• Physician market power

    On Aaron’s suggestion, I’m reading Paul Starr’s The Social Transformation of American Medicine (all posts pertaining to it are under the STAM tag). It is too good not to quote. So, I’ll be doing so as I read it. Here’s what caught my eye on page 24:*

    What’s interesting about this passage is it suggests that individuals are not able to offset the market power of physicians but organizations can. In other words, this is an argument for “salaried arrangements,” as provided in the passage, but also for a role of insurers as care managers and bulk purchasers. Naturally, no arrangement is a perfect solution to all problems. Which solution is to be preferred depends on how relevant factors are prioritized, such as overall cost, out-of-pocket cost, consumer-directedness, physician autonomy, quality, etc.

    *I don’t have an electronic copy from which I can cut and paste text. I’ve typed in paragraphs from books in prior posts, but it’s not fun. Many pages are available via Google Books and I’ll be capturing images from those. The disadvantages are that I can’t streamline the text with ellipses and it doesn’t render searchable text. Oh well.

    • Yes, for the love of God, salaried Physicians! Stop everything else you’re working on.

    • I think another reason why so much market power exists in healthcare is the lack of patient knowledge . When no one know really knows what is going on, it is easier to gain more and more market share.

      • @Richard – Except it won’t happen, or not soon anyway. Thus it is worth trying to improve the system we have. Plus, I’ve got to earn a living too. Can’t do that with 100% focus on convincing America to go with salaried physicians.

        @Aaron G – Exactly. One can’t become as educated as a physician. They will always possess some market power w.r.t. non-expert individuals. However, if there are fewer incentives to use that power or that power is countered by another entity, then it’s less of a problem. Again, that’s not easy to pull off, politically.