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	<title>Comments on: Indifference To Hospital Quality</title>
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	<link>http://www.overcomingbias.com/2009/08/hospitalquality.html</link>
	<description>Overcoming Bias is economist Robin Hanson’s blog, on honesty, signaling, disagreement, forecasting, and the far future.</description>
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		<title>By: billswift</title>
		<link>http://www.overcomingbias.com/2009/08/hospitalquality.html#comment-431486</link>
		<dc:creator>billswift</dc:creator>
		<pubDate>Thu, 13 Aug 2009 23:46:00 +0000</pubDate>
		<guid isPermaLink="false">http://www.overcomingbias.com/?p=19275#comment-431486</guid>
		<description>The comment was from John Thacker at 1:20 this afternoon, I intended to include that attribution, then forgot until I hit the post comment button.</description>
		<content:encoded><![CDATA[<p>The comment was from John Thacker at 1:20 this afternoon, I intended to include that attribution, then forgot until I hit the post comment button.</p>
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		<title>By: billswift</title>
		<link>http://www.overcomingbias.com/2009/08/hospitalquality.html#comment-431483</link>
		<dc:creator>billswift</dc:creator>
		<pubDate>Thu, 13 Aug 2009 23:42:12 +0000</pubDate>
		<guid isPermaLink="false">http://www.overcomingbias.com/?p=19275#comment-431483</guid>
		<description>Robin, this is a bit off-topic for this post, but it&#039;s the only recent medical economics post I&#039;ve seen, so here goes: a commenter on Megan McArdle&#039;s blog came up with a good question:
&lt;blockquote&gt;That brings up another point: What do the calculations of &quot;percentage of GDP spent on health care&quot; cover? If one system, like the US, has doctors paying high tuition at medical school, which is then passed on to consumers as higher health care costs, but another system has doctors&#039; tuition paid &quot;for free&quot; out of other tax money, do these comparisons count the subsidized doctor education as part of &quot;health care costs?&quot; Or is that slid into &quot;these countries spend more on education and less on health care?&quot; Similarly, if a country decides that it wants to research pharmaceuticals through government research instead of using the profit system, are the taxes used to pay that counted as &quot;health care costs&quot; or as &quot;this country saves on health care costs so it can spend more on science and research?&quot;&lt;/blockquote&gt;
Maybe you could get  some of your students to research it, like Lomborg got his students to examine some of Julian Simon&#039;s claims he had doubts about.</description>
		<content:encoded><![CDATA[<p>Robin, this is a bit off-topic for this post, but it&#8217;s the only recent medical economics post I&#8217;ve seen, so here goes: a commenter on Megan McArdle&#8217;s blog came up with a good question:</p>
<blockquote><p>That brings up another point: What do the calculations of &#8220;percentage of GDP spent on health care&#8221; cover? If one system, like the US, has doctors paying high tuition at medical school, which is then passed on to consumers as higher health care costs, but another system has doctors&#8217; tuition paid &#8220;for free&#8221; out of other tax money, do these comparisons count the subsidized doctor education as part of &#8220;health care costs?&#8221; Or is that slid into &#8220;these countries spend more on education and less on health care?&#8221; Similarly, if a country decides that it wants to research pharmaceuticals through government research instead of using the profit system, are the taxes used to pay that counted as &#8220;health care costs&#8221; or as &#8220;this country saves on health care costs so it can spend more on science and research?&#8221;</p></blockquote>
<p>Maybe you could get  some of your students to research it, like Lomborg got his students to examine some of Julian Simon&#8217;s claims he had doubts about.</p>
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		<title>By: Joseph Knecht</title>
		<link>http://www.overcomingbias.com/2009/08/hospitalquality.html#comment-431345</link>
		<dc:creator>Joseph Knecht</dc:creator>
		<pubDate>Tue, 11 Aug 2009 06:02:44 +0000</pubDate>
		<guid isPermaLink="false">http://www.overcomingbias.com/?p=19275#comment-431345</guid>
		<description>Are you sure they weren&#039;t communists or Nazis, mentally?</description>
