Monday, December 15, 2008

A few good MEN

"Now, some may ask how, at this moment of economic challenge, we can afford to invest in reforming our health care system. Well, I ask a different question – I ask how we can afford not to." [Barack Obama, today.]

On the occasion of Barack Obama's rollout of his health policy team, and given that, according to a couple of pieces of paper I have around here somewhere, I'm a doctor, this seems a good time to spout off -- yet again -- on the state of health care in the US. What it really boils down to is this: we need to reduce cost and raise quality. As long as the discussion is only about paperwork, ie, single payer vs current insurers, electronic vs paper records; and as long as the only real efforts to control costs are in reducing payments to providers, we'll be getting nowhere. As usual.

I've written about why I favor single-payer, and have acknowledged that among physicians I'm in a distinct minority. I've said pretty much all I know about that aspect of it. Moreover: as controversial as it is, it's really only nibbling around the edges. Solutions --REAL solutions -- will come from fundamentally changing the nature of care itself, and how we provide it. And if you think addressing insurance is complicated and daunting, you ain't seen nothin'

yet! the rest here

The HMO Death Watch 2 - How Shall We Regard Medicare Advantage?
December 12th, 2008 by DrRich

DrRich has never really understood the government’s rationale for funding Medicare Advantage.

Being a Milton Friedman capitalist, DrRich is all in favor of having plenty of robust, profit-seeking entities knocking about within the American economy, even within the healthcare sector of the economy. In principle, he is even in favor of giving for-profit health insurance companies a chance to prove that they can deliver quality healthcare with greater efficiency and better outcomes than certain non-profit entities, such as, say, the government. If the insurance companies can give us good healthcare at lower cost, more here

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