1) Medicare is finding out that preventive care may cost more money in the short term.
My take: The mantra of Barack/Hillarycare the current health reform proposals is that it will be partially paid for by an emphasis on preventive care.
Wrong.
Studies have shown, and Medicare is finding out, that preventive care will be more expensive at first. The savings, if any, will be realized generations down the road. I doubt there will be the political patience for that.
The only way for instant savings is to say “no” and to ration care. Medicare will find out soon enough.
2) Dartmouth Atlas comes out with their latest report, suggesting that the intensity of end-of-life care can be a huge cost contributor.
My take: More medicine doesn’t necessarily mean better care. An oft-repeated theme here. This is especially true in the end-of-life setting.
Patients need to accept this counter-intuitive conclusion. As long as there are family members who “want everything done”, and back that up with threats of lawsuits, physicians will have little say in the matter.
Publicizing and accepting the findings of the Dartmouth Atlas Project is a small but essential step in educating the public.
3) Emerging guidelines are suggesting oncologists start to discuss cost with patients when talking about cancer therapy.
My take: As our health care system spirals into fiscal oblivion, this movement will spread to other fields.
In medical school, doctors are taught to do what’s in the patient’s best interest. Cost was often not part of the equation. “Money should not get in the way of patient care” was the mantra.
Times are changing. Financial concerns weigh heavily on a patient’s mind, and now play a significant role in many medical decisions.
4) Grady Memorial Hospital in Atlanta gets bailed out with a $200 million gift.
My take: Solves the symptom, not the disease. Charity hospitals are teetering on bankruptcy, as they are not paid for the large proportion of uninsured patients they serve.
I have no doubt that Grady will find itself in a similar situation very soon.
