Dec 1992 10:46:57 -0600
- Organization: CS Dept, University of Texas at Austin
- Lines: 63
- Message-ID: <1hi2a1INN3s8@im4u.cs.utexas.edu>
- References: <1992Dec18.232913.11952@netcom.com>
- NNTP-Posting-Host: im4u.cs.utexas.edu
- Summary: Not in the US.
-
- -*----
- In article <1992Dec22.220418.5737@bnr.ca> labiche@bnr.ca (Maurice LaBiche) writes:
- > If capitalism isn't affecting the cost of medical care why do
- > we pay so much for it? Is it because we've got so many
- > middle-men collecting processing fees? Is it because of
- > socialized medicine in Canada?
- >
- > Oh no, that's right we don't have a free market here at all.
-
- You got it. When it comes to medical care, there is very
- little in the way of a free market. For example, if one
- wants to look at the why's and wherefore's of how much medical
- care costs and how the costs are structured, one has to take
- into account such things as:
-
- o a government controlled and protected insurance industry,
- o an artifical (and idiotic) linkage between employment and
- health insurance,
- o government regulations in the development of drugs and medical
- treatments,
- o government protection of pharmaceutical interests,
- o government control over how many hospitals are constructed, how
- they are constructed, and how they are run,
- o government provision of medical care for large portions of
- the population,
- o artificial and schlerotic professional specialization,
- o government influence in fee structures,
-
- and many, many others. There are historic reasons for these
- things, and there are even reasonable arguments that some of them
- are good things (though not nearly so many nor so good as most
- people think).
-
- But it is foolish to pretend that the cost structure of medical
- care in the US reflects free market evolution. It doesn't.
-
- -*----
- On Reliability Engineering:
-
- > I understand that many processes are put in place by Companies
- > or Standards Associations to ensure the quality of a product
- > which may be involved in real life situations. However, that
- > does not mean that all projects which get into the real world
- > as products go through these stringent processes to ensure
- > their dependability. ...
-
- Nor should they. Very few computer systems serve as critical
- a function as the control systems of an airliner, for example.
- It is much more economical for a PC used for accounting to
- have a convenient level of reliability, and then just to
- replace parts as it fails. For accounting purposes, one would
- not want to pay the expense of achieving a much greater level
- of reliability.
-
- What I was previously noting was that great reliability in
- software systems is *not* achieved by hiring more careful
- programmers. This is a common, but mistaken, notion.
-
- Russell
-
-
-
-
-