One of the unfortunate realities about Health Care Reform is that there will be pain. The current trajectory of health insurance costs is unsustainable. We are pushing 18% of the Gross National Product, more than double other industrialized countries and severely depressing our competitive edge in the world economy. Left unattended health care will continue to eat into American productivity, lifestyle, competitiveness and influence. The solutions are not difficult to understand. The question is how to equitably distribute the pain. The strategy of “just saying no “ will just momentarily and ineffectively defer the pain. There are three ways, or combinations there of to do it. The menu please!
2. Control Utilization. Yes, we are talking about the “R” word – rationing.. It is going on right now. Just ask your insurance company for access to a promising, but experimental drug regimen or procedure and see what the result is. Expect more of it and get over it. Yes you can get it, if you can afford it. We can approach the expensive chronic illnesses and end of life care with rationing of care or with prevention or with greater efficiency of evidence based medicine, and EMR, but not likely without significant government intervention. We Americans are always looking on the horizon for the prospect of a cure that will extend our useful lives, but that dream will likely require some modifications and limitations. If you want to live free or die, die might just be the answer, unless you can afford it. If health reform arrives, expect at least a three tiered system here – the Cadillac; the Chevy and the Yugo.
3. Control Rates. Lots of issues here. Those insurance systems and medical systems that effectively control costs operate on a physician salary basis. Kaiser, the Mayo Clinic all pay their physicians a salary with some structure of bonus. Fee for service medicine is a luxury that has had its day and will not likely survive meaningful health reform. We cannot continue to turn out more and more doctors with more and more school debt to recover in more and more narrow specialties so award more and more compensation based upon more and more tests and procedures. We cannot duplicate expensive medical technology in every urban hospital and bill the government and the public for the down time. Again the idea of private medicine will be a fixture of the past. Those physicians who can truly stand on their own without government or insurance support will likely be free to do so, but that will be a narrow segment of medicine. Are we heading to socialized medicine. No, we arrived many years ago. The public sector is only now insisting on a return on its investment. Insurance reform will need to be part of the picture as insurance companies will have to and frankly should justify their reason for existing and generating those huge executive salaries through meaningful contribution to the system.
These are the moving parts of health care reform – so simple and yet so complex, with so many oxen to gore and so much pain to be distributed. Scalpel please!!!
Yes I agree completely...there will be pain.
Posted by: EMR | September 02, 2009 at 03:30 PM
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Posted by: hcg diet weight loss | September 18, 2009 at 02:39 PM
If we stay away for Marxist Medicine and Commie Care, there may be no pain at all.
Posted by: HealthCare Reform | September 27, 2009 at 08:51 PM
As Democrats of the Democratic Party, and we are joining together in seeking reform within the Democratic Party.
Many of our elected representatives within the Democratic Party are no longer following in the time-honored footsteps laid down by the founding fathers of our great Nation. More importantly, we as democrats see our elected representatives within the Democratic Party abandoning the values and principles as set forth within the Declaration of Independence and the Constitution of the United States.
Nonetheless, this is only the beginning of our problems as Democrats, for the current Democratic Party leadership is tainted by corruption and being taken over by Socialists. These Socialists are clearly a threat to everything we hold sacred in America, and they are gaining evermore control over our Democratic Party, our Nation, and the American people.
Despite this, we as Democrats can restore control of the Democratic Party back to the party members. All we need to do is cut off donations to the local, state, and national headquarters of the Democratic Party, and to make sure the donations are made directly to patriotic and honorable Democratic Party candidates that are not corrupt and/or Socialist.
So please help spread the message to everyone of our fellow Democrats. Also, don't forget to contact and request the Unions and other outside contributors to follow our lead as patriotic Americans.
Thank you, and God Bless America.
Web site: http://www.democraticreformparty.com
Blog site: http://blog.democraticreformparty.com
Posted by: Eric Pearson | November 06, 2009 at 05:01 PM
A good article on the difficult trade-offs. I wish the politicians would be more clear with their trade-offs, because if you believe them, we would all get great health care at no additional charge.
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