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Those of you who are so pro-Democrat (and I am no Republican) should be aware of this as you ponder health reform:  http://www.washingtonpost.com/wp-dyn/content/article/2009/07/20/AR2009072003363.html?wpisrc=newsletter

There are excesses on both sides. It's very hard to see clearly and believe anyone at this point.

posted 3 years, 10 months ago
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Dingdingding!

There won't be, no. And there is certainly going to be a problem if payments are cut. I understand that the system needs to be paid for, but hospitals are in danger of closing now. Providers need to be able to keep their doors open without cutting down the time they spend with you to, what, three minutes??

posted 3 years, 10 months ago
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I have to disagree with you. If you read the details in some of the proposed reform bills--and the devil is in the details--you will see that not only do the reform efforts change insurance, thsy will change how care is delivered as well. And not all of them do so for the better. It will affect how you interact with your provider, and in one of the bills, it appears that your provider could be a PA or NP. It is not at all clear that you will be allowed free choice.

posted 3 years, 10 months ago
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I agree that we do not so much need health care reform as we need health insurance reform.

I saw Dr. Denis Cortese interviewed (head of Mayo Clinic), and he stated that you can't fix a system that isn't actually a system. We never designed a rational health care system in the first place; we just have a hodge-podge of things. We need to sit down and decide what we want to build. This is the same thing that Dr. Kitzhaber has been saying.

I am listening now to the gentleman from the Brookings Institute. Yes, people are happy with their Medicare coverage--and they almost all have a private supplemental policy. I am distressed that he can be so disingenuous about this. For the record, the VA does not offer comprehensive care--only care for service-covered disabilities. For all the much-vaunted Federal programs, there are holes in those systems, and we need to look at them before we just jump.

As for his statement that "every time you go to the doctor you have to fill out paperwork," yes--you do. And that is because of Federal mandates like HIPAA and the newly-enacted Red Flag laws. And "every time you go to the doctor you get a test." Really? Seriously? Because actually, I don't think so. But I don't think some Magic New System is going to change everything overnight. Luke T is right. People are living longer, and that is part of the problem. However, I do think that there is immense waste in the middle management of insurance, and that is an issue as well.

posted 3 years, 10 months ago
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yeah--that made me raise my eyebrows as well. Very good point.

posted 3 years, 10 months ago
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I thought the July 6 show was great, and look forward to the rest of your health care series.

For topics: are you aware of the Wendell Potter stuff that is going on?

http://www.prwatch.org/node/8422

http://www.cjr.org/campaign_desk/excluded_voices_6.php

And for a local health care resource, I hope you are aware of The Lund Report:  http://www.thelundreport.org/

Thanks!

posted 3 years, 10 months ago
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Lunoshard, I can't speak for the other physicians here, including the ones who spoke on air. I can only speak for myself.

It's not that I was trained to ignore the costs of treatment; this was not the case at all. It was more that I was trained not to take the patient's level of resources into consideration, as that could possibly bias my treatment decisions. One is trained to provide the most appropriate care, and, when all appropriate options are equal, then the selection on the basis of cost would be encouraged.

If one has detailed knowledge of a patient's resources, or makes incorrect assumptions about them, one may make inappropriate treatment selections. It's best to select the best treatment options, discuss that with the patient, and then figure out a way if it proves that the resources are an issue.

It's a delicate ethical balance. Yes, one is running a business, but you don't want to look at every patient encounter from a monetized perspective. That's how you get McAllen, TX.

On the other hand, you want to provide good patient care, and that may not be the cheapest thing.

posted 3 years, 10 months ago
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