>>There are only 3 parties - caregivers, patients, and insurers.
>>
>>OK, but you've included a lot of stuff in "caregivers" apart from doctors and nurses. You'd need to include ambulance services, hospital/hotel owners, pharmaceutical manufacturers and wholesalers, equipment suppliers, sterile supply suppliers... sheesh, there's a lot of stuff bundled into that innocuous term. ;-)
>>
>>>>Yes, insurers are skimming, but a whole lot of people are covered by Medicare and Medicaid, which are non-profit.
>>
>>Agreed, but if the cost of care is high then the cost of care is high whether the funder is non-profit or not. Theoretically, insurer dividends are another layer on top.
>>
>>>>The AMA has done a great job of vilifying trial lawyers for the incompetence of its own members who routinely put people at serious risk for cosmetic improvements.
>>
>>Is that all trial lawyers do? OK... except that Texas lost its ability to provide specialist obstetric care through most of the state and had to impose limits on litigation to get providers back. I'm not sure obstetricians perform many cosmetic procedures: the problem was that if an obstetrician faces a 1 in 3 chance of being sued every year, you're better off practicing in a place with fewer moochers- because this is driven by the lawyers, not by the patients.
>>
>>>>Unless you can find someone else, that only leaves one group that is skimming most of the cash, John.
>>
>>Alas, not just one group- surely you split the pharmaceutical suppliers from the nurses who dispense the meds to patients?
>
>OK, the brush was a bit broad.
>Nurses, aides, etc. certainly aren't skimming.
>Some private hospitals might be skmming, but there are none around here.
>Pharma and MD's, however, are joined at the hip here in the US. I've rarely been to see an MD without at least one pharma rep coming by to visit.

I'm seeing this all the time. Pharmacies are buying them into medical practices. Do you need an ultrasound machine and you do not have the money... no problem. If you subscribe our drugs we will get two for you. At conferences the pharmacies are giving the best parties... for all the clients (yep, I've been there a couple of times, sneaking in through mutual clients). BTW, not only in the US, but also in Europe. However since there are more price regulations here on what a certain treatment (not talking about individual procedures) might cost, the big money is to be earned in the US, not Europe.

Our company has been approached multiple times by pharmacies because they are interested in the analysis of our data. However we have not gone into that path "If you're in bed with an elephant, sooner than later you'll be crushed".

>Why do they do that if there is no ROI and why do the MD's spend time with them if there is no ROI?

Exactly.

>Litigation is another matter. Juries are making those awards based on something.

Seen that a couple of times. Mistakes happen, and in one occasion it cost my client several hundred thousand dollar. Something that would not have happened here as the lawyer culture is almost absent here.