		<content:encoded><![CDATA[<p>Are you sure they weren&#8217;t communists or Nazis, mentally?</p>
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		<title>By: Jess Riedel</title>
		<link>http://www.overcomingbias.com/2009/08/hospitalquality.html#comment-431338</link>
		<dc:creator>Jess Riedel</dc:creator>
		<pubDate>Mon, 10 Aug 2009 22:19:01 +0000</pubDate>
		<guid isPermaLink="false">http://www.overcomingbias.com/?p=19275#comment-431338</guid>
		<description>Because patients would still want their doctor to take into account their individual illness.  Also, because (as I mention below) patients don&#039;t feel capable of interpreting such survey results.</description>
		<content:encoded><![CDATA[<p>Because patients would still want their doctor to take into account their individual illness.  Also, because (as I mention below) patients don&#8217;t feel capable of interpreting such survey results.</p>
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		<title>By: Jess Riedel</title>
		<link>http://www.overcomingbias.com/2009/08/hospitalquality.html#comment-431337</link>
		<dc:creator>Jess Riedel</dc:creator>
		<pubDate>Mon, 10 Aug 2009 22:15:46 +0000</pubDate>
		<guid isPermaLink="false">http://www.overcomingbias.com/?p=19275#comment-431337</guid>
		<description>Where do I obtain these objective ratings?  Can I trust them?  What if one hospital has an overall lower infection rate, but another has more knee replacements resulting in full mobility?  How to I measure the trade-off (mortality vs. mobility) when deciding where to get my knee replacement done?  What if I don&#039;t even know what statistically significant means?</description>
		<content:encoded><![CDATA[<p>Where do I obtain these objective ratings?  Can I trust them?  What if one hospital has an overall lower infection rate, but another has more knee replacements resulting in full mobility?  How to I measure the trade-off (mortality vs. mobility) when deciding where to get my knee replacement done?  What if I don&#8217;t even know what statistically significant means?</p>
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		<title>By: Constant</title>
		<link>http://www.overcomingbias.com/2009/08/hospitalquality.html#comment-431329</link>
		<dc:creator>Constant</dc:creator>
		<pubDate>Mon, 10 Aug 2009 18:00:05 +0000</pubDate>
		<guid isPermaLink="false">http://www.overcomingbias.com/?p=19275#comment-431329</guid>
		<description>Medicine is so far from being free market that the usual conclusions one might draw on the assumption that it is remain dubious. Lack of something provided is evidence of lack of demand in a largely free market. The shortages of toilet paper in Cuba is not strong evidence that Cubans don&#039;t want toilet paper.

Proper nutrition is the first medicine and food is much, much close to being free market, so if your views are correct they are likely to apply.</description>
		<content:encoded><![CDATA[<p>Medicine is so far from being free market that the usual conclusions one might draw on the assumption that it is remain dubious. Lack of something provided is evidence of lack of demand in a largely free market. The shortages of toilet paper in Cuba is not strong evidence that Cubans don&#8217;t want toilet paper.</p>
<p>Proper nutrition is the first medicine and food is much, much close to being free market, so if your views are correct they are likely to apply.</p>
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		<title>By: Robin Hanson</title>
		<link>http://www.overcomingbias.com/2009/08/hospitalquality.html#comment-431325</link>
		<dc:creator>Robin Hanson</dc:creator>
		<pubDate>Mon, 10 Aug 2009 17:43:42 +0000</pubDate>
		<guid isPermaLink="false">http://www.overcomingbias.com/?p=19275#comment-431325</guid>
		<description>If subjective doc evals contain useful info about hospital quality, one could survey docs and use that to construct public ratings of hospitals.  This would be much better than individual doc evals.  So why aren&#039;t such survey results available if consumers are eager to get them?</description>
		<content:encoded><![CDATA[<p>If subjective doc evals contain useful info about hospital quality, one could survey docs and use that to construct public ratings of hospitals.  This would be much better than individual doc evals.  So why aren&#8217;t such survey results available if consumers are eager to get them?</p>
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		<title>By: eot</title>
