Theodore Schwartz: evaluation

Transcript context

…Let’s say I need a neurosurgeon and assume, also, I can’t contact you. I have a decent income, but not so much money that I can just buy the best talent in the world. How should I actually make that choice? The economics of medicine are quite different than other things because most doctors will take most insurance plans. If you have a private insurance, whether it’s United, Blue Cross, or Aetna, you can see an incredibly good neurosurgeon who is likely to take your insurance. There are some pockets of places in the country where some physicians may not take insurance plans, but for the most part, most of them do, because the insurance companies have such a powerful control over the patients and the patient volume. I know economics is really what you are all about. If you think about it, it’s somewhat unfair to the physician because the insurance company fixes the rate that they’ll pay a surgeon. If I am day one out of my neurosurgery training, and I take out a brain tumor, and you have UnitedHealthcare, whatever your insurance is, I’ll get paid X dollars. If I’m 30 years older, and I have 30 years more experience, and I take UnitedHealthcare, and you come to me 30 years later, and you’re going to get a much better product, I get paid exactly the same amount as the resident who was the first day out of their training. There’s no accounting for experience and expertise in reimbursement for physicians for what they do. I may have a bigger volume. I may do more cases because more patients come to me because I have more experience and more of a reputation. But for every widget I produce, I get paid exactly the same, and the quality of the product can be dramatically different. How do I find someone, say, as good as you? Do I call up Harvard? What do I actually do, concretely? I google who’s the best neurosurgeon?…

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