Posts Tagged Healthcare reform
Sanjay Gupta to Regina Benjamin? Talk about a U-turn
Posted by admin in Uncategorized on July 13th, 2009
Sanjay Gupta, American neurosurgeon and media personality. A frequenter of breakfast TV and Time magazine couldn’t have been a more different choice from the now announced Surgeon general Regina Benjamin (following sanjay’s self-removal from the post). Dr Regina Benjamin is a primary care physician. She has spent most of her life treating those who usually have very little access to healthcare. A commitment she was forced to make to gain funding for medical school.
Dr. Benjamin is understated and although coming into the limelight slightly after her show of determination during hurricane Katrina she far away from the glamour of Sanjay Gupta’s career path. Why then the change of direction? In this writers eyes she reflects the direction of the health reform currently circling the minds of policy makers. Primary care is cheaper. Primary physicians are among the lowest paid of medical school graduates and there numbers are diminishing. Pushing a higher proportion of future doctors into primary care makes sense for a lot of reasons. Mainly, the patient feels like they have more access to care yet the is less cost. A win win situation. This is already a policy adopted by countries such as the United Kingdom leading to recent ballooning of u.k primary care physician salaries so that most now earn well over $200,000.
Is there a bad side? While increased primary care may leave the patient feeling satisfied and not bankrupt, decreased investment in hospital care and speciality medicine is likely to have an impact on innovation and while it may make us feel better to have more access to doctors temporarily, a cure for cancer would be worth much much more.
No!
Posted by admin in Medical News on May 7th, 2009
Why do governments interfere so? As if MA wasn’t a good enough lesson (see previous blog post on MA healthcare reform) In the U.K., policy of what will most likely end up as the next ruling party in general election (UK Conservative party) is toying with healthcare… again. The plan is to pay physicians based on targets reached in the patients health. That way patients will only be paying for what they get right?
Why spend time reaching targets in preventing unpreventable diseases when you can earn yourself, and the hospital more money by sticking to those with step throat.
Governments need to learn, you can’t manipulate markets to help consumers. In ANY industry.
Massachusetts Healthcare Reform – Out of the Frying pan, into the Fire
Posted by admin in Medical News on March 17th, 2009
For those who didn’t know, if you live in MA, you get universal healthcare. That is you are obligated to purchase health insurance, under threat of a fine. Those who are deemed unable to afford healthcare (earning under approx $66000) will get support from the state.
While this plan might sound like just what America was looking for, the perfect mix between a private healthcare system and a universal healthcare system, healthcare costs are ballooning. To the extent that MA is no longer able to foot the bill.
The answer? two solutions:
- Kill of a few MA residents by pushing forward eligibility requirements reducing the number of people gaining healthcare support from the state.
- Reform the way hospitals and doctors are paid
The latter was chosen. The idea is that instead of paying doctors and hospitals for every service they provide, e.g. a CT scan, a consultation etc. They will be paid based on performance and prevention.
At first look this might sound brilliant. Doctors lose the motivation to send you through thousands of tests and around various hospitals in an attempt to cash in on the HMO’s backs. There are drawbacks. We add a new motivation to treat curable patients. How is that bad? What about the cancer patient guaranteed to die within a few months yet perhaps prolonged to a few years with surgery and an aggressive course of chemo. Very expensive treatment for the hospital, and if they could get the same income from treating someone with less aggressive “curable” cancer, with much cheaper meds presumably they would put them first.
Do we really want a situation where patients needing the most medical attention are going to be put aside in preference of those needing the least. The is the situation the would inevitably occur if each patient was only paying a set amount, as opposed to per service. Something that HMO’s such as blue shield in MA are already carrying out.
Unfortunately for now, this reform seems inevitable. In the midst of a recession there is nowhere else to turn. The problem with healthcare is that it doesn’t behave like a normal market. Drugs that prolong lives immediately have a monopoly as through patent laws, no other drug will ever do what it can do. Also the drugs value is priceless, people will pay any amount of money to stay alive.
We cannot treat Healthcare like any normal free market because it just isn’t normal. The answer? We need to maintain a pay-for-services system, not pay per patient, yet through government regulation we need to work to lower ballooning healthcare costs.
As for MA all we can do is watch. At least it will provide a good test market for the rest of the country.
