Random Thread - Anything Goes

[Dashrender]

@scottalanmiller said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

Basically... McDonald's takes transmitting your order from cashier to cook more seriously than most doctors take getting your prescription from doctor to pharmacist.

This was definitely true a few years ago, but becoming much and much less true. Electronic submissions of prescriptions is pretty common today. My office has been doing it for nearly 10 years.

Becoming less true, but still vastly true. My family has loads of pharmacists in it and they talk about all the garbage that happens still today. And we know doctors that don't even have computers in their offices still. It's very much still true today. And that 7,000 number is the rate per year that sloppy handwriting causes deaths TODAY after many doctors have moved away from handwriting. Think about that... imagine what the figure was just ten years ago, maybe 70,000?

Definitely horrible - I blame the pharmacists though as much as I do the doctor. They are clearly guessing at what the doctor meant, instead of confirming. If the pharmacists were to push back on the doctors by calling and refusing to fill a prescription until they confirmed a messy script, the doctors would likely be pressured into writing better.

[wirestyle22]

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

Basically... McDonald's takes transmitting your order from cashier to cook more seriously than most doctors take getting your prescription from doctor to pharmacist.

This was definitely true a few years ago, but becoming much and much less true. Electronic submissions of prescriptions is pretty common today. My office has been doing it for nearly 10 years.

Becoming less true, but still vastly true. My family has loads of pharmacists in it and they talk about all the garbage that happens still today. And we know doctors that don't even have computers in their offices still. It's very much still true today. And that 7,000 number is the rate per year that sloppy handwriting causes deaths TODAY after many doctors have moved away from handwriting. Think about that... imagine what the figure was just ten years ago, maybe 70,000?

Definitely horrible - I blame the pharmacists though as much as I do the doctor. They are clearly guessing at what the doctor meant, instead of confirming. If the pharmacists were to push back on the doctors by calling and refusing to fill a prescription until they confirmed a messy script, the doctors would likely be pressured into writing better.

Once the patient leaves their office they don't give a shit from what I've seen

[RojoLoco]

@wirestyle22 said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

Basically... McDonald's takes transmitting your order from cashier to cook more seriously than most doctors take getting your prescription from doctor to pharmacist.

This was definitely true a few years ago, but becoming much and much less true. Electronic submissions of prescriptions is pretty common today. My office has been doing it for nearly 10 years.

Becoming less true, but still vastly true. My family has loads of pharmacists in it and they talk about all the garbage that happens still today. And we know doctors that don't even have computers in their offices still. It's very much still true today. And that 7,000 number is the rate per year that sloppy handwriting causes deaths TODAY after many doctors have moved away from handwriting. Think about that... imagine what the figure was just ten years ago, maybe 70,000?

Definitely horrible - I blame the pharmacists though as much as I do the doctor. They are clearly guessing at what the doctor meant, instead of confirming. If the pharmacists were to push back on the doctors by calling and refusing to fill a prescription until they confirmed a messy script, the doctors would likely be pressured into writing better.

Once the patient leaves their office they don't give a shit from what I've seen at all.

FTFY

[Dashrender]

@rojoloco said in Random Thread - Anything Goes:

@wirestyle22 said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

Basically... McDonald's takes transmitting your order from cashier to cook more seriously than most doctors take getting your prescription from doctor to pharmacist.

This was definitely true a few years ago, but becoming much and much less true. Electronic submissions of prescriptions is pretty common today. My office has been doing it for nearly 10 years.

Becoming less true, but still vastly true. My family has loads of pharmacists in it and they talk about all the garbage that happens still today. And we know doctors that don't even have computers in their offices still. It's very much still true today. And that 7,000 number is the rate per year that sloppy handwriting causes deaths TODAY after many doctors have moved away from handwriting. Think about that... imagine what the figure was just ten years ago, maybe 70,000?

Definitely horrible - I blame the pharmacists though as much as I do the doctor. They are clearly guessing at what the doctor meant, instead of confirming. If the pharmacists were to push back on the doctors by calling and refusing to fill a prescription until they confirmed a messy script, the doctors would likely be pressured into writing better.

Once the patient leaves their office they don't give a shit from what I've seen at all.

FTFY

Nah - that's truly overstating it from my experience - at least to the patients faces, the doctor cares - the staff generally doesn't, but the doc does. Now, once they move past you as a patient, who knows if they continue to care or not - but I gotta ask - how many IT people care about their customer once they get done with them? I bet around the same number of docs who care about the patient afterwards.

Now you might say - oh.. but he's a doctor, he should care.. really? why?

[wirestyle22]

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@wirestyle22 said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

Basically... McDonald's takes transmitting your order from cashier to cook more seriously than most doctors take getting your prescription from doctor to pharmacist.

