Despite all the big talk about reform, very little may actually happen.
The reason, says Joe Paduda, is the failure to address costs. Blindly focusing on the uninsured and increasing coverage will drive up utilization of services, and “once the medical/pharma/device/hospital industry figures out there are a lot more people with coverage, they will raise prices, buy more technology, and build more capacity to service those new customers.”
You have to spend money to save money – such as expanding the primary care physician base and instituting the medical home model – but it’s doubtful that our government has the foresight to do that.
Related posts:
- AMA: Curbing the rise in health care costs is key to health-system reform
- Will the government delay comprehensive health reform?
- How to get doctors to embrace health care reform
- Indian Health Service needs reform
- How Obama’s health reform will hurt Canada
- How health care reform can improve public health
- AMA: A look at the facts on health reform
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{ 2 comments }
Boutique or retainer medicine is the best thing that can happen to medicine. Getting it out from under the insurance companies and having physicians and patients achieve relative freedom can only help the field. Indeed, some of the best physicians I know are going this route (in particular, MDVIP). The view the patient takes of this is offensive to me: “Doesn’t boutique medicine go against what most doctors are pledged to do, help people while ensuring equal access for all?”
I never signed or signed on to any pledge for ‘equal access for all’? Does the lawyer, pharmacist, store-owner, or gas-station owner also sign on to such pledges? I don’t think this person has thought through the implications of the statement. If no price is too low (paid by the insurance company) then I am obliged (ethically?) to accept all prices – even zero. Working as a slave for nothing (or next to nothing) is hardly an answer to health care access!
The person also indicates that they cannot afford the fee. Usually the case is rather that they are unwilling to do so – since the fees often amount to the same price as a cappucino at Starbucks per day.
I too do not feel the obligation to provide care to everyone. How can one be obligated to do what can’t be done? I do feel an obligation to provide the best care that I can to those who are my patients–and feel free to chose who among those that solicit my services on the basis of my ability to provide a quality of care of which I can be proud.
If anyone else embarks on the quixotic chore of saving the world, they have no entitlement to lay claim to me or mine in the service of their quest.
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