		<link>http://www.overcomingbias.com/2009/08/hospitalquality.html#comment-431324</link>
		<dc:creator>eot</dc:creator>
		<pubDate>Mon, 10 Aug 2009 17:24:26 +0000</pubDate>
		<guid isPermaLink="false">http://www.overcomingbias.com/?p=19275#comment-431324</guid>
		<description>Robin was obviously referring to looking at objective ratings of hospital performance for different treatments/conditions, not making uneducated judgments based on arbitrary criteria.</description>
		<content:encoded><![CDATA[<p>Robin was obviously referring to looking at objective ratings of hospital performance for different treatments/conditions, not making uneducated judgments based on arbitrary criteria.</p>
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		<title>By: Constant</title>
		<link>http://www.overcomingbias.com/2009/08/hospitalquality.html#comment-431322</link>
		<dc:creator>Constant</dc:creator>
		<pubDate>Mon, 10 Aug 2009 16:08:21 +0000</pubDate>
		<guid isPermaLink="false">http://www.overcomingbias.com/?p=19275#comment-431322</guid>
		<description>&lt;em&gt;wasted a half-hour calling two hospitals and the surgeon to see what their fees were&lt;/em&gt;

I had similar experiences, and James Donald had a &lt;a href=&quot;http://blog.jim.com/economics/how-to-do-health-care-right.html&quot; rel=&quot;nofollow&quot;&gt;similar experience&lt;/a&gt;.

&lt;blockquote&gt;My wife was advised to get a colonoscopy. We shopped around, got a reasonable price at a doctor with a good reputation, negotiated with the insurance company, did all the stuff one does in an environment which actually has prices. Then after the colonoscopy was done, the hospital pulled a huge list of stupendously expensive charges out of their ass, most of which were obviously ridiculous or completely made up out of thin air, just trying it on to see what they could get away with, and all of which were charges we had definitely not agreed to, nor consented to in any way, formal or informal, written or unwritten. They just were not used to doing stuff on the basis that one has a definite price, and that the price one charges affects demand for one’s services. The concept seemed alien and incomprehensible to them. Mentally, they were socialists.&lt;/blockquote&gt;</description>
		<content:encoded><![CDATA[<p><em>wasted a half-hour calling two hospitals and the surgeon to see what their fees were</em></p>
<p>I had similar experiences, and James Donald had a <a href="http://blog.jim.com/economics/how-to-do-health-care-right.html" rel="nofollow">similar experience</a>.</p>
<blockquote><p>My wife was advised to get a colonoscopy. We shopped around, got a reasonable price at a doctor with a good reputation, negotiated with the insurance company, did all the stuff one does in an environment which actually has prices. Then after the colonoscopy was done, the hospital pulled a huge list of stupendously expensive charges out of their ass, most of which were obviously ridiculous or completely made up out of thin air, just trying it on to see what they could get away with, and all of which were charges we had definitely not agreed to, nor consented to in any way, formal or informal, written or unwritten. They just were not used to doing stuff on the basis that one has a definite price, and that the price one charges affects demand for one’s services. The concept seemed alien and incomprehensible to them. Mentally, they were socialists.</p></blockquote>
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		<title>By: AnnJo</title>
		<link>http://www.overcomingbias.com/2009/08/hospitalquality.html#comment-431321</link>
		<dc:creator>AnnJo</dc:creator>
		<pubDate>Mon, 10 Aug 2009 15:59:57 +0000</pubDate>
		<guid isPermaLink="false">http://www.overcomingbias.com/?p=19275#comment-431321</guid>
		<description>Relying on one&#039;s doctor&#039;s advice as to hospitals, or a hospital&#039;s reputation (record) for care of one&#039;s condition isn&#039;t the same as being indifferent to hospital quality, is it?   Especially since choosing one&#039;s doctor for a procedure may dictate what hospital one uses for it.</description>
		<content:encoded><![CDATA[<p>Relying on one&#8217;s doctor&#8217;s advice as to hospitals, or a hospital&#8217;s reputation (record) for care of one&#8217;s condition isn&#8217;t the same as being indifferent to hospital quality, is it?   Especially since choosing one&#8217;s doctor for a procedure may dictate what hospital one uses for it.</p>
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