This was definitely true a few years ago, but becoming much and much less true. Electronic submissions of prescriptions is pretty common today. My office has been doing it for nearly 10 years.

Becoming less true, but still vastly true. My family has loads of pharmacists in it and they talk about all the garbage that happens still today. And we know doctors that don't even have computers in their offices still. It's very much still true today. And that 7,000 number is the rate per year that sloppy handwriting causes deaths TODAY after many doctors have moved away from handwriting. Think about that... imagine what the figure was just ten years ago, maybe 70,000?

Definitely horrible - I blame the pharmacists though as much as I do the doctor. They are clearly guessing at what the doctor meant, instead of confirming. If the pharmacists were to push back on the doctors by calling and refusing to fill a prescription until they confirmed a messy script, the doctors would likely be pressured into writing better.

Once the patient leaves their office they don't give a shit from what I've seen at all.

FTFY

Nah - that's truly overstating it from my experience - at least to the patients faces, the doctor cares - the staff generally doesn't, but the doc does. Now, once they move past you as a patient, who knows if they continue to care or not - but I gotta ask - how many IT people care about their customer once they get done with them? I bet around the same number of docs who care about the patient afterwards.

Now you might say - oh.. but he's a doctor, he should care.. really? why?

It's a human life?

[RojoLoco]

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

[Dashrender]

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

That's a whole different story.

[RojoLoco]

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

That's a whole different story.

If doctors actually cared, then money wouldn't drive everything they do. They may seem to "care" while they're in the same room as you, but they care more about that new vacation house on an island, or their new, ridiculously expensive supercar, or whatever. The patient is just a cash cow, and they only need to care enough to keep that revenue stream rolling.

Why yes, I am VERY cynical... I call it being realistic.

[Dashrender]

@rojoloco said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

That's a whole different story.

If doctors actually cared, then money wouldn't drive everything they do. They may seem to "care" while they're in the same room as you, but they care more about that new vacation house on an island, or their new, ridiculously expensive supercar, or whatever. The patient is just a cash cow, and they only need to care enough to keep that revenue stream rolling.

Why yes, I am VERY cynical... I call it being realistic.

Do you consider doctors elsewhere on the planet (in first world countries) different? To that end I have no idea.
It seems unlikely that doctors in France/Germany/UK, etc aren't thinking about expensive supercars either.

These are people after all. While there are some people who give fully of themselves for others, I certainly don't expect it from most.

[scottalanmiller]

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

That's a whole different story.

If doctors actually cared, then money wouldn't drive everything they do. They may seem to "care" while they're in the same room as you, but they care more about that new vacation house on an island, or their new, ridiculously expensive supercar, or whatever. The patient is just a cash cow, and they only need to care enough to keep that revenue stream rolling.

Why yes, I am VERY cynical... I call it being realistic.

Do you consider doctors elsewhere on the planet (in first world countries) different? To that end I have no idea.
It seems unlikely that doctors in France/Germany/UK, etc aren't thinking about expensive supercars either.

These are people after all. While there are some people who give fully of themselves for others, I certainly don't expect it from most.

But are they given a free pass to act like incompetent buffoons and not behave like a competent secretary who would never communicate sensitive, life threatening information by hand rather than digitally? The US treats doctors like they are simultaneously idiot children that can't be expected to function in society, and as the critical holders of our healthcare. No other profession would be socially accepted to write critical life saving or death causing information by hand, let alone routinely in a way that cannot be read. None

[RojoLoco]

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

That's a whole different story.

If doctors actually cared, then money wouldn't drive everything they do. They may seem to "care" while they're in the same room as you, but they care more about that new vacation house on an island, or their new, ridiculously expensive supercar, or whatever. The patient is just a cash cow, and they only need to care enough to keep that revenue stream rolling.

Why yes, I am VERY cynical... I call it being realistic.

Do you consider doctors elsewhere on the planet (in first world countries) different? To that end I have no idea.
It seems unlikely that doctors in France/Germany/UK, etc aren't thinking about expensive supercars either.

These are people after all. While there are some people who give fully of themselves for others, I certainly don't expect it from most.

I really don't know anything about doctors in other countries. All I know is that the US is the only place where drug companies advertise so heavily that they have tricked the patients into asking for or demanding this or that new prescription drug. I know that in other countries, the doctor tells you what medicine to take, not the other way around. In that respect, I'm sure that most foreign doctors have the patient's well being as a higher priority than making sure to prescribe stuff from the drug companies that pay them the most.

[scottalanmiller]

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

You also don't use government corruption to hold your customer hostage and threaten their lives if they don't come to you.

[scottalanmiller]

@rojoloco said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

That's a whole different story.

