Maggie Mahar is right, voters are powerful and can offset the lobbying force:
Voters still have tremendous power. And as we head toward Medicare reform — and eventually toward national health reform””legislators are going to have to weigh the power of the vote against the power of the lobbyists’ dollar.
Physicians need to align themselves with the voters, as they did with seniors in passing the recent Medicare bill.
It is imperative that any physician payment reform be framed in such a way that will benefit patients. That is the only way we can get the public on our side.
Related posts:
- Cigarettes versus children’s health: The voters speak
- My take: Payment, work-life balance, demanding scans
- How to get doctors to embrace health care reform
- Physician voices
- A warning to those who want government negotiation of drug prices
- Physicians versus administrators
- Medicare fallout
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Voters usually get focus only when an issue effects them directly and immediately, such as California’s Proposition 13 that brought real estate taxes under control. Health payment is too diffuse, and most voters with insurance has bought into an entitlement system. Additionally, not all that many voters take personal responsibility for their own health. The patient as customer controlling the money has long ago vanished, and the doctor-patient relationship has been supplanted with myriad bit players whose interest do not conincide with doctors or patients. Making such decisions based on popular vote can only lead to more of same: a highly politicized and irrational health ’system’ so called; a more accurate description would be a division of spoils.
Thanks Kevin.
Chuck–I expect Medicare reform to come first–putting some of the pieces in place for national health reform by: raising payments to primary care docs and those who provide “medical homes” for patients suffering from chronic diseases while lowering payments to some specialists for some services (that are highly priced and not proven to be effective for many of the patients receiving these services);
setting up a compartive effectiveness institute and using head-to-head comparisons of drugs, devices and procedures to make coverage decisions; paying doctors more to co-ordinate care; tightening up hospital inspections to focus on hospital errors, patient safety, and ultimately, refusing to pay hospitals that do not meet high standards; refusing to pay for certain re-admissions. . .
(Under the new Medicare law, the Joint Commission will no longer have unique control over hospital inspection and certification. This should lead to much better inspections, focusing on the things that really matter, and, I would hope, some hospital closings.
Private insurers will follow Medicare’s coverage decisions and payment schedule (as they do now.)
As for voters focusing– seniors are very good at focusing on an issue that effects Medicare (or Social Security) and voting, in large numbers, to protect their interests. They have time; they are good at organizing; many are very articulate.
Do you remember the “Grey Panthers”? They were quite effective at targeting Congressmen who were not serving their interests and throwing them out of office. Seniors realize that Medicare co-pays and deductibles have been rising sharply–and it’s getting harder to find doctors who take Medicare.
Kevin is right: physicians should unite with patients–particularly seniors.
The interests of seniors are best served by continuing Medicare’s Ponzi scheme as long as possible. Then, they’ll be dead and gone while us and our children are saddled with enough debt to cripple the economy and generalist medicine has been destroyed.
They might make useful political allies occasionally but younger citizens and physicians have very different interests overall.
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