Comments on: Health reform: Choose your side http://www.kevinmd.com/blog/2007/10/health-reform-choose-your-side.html Tue, 14 Feb 2012 23:00:00 +0000 hourly 1 By: Anonymoushttp://www.kevinmd.com/blog/2007/10/health-reform-choose-your-side.html#comment-80589 Anonymous Tue, 02 Oct 2007 02:36:00 +0000 http://clients.emmense.com/kevinmd/2007/10/health-reform-choose-your-side.html#comment-80589 What is needed is a system where only catastrophic care is covered by standard insurance policy. First dollar insurance coverage should only be available to the very wealthy should they choose to waste their money that way. For the masses, HSA's or self pay would be the norm up to say five thousand dollars per year. For the indigent, public health clinics and rationed care should be the norm considering taxpayers foot the bill. What is needed is a system where only catastrophic care is covered by standard insurance policy. First dollar insurance coverage should only be available to the very wealthy should they choose to waste their money that way. For the masses, HSA’s or self pay would be the norm up to say five thousand dollars per year. For the indigent, public health clinics and rationed care should be the norm considering taxpayers foot the bill.

]]> By: Zagreus Ammonhttp://www.kevinmd.com/blog/2007/10/health-reform-choose-your-side.html#comment-80573 Zagreus Ammon Mon, 01 Oct 2007 22:24:00 +0000 http://clients.emmense.com/kevinmd/2007/10/health-reform-choose-your-side.html#comment-80573 Sorry Kevin, I don't think it's that simple. I'm a firm believer in multifactorial causation, so <a> href="http://www.cato-unbound.org/2007/09/12/david-m-cutler/use-a-scalpel-not-a-meat-cleaver/this</a> makes more sense to me. <br/><br/>Not that you're wrong, but administrative costs, CYA medicine, errors etc all contribute significant chunks as well IMHO. Sorry Kevin, I don’t think it’s that simple. I’m a firm believer in multifactorial causation, so href=”http://www.cato-unbound.org/2007/09/12/david-m-cutler/use-a-scalpel-not-a-meat-cleaver/this makes more sense to me.

Not that you’re wrong, but administrative costs, CYA medicine, errors etc all contribute significant chunks as well IMHO.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/10/health-reform-choose-your-side.html#comment-80571 Anonymous Mon, 01 Oct 2007 21:37:00 +0000 http://clients.emmense.com/kevinmd/2007/10/health-reform-choose-your-side.html#comment-80571 What Republicans are saying this? What Republicans are saying this?

]]> By: Anonymoushttp://www.kevinmd.com/blog/2007/10/health-reform-choose-your-side.html#comment-80568 Anonymous Mon, 01 Oct 2007 16:00:00 +0000 http://clients.emmense.com/kevinmd/2007/10/health-reform-choose-your-side.html#comment-80568 Neither side has the correct answer. Until the system itself is revamped and the Flexner anti-competitive measures removed, the current overly expensive, lack of access to care, lack of good healthcare system will continue to exist. Neither side has the correct answer. Until the system itself is revamped and the Flexner anti-competitive measures removed, the current overly expensive, lack of access to care, lack of good healthcare system will continue to exist.

]]> By: Weschtester Orthopedisthttp://www.kevinmd.com/blog/2007/10/health-reform-choose-your-side.html#comment-80563 Weschtester Orthopedist Mon, 01 Oct 2007 12:21:00 +0000 http://clients.emmense.com/kevinmd/2007/10/health-reform-choose-your-side.html#comment-80563 I strongly agree with the premise of the arguement that if a portion of the cost is shared by the patient, utilization will decrease and costs with it. <br/><br/>I have already witnessed this trend with my patients who have HSAs, combined with a high deductible plan. <br/><br/>My questions that I put forth the other day, http://www.howardluksmd.com/journal/hsas-and-shared-risk.html is what happens to the risk environment? What will the standard of care be if a patietnt refuses an exam due to cost...only to find out months later they suffer from a horrible disease that the aforementioned test would have picked up? How is the risk shared in that circumstance? What will the standard be when a patient refuses a test we feel is needed. This has happened to me and I found the documentation of the refusal nearly as onerous as the documentation of risks leading to surgery. There is no case law out there---that I am aware about regarding risk sharing in these circumstances. It's coming... will be interesting to see waht the courts decide. I strongly agree with the premise of the arguement that if a portion of the cost is shared by the patient, utilization will decrease and costs with it.

I have already witnessed this trend with my patients who have HSAs, combined with a high deductible plan.

My questions that I put forth the other day, http://www.howardluksmd.com/journal/hsas-and-shared-risk.html is what happens to the risk environment? What will the standard of care be if a patietnt refuses an exam due to cost…only to find out months later they suffer from a horrible disease that the aforementioned test would have picked up? How is the risk shared in that circumstance? What will the standard be when a patient refuses a test we feel is needed. This has happened to me and I found the documentation of the refusal nearly as onerous as the documentation of risks leading to surgery. There is no case law out there—that I am aware about regarding risk sharing in these circumstances. It’s coming… will be interesting to see waht the courts decide.

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