If doctors actually cared, then money wouldn't drive everything they do. They may seem to "care" while they're in the same room as you, but they care more about that new vacation house on an island, or their new, ridiculously expensive supercar, or whatever. The patient is just a cash cow, and they only need to care enough to keep that revenue stream rolling.

Why yes, I am VERY cynical... I call it being realistic.

Do you consider doctors elsewhere on the planet (in first world countries) different? To that end I have no idea.
It seems unlikely that doctors in France/Germany/UK, etc aren't thinking about expensive supercars either.

These are people after all. While there are some people who give fully of themselves for others, I certainly don't expect it from most.

I really don't know anything about doctors in other countries. All I know is that the US is the only place where drug companies advertise so heavily that they have tricked the patients into asking for or demanding this or that new prescription drug. I know that in other countries, the doctor tell you what medicine to take, not the other way around. In that respect, I'm sure that most foreign doctors have the patient's well being as a higher priority than making sure to prescribe stuff from the drug companies that pay them the most.

Having used doctors in other countries, I've never got any feeling that they weren't totally looking out for us. Often working totally for free. While I've had decent US doctors, and horrible US doctors, I've never felt that any of them was doing it for my benefit but only as a job to make money from my health needs. And often just extortion - keeping me from getting what I already knew that I needed and not providing any healthcare but literally only existing to prevent it.

[Grey]

@scottalanmiller said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

That's a whole different story.

If doctors actually cared, then money wouldn't drive everything they do. They may seem to "care" while they're in the same room as you, but they care more about that new vacation house on an island, or their new, ridiculously expensive supercar, or whatever. The patient is just a cash cow, and they only need to care enough to keep that revenue stream rolling.

Why yes, I am VERY cynical... I call it being realistic.

Do you consider doctors elsewhere on the planet (in first world countries) different? To that end I have no idea.
It seems unlikely that doctors in France/Germany/UK, etc aren't thinking about expensive supercars either.

These are people after all. While there are some people who give fully of themselves for others, I certainly don't expect it from most.

I really don't know anything about doctors in other countries. All I know is that the US is the only place where drug companies advertise so heavily that they have tricked the patients into asking for or demanding this or that new prescription drug. I know that in other countries, the doctor tell you what medicine to take, not the other way around. In that respect, I'm sure that most foreign doctors have the patient's well being as a higher priority than making sure to prescribe stuff from the drug companies that pay them the most.

Having used doctors in other countries, I've never got any feeling that they weren't totally looking out for us. Often working totally for free. While I've had decent US doctors, and horrible US doctors, I've never felt that any of them was doing it for my benefit but only as a job to make money from my health needs. And often just extortion - keeping me from getting what I already knew that I needed and not providing any healthcare but literally only existing to prevent it.

https://berniesanders.com/medicareforall/
Health care must be recognized as a right, not a privilege. Every man, woman and child in our country should be able to access the health care they need regardless of their income. The only long-term solution to America's health care crisis is a single-payer national health care program. - Bernie Sanders

[Dashrender]

@rojoloco said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

That's a whole different story.

If doctors actually cared, then money wouldn't drive everything they do. They may seem to "care" while they're in the same room as you, but they care more about that new vacation house on an island, or their new, ridiculously expensive supercar, or whatever. The patient is just a cash cow, and they only need to care enough to keep that revenue stream rolling.

Why yes, I am VERY cynical... I call it being realistic.

Do you consider doctors elsewhere on the planet (in first world countries) different? To that end I have no idea.
It seems unlikely that doctors in France/Germany/UK, etc aren't thinking about expensive supercars either.

These are people after all. While there are some people who give fully of themselves for others, I certainly don't expect it from most.

I really don't know anything about doctors in other countries. All I know is that the US is the only place where drug companies advertise so heavily that they have tricked the patients into asking for or demanding this or that new prescription drug. I know that in other countries, the doctor tells you what medicine to take, not the other way around. In that respect, I'm sure that most foreign doctors have the patient's well being as a higher priority than making sure to prescribe stuff from the drug companies that pay them the most.

I completely agree this is horrible - patients being advertised to directly. Patients know nothing about drugs, and rarely if ever actually research about those drugs before asking for them. So on one hand, who's fault is this? This is the patient choosing to not do the right thing.
And the doctor should be saying - stop watching those ads,

But I also wonder, is there enough time for a GP to study every new med that comes out, read all the studies, etc so they can be up to date on all the new options? This seems untenable. But Then someone will probably say - uh wait, You're in IT right? Isn't it your job to stay up to date on all those new IT things - to which I reply, that's a practical impossibility. There are to many things out there, often times out of financial reach to study them all, nor the time to do so. So most stick to a much smaller subset.

[scottalanmiller]

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

Basically... McDonald's takes transmitting your order from cashier to cook more seriously than most doctors take getting your prescription from doctor to pharmacist.

