It is looking more and more like Government initiated health care reform is coming. That is, possibly, good news. It will cover, hopefully, all Americans. If it does, that will be its only real reform achievement. It basically leaves the system as it is, puts in more price caps and allows for buying cooperatives to get coverage through group buying power. All decent ideas but nothing that will improve or change a system that is rife with abuse, excess costs, poor governance and inconsistent standard. Cost caps can unfairly hurt some good practices and agencies. Pay for performance can help improve systems, if there are requisite education and helpful tools made available to those organization that struggle with improving their quality of care. The most bizarre and idiotic health care ideas, such as the Republicans calling for the ability to purchase insurance across state lines...were blissfully left out. If I were able, I had a good post for that idea. I've been involved with health insurers in the past. The reason health insurance is so much cheaper in a place like Utah, is because it is cheaper to get care in Utah! If you allow New Yorkers, with some of the highest insurance and care costs in the country, to buy coverage from Utah, and then get care in NY, you would eventually drive up the cost of Utah insurance much closer to NY's. All you would accomplish with that poorly thought out nonsense is to hurt citizens of Utah. Unless you don't like Utah, why would you do that?
HOWEVER:
I propose a lot of things, some written about here before, that would fundamentally alter the cost structure of health care, now and going forward, increase competition for health plans with agencies better able to deliver quality yet cost-effective care than the insurers who often pay for it now and try to manage the care with new cost layers of review and management. In the coming days and weeks I will review what i have already proposed here, and offer a lot of new material that I have been working on. In the longer run, once a minimum plan of reform is implemented, I believe we will run into many of our past problems if we do not take the current opportunity of the drive for reform, to truly improve our system. And I mean improve. I have said here many times before...I like our system, but we need to fix it to keep it!
Subscribe to:
Post Comments (Atom)
Posts
3 comments:
I am pleased to read that you are skeptical that the changes being considered will bring about positive alterations to our current system.
As you know I read only a bit on Healthcare policy. But my 17 year association with medical education has left me with a few opinions. My family medicine/primary care colleagues are deeply disappointed in how President Obama has handled his initiatives. He made some sort of sweetheart deal with the [specialist dominated] AMA, and has failed to propose any 'primary care initiates'...
This outrageous omission is particularly poignant as some of them are cost free. For instance, a cost free way to address the shortage of primary care physicians is to tie federal funding to medical schools to increases in the percentage of primary care docs they graduate. This has been one hallmark of Family Medicine's lobbying effort.
This omission can only be because President Obama sold out to the interests of the AMA, which is generally hostile to primary care initiatives. Sad.
I am not happy with the current plan, but it is a beginning. I am also waiting to see details of how the inequities in Medicare payments will be redressed to encourage preventative medicine, such as revising some of the ways screening blood tests are not paid for by Medicare. As you also may remember, I also addressed the inequity that pushes students away from primary care:
http://heres-to-your-health-america.blogspot.com/2008/11/tax-credits-are-supposed-to-help.html
Post a Comment