tag:blogger.com,1999:blog-11034229.post6237440715412490147..comments2023-07-14T02:53:40.719-07:00Comments on retired doc's thoughts: More and more to come on the concept of "value" in medical carejames gaultehttp://www.blogger.com/profile/05537303135780186926noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-11034229.post-57492558281212738342011-01-01T14:45:09.333-08:002011-01-01T14:45:09.333-08:00The experts would work with interdisciplinary team...The experts would work with interdisciplinary teams to determine some multi-dimensional value.What happen to the economic idea that value was subjective and in the eyes of the person who purchases a good or service and not in the work or labor that went into it.Did not an economist in the 1800s show that the labor theory of value was invalid.But wait, the whole RBRVS system is basically a return to the generally discredited labor theory of value.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-11034229.post-21828160888900185812010-12-29T11:48:47.806-08:002010-12-29T11:48:47.806-08:00A very interesting post. While they're at it,...A very interesting post. While they're at it, one might also ask these "value" experts to let us know how many angels can dance on the head of a pin. You know, in economic systems as in many other aspects of nature there are far too many variables and far too much complexity for mere humans to sort it out effectively. Let's take a very simple example - much simpler than anything healthcare is going to throw at us. <br /><br />Three different airlines offer slightly different prices to fly you from Seattle to New York. One is cheaper, but it has stops along the way and takes a little longer. Another is more expensive and quicker, but the planes are always dirty and crowded and the flight attendants tend to be rude. The third takes an intermediate amount of time, but stops in Chicago where the weather is iffy this time of year. You might end up stuck for days if you're unlucky. They serve free drinks, but also have a baggage fee. But they also tend to lose your baggage at a higher rate than the other two. Quick question for Drs. Lee and Porter: Which one provides the best "value"?<br /><br />The answer, of course, is that it depends on who you are and what your relative priorities and values are. Wasting valuable resources on coming up with a global "3rd party" assessment is a complete waste, and a fool's errand. There are too many variables - not just with respect to the airlines but also in the customers they are serving. This is why we have free markets, and why they have proven time and again (for centuries!) to be the most efficient way of allocating things. Have the folks at Harvard not heard of them???<br /><br />Oops. I forgot. Harvard is where RBRVS was invented...Doug Perednia, MDhttp://www.roadtohellth.comnoreply@blogger.com