Liberal Values Defending Liberty and Enlightened Thought

Steve Benen quotes Sue Lowden’s ideas on getting down the cost of health care:

Lowden is a former state senator and chair of the Nevada Republican Party. She’s also, according to nearly every recent poll, the favorite to defeat Senate Majority Leader Harry Reid (D) in November. Lowden is not, as one might imagine, a supporter of recent improvements to the broken health care system, and she was asked at a candidate forum the kind of policies she’d prefer to see. Among her proposals:

“…I would have suggested, and I think that bartering is really good. Those doctors who you pay cash, you can barter, and that would get prices down in a hurry. And I would say go out, go ahead out and pay cash for whatever your medical needs are, and go ahead and barter with your doctor.”

I wonder if she had read today’s Dilbert strip (above) before making this suggestion. We know Scott Adams was joking, but apparently this Republican candidate is serious.

One problem is that pay to one’s doctor is a small part of health care costs. Presumably she means bargain as opposed to bartering to bring down the cost. For the sake of discussion, let’s say that a patient took her advice and I agreed to take 25 percent of the price for my office calls. That’s fine for someone who just needs one or two visits, but a person with serious chronic problems could still run up a huge bill over time. Insurance just might come in handy here (especially if the insurance cannot drop them because of having chronic medical problems).

The bigger problem which comes up when I have uninsured patients is not payment for the office calls but payment for everything I order outside of the office for diagnosis and treatment. Just because I agree to cut the charges for office calls (if Lowden meant bargaining) or agree to accept her goat (if she really means bartering), doesn’t mean that the reference lab I send the patient’s blood to will give them a break. The same is true if x-rays are needed. If surgery is needed the patient then not only needs to make a deal with the surgeon but also the facility where the surgery is performed.

If medications are needed it might be possible to give samples (but pharmaceutical companies are getting stingier with them). It might even be possible to get the patient free medications from a patient assistance program if their income is low enough to qualify. They also better be able to wait a while to get their medications.

This would be quite a challenge for a healthy person to go to all the work, and tolerate the delays, in order to receive medical care at a discount. (Hey, isn’t delays the reason conservatives say we should be terrified of the Canadian system?) If someone happens to be sick, this process goes from unlikely to succeed to virtually impossible. It’s just another unrealistic Republican suggestion for health care.