Tuesday, January 6, 2009

Role of Providers in Health Care Reform

In my mind, based on personal and familiar experience, the jury is still out on the motivation of physicians. I've seen the work of some good ones, but I've seen the disasters caused by probably more of them who were driven by the need to maximize revenues through all aspects of the "medical-industrial complex" ( a term that I coined many years ago).

It is probably quite true that over-treatment also comes from the need to practice "defensive medicine". Again, I concur that computerizing and standardizing, and making universal access to medical records would not only create efficiency in resource use, if the hospital and clinic administrators truely want this (and remember physicians invest in health care facilities), but could also be helpful to physicians in determining "best practices" and could be most useful in medical research. Sometimes, I wonder though, if medical research has not become a self-perpetuating "industry", with largely diminishing returns.

Most hospitals are not-for-profit, but there has been the insidious entry of for-profit corporations onto the scene in the last twenty to thirty years. Certainly, there is no room for profit in any aspect of health care. (I leave room for not-for-profit organizations). Also, the need of non-profits to compete with regards to the latest technologies and the updating of physical amenities has been a huge driver in the escalation of health care costs. There are far too many hospitals and they are far too redundantly equipped with a lot of what could be considered unnecessary technologies. Only by pooling the equity and assets of hospitals, clinics, etc. can we correct this situation and ratchet down the costs of health care. This is the beauty of an equity union and the private sector participation is necessary from not only a payers' perspective (i.e. "double payer" system), but especially with respect to reining in the costs associated with over-utilization, be it from provider abuse and/or defensive medicine.

I paid dues to the Physicians for a National Health Plan (PNHP) for a couple of years. They make some excellent points about the inefficiencies and ineffectiveness of the current health insurance industry. I agree that great savings could accrue from reforming said businesses (again, a combination of for-profits and non-profits). However, PNHP has yet to acknowledge and speak to the abuses on the Provider side of the equation, except to criticize the pharmaceutical industry.

Let's see more talk and writings from the Provider Community concerning their role in the continuing tragedy and impending disaster of the health care system in the USA.

Then there is all the issues of environmental, and thus public health, a subject of another, very large, discussion.

I'm a Work kin for peace and cooperation.

With much love and care,

Mike Morin

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