This was definitely true a few years ago, but becoming much and much less true. Electronic submissions of prescriptions is pretty common today. My office has been doing it for nearly 10 years.

"Pretty common" is a far cry from "essentially ubiquitous" and "socially unacceptable for it to be any other way" or "instantly criminal negligence to use handwritten scripts unless absolutely necessary (like from a power ourage.)"

[Dashrender]

@scottalanmiller said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

You also don't use government corruption to hold your customer hostage and threaten their lives if they don't come to you.

No doubt! Though, I have hard time not thinking this is mostly driven by the insurance companies than it doctors themselves.. but that's just a feeling, one I'm sure Scott is about to tell me why it's wrong.

[scottalanmiller]

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

Basically... McDonald's takes transmitting your order from cashier to cook more seriously than most doctors take getting your prescription from doctor to pharmacist.

This was definitely true a few years ago, but becoming much and much less true. Electronic submissions of prescriptions is pretty common today. My office has been doing it for nearly 10 years.

Becoming less true, but still vastly true. My family has loads of pharmacists in it and they talk about all the garbage that happens still today. And we know doctors that don't even have computers in their offices still. It's very much still true today. And that 7,000 number is the rate per year that sloppy handwriting causes deaths TODAY after many doctors have moved away from handwriting. Think about that... imagine what the figure was just ten years ago, maybe 70,000?

Definitely horrible - I blame the pharmacists though as much as I do the doctor. They are clearly guessing at what the doctor meant, instead of confirming. If the pharmacists were to push back on the doctors by calling and refusing to fill a prescription until they confirmed a messy script, the doctors would likely be pressured into writing better.

Doctors are the sole ones making the choice to force the guessing, though. If the doctor didn't DEMAND guessing, they wouldn't be writing crap by hand. The pharmacists are forced to work with what is given to them. It's also up to the patient to know at that point, right? Pharmacists do check, and I know pharmacists that say that they routinely save lives because they know that the doctor made a mistake. But that's how bad it is. And only doctors can fix this, you can't pass the blame along. There is one and only one party truly at fault.

[scottalanmiller]

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

That's a whole different story.

If doctors actually cared, then money wouldn't drive everything they do. They may seem to "care" while they're in the same room as you, but they care more about that new vacation house on an island, or their new, ridiculously expensive supercar, or whatever. The patient is just a cash cow, and they only need to care enough to keep that revenue stream rolling.

Why yes, I am VERY cynical... I call it being realistic.

Do you consider doctors elsewhere on the planet (in first world countries) different? To that end I have no idea.
It seems unlikely that doctors in France/Germany/UK, etc aren't thinking about expensive supercars either.

These are people after all. While there are some people who give fully of themselves for others, I certainly don't expect it from most.

I really don't know anything about doctors in other countries. All I know is that the US is the only place where drug companies advertise so heavily that they have tricked the patients into asking for or demanding this or that new prescription drug. I know that in other countries, the doctor tells you what medicine to take, not the other way around. In that respect, I'm sure that most foreign doctors have the patient's well being as a higher priority than making sure to prescribe stuff from the drug companies that pay them the most.

I completely agree this is horrible - patients being advertised to directly. Patients know nothing about drugs, and rarely if ever actually research about those drugs before asking for them. So on one hand, who's fault is this? This is the patient choosing to not do the right thing.
And the doctor should be saying - stop watching those ads,

But I also wonder, is there enough time for a GP to study every new med that comes out, read all the studies, etc so they can be up to date on all the new options? This seems untenable. But Then someone will probably say - uh wait, You're in IT right? Isn't it your job to stay up to date on all those new IT things - to which I reply, that's a practical impossibility. There are to many things out there, often times out of financial reach to study them all, nor the time to do so. So most stick to a much smaller subset.

Problem is, according to pharmacists, that doctors know nothing about drugs either.

[scottalanmiller]

@dashrender said in Random Thread - Anything Goes:

@scottalanmiller said in Random Thread - Anything Goes:

@rojoloco said in Random Thread - Anything Goes:

@dashrender I don't claim to care one bit about our customers, but I don't work in a field that has the word "care" in it's name. And if doctors really did care at all, the American health care system would be much less of a joke. Doctors haven't cured anything in decades because they figured out all the $$$$$$ is in treatment of disease, not eradication of disease.

You also don't use government corruption to hold your customer hostage and threaten their lives if they don't come to you.

No doubt! Though, I have hard time not thinking this is mostly driven by the insurance companies than it doctors themselves.. but that's just a feeling, one I'm sure Scott is about to tell me why it's wrong.

No, it's driven by doctors. Take away the insurance, and the issue remains 100%. Insurance companies control your money, but doctors control your access to healthcare. I use doctors directly without insurance and still am extorted. If I need medicine, I can't just buy it without paying a bribe to a doctor.