Published: Thursday, Oct. 18 2012 12:00 a.m. MDT
Re: "We need to think of health and approach its improvement from more of a
'systems' perspective."Blah, blah.The most
refreshing and innovative recent "systems" approach is the suggestion of
a young doc that all Americans be able to get health care the way docs do.He set up a small net where a patient calls a doc, is interviewed using
a set of protocols that permit diagnosis of most minor illnesses over the phone.
The doc then prescribes treatment or calls in a prescription, and the patient
gets quickly back to health.In those cases requiring diagnostic
procedure or a clinical visit, it's arranged over the phone, same day or
next.The idea came from this young doc's own experience. A
friend, who was having trouble with his appendix called. The doc referred him to
a surgeon buddy, who scheduled the surgery that day in an outpatient facility,
saving the patient and his insurer $100G.The "systems"
approach we need? Make the system work for us the way it works for docs.
Let's see, the Doc looked at my knee, took an x-ray, and said "yea, the
other Doc was right you have arthritis in your knee".Oh, and by
the was he sent us a bill for $3,000.00! You think we have a problem
with health care?
Pretty simple solution, it's why the rest of the industrialized world has
moved to this system...SINGLE-PAYER-SYSTEM!Cut the fat,
cut the greed, cut the middle-man. Those working in insurance? Find real jobs
folks. Go back to school if you have to.
Health care is complex with no easy answers. Most of us envision an artificial
world where we are in control. We budget money for every expense. We budget a
health insurance premium and think of that as "heath care", knowing that
if we get sick, we have limited our extra expense to the deductible. That is
not health care and that is not good policy.The doctor made some
valid points. A "systems" approach would include the entire problem,
from examining self-destructive behavior to examining the rushing of people
through exams and procedures, as if we were cattle. Obamacare is
the worst possible plan because it focuses on reducing payments to doctors and
hospitals instead of focusing on curing the patient.Successful
businesses of all kinds use a "systems approach" when they organize
their business. They streamline things so that each employee is highly
productive - and costs are minimized.Using a "systems
approach" to medicine would improve care while reducing overall cost.
Changes can't happen if people simply sit in their overstuffed chairs and
The real problem is simple. It MONEY or more specifically the desire of some
people and companies to acquire as much as they can of the stuff.Until for-profit insurance companies are out of the picture, nothing will
change. And since for-profit insurance lobbies are so strong and able to
purchase the votes of so many state and Federal legislators, nothing will
change.ACA is the only step that has made toward changing any of
that -- but because of the political power of for-profit organizations, it has
been gutted of any effective solutions.It does not need to be
repealed, but it does need to be amended and set up in a manner that will help
all of us. It might even be possible to help the bottom lines of insurance
companies.But GOP ideology and their desire to obey their corporate
owners will make that very, very difficult.
The doctor is correct. Fundamental changes are needed It is naive to think that
doctors receive better care than the rest of us. The ACA is unsustainable
financially and has a myriad of unintended consequences. The ACA was supported
by insurance companies because the president bought them off.
Dr. Swanson,there is a very large obstacle to the reform you propose -
it's called Obamacare.Obamacare does nothing about the delivery
of health care in our nation, it just makes everyone buy insurance for it, and
fattens up the insurance companies as a result. Why do you think they opposed
Hillarycare in 1993 but did not oppose Obamacare in 2009?
Heard a very interesting interview on NPR, (Sept 19) the Diane Rehm Show, with
a Dr. Marty Makary a surgeon at Johns Hopkins. Near the end of the interview he
talked about the corporatization of hospitals and the pressure on Drs. to
recommend and perform unnecessary procedures to boost profits. He also talked
about the lack of transparency in the healthcare system which can lead to people
getting substandard care and higher costs.Drs. like Makary need to
be a part of an honest conversation in improving and reducing the costs of
healthcare. A Dr. I know believes ACA is a step in the right direction,
probably the best we could do with the current political constraints, but
would've preferred single-payer.
It doesn't help with medical costs when you are victimized by for profit
hospitals that charge $600 for two pills that would cost about 10$ each outside
of the hospital. That actually happened to me. And, there is no way to
challenge that kind of greed motivated billing without them ruining your
credit.We need to return to a non profit model like we had in the
past. Make larger faith based institutions responsibe for running them as
consideration for the significant tax breaks that they get on donation
revenue.As for the "systems" approach, you might get some
efficiency improvements which will reduce costs, but it is unlikely that any of
those cost savings would be passed on to consumers.
The problem is that when people do come up with new ideas, the government
regulates them out of existence.For example, a NY Dr. set up his
clinic like a gym membership. For a set monthly fee you see the Dr. as often as
you wanted. He was shut down.A few years ago some healthcare
companies started to operate "grocery store" clinics where a you could
go to see a Dr for minor problems and be taken care of for $25, with or without
insurance.Outside of that you have clinics that can handle off hour
non-emergency care.The Doctors don't need to be educated, the
public does. How do you teach people to question what procedures and tests are
being called for?
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