1) Panda Bear suggests that ED physicians are upset when the default PCP telephone advice is “go to the emergency room”.

My take: Over the phone, it is impossible to obtain an accurate clinical picture. You can’t visually assess the patient and the chart is often unavailable, leading to zero context for the symptoms. If someone calls with a “headache”, the causes can include things like sinusitis, migraine, tension headache, or a brain hemorrhage. No way to conclusively tell over the phone. If it turned out to be the latter, you can bet that the lawyer grilling the PCP on the stand would ask, “Why didn’t you send the patient to the ED?”

Just as some ED physicians’ default plan for bogus low-probability chest pain is “admit, rule-out MI”, some PCPs advise everyone over the phone to go to the emergency room.

Panda, you know this is simply another form of defensive medicine. We both know what game is being played.

2) WSJ op-ed: “Making health insurance more affordable would be a lot easier if they [politicians] would stop legislating what it has to cover.”

My take: You can’t have a Cadillac for the price of a Hyundai. Politicians are pressured to include everything in their mandated health plans. Chiropractors, wigs for cancer patients, massage therapists and naturopathic practitioners are “must-haves” in health plans for a number of states. While those options may be nice, they also drive up cost, making plans less affordable.

Lowering health plan costs is the surest method to ensure the greatest amount of coverage. Stripping down some of the “benefits” health plans are mandated to offer would be a good start.

Hyundais are good cars too, and sometimes that’s all you really need.