Evan Falchuk has an important post today. He rightly points out that the current debate focuses on the wrong issues.
Your care may be paid for by a private insurer or a public one. Your coverage may be called a “Cadillac” plan or a high deductible plan. You may be uninsured. But there are some things that will be virtually certain if you get sick regardless of who and pays for your care and how:
The majority of your medical visits are going to feature face-to-face contact with your doctor of 15 minutes or less. Your care is going to be fragmented, with information about you stored in paper files, electronic records, and the memories of the doctors you have seen. You’re going to be on your own, facing important decisions, with too few places to turn to for help.
It’s bad, and in my experience, almost everyone I talk to on this subject has some personal experience with health care that looks just like this.
We do not have a health care system. What works for the convenience of subspecialists does not work for patients or primary care physicians. We need some new thinking.
In this blog I have recently advocated having primary care leave the current insurance paradigm. My reasons focus on the high overhead dealing with insurance companies, the irrational documentation requirements and the payment challenges.
Evan has it right, true health care reform is not just about money, but rather the entire structure of providing health care. It is about patients, not about physicians. Of course the radical right and left both miss the point and the middle does also. Few pundits understand the problem, thus the solution will remain obscured.
We need to spend enough time with each patient. We must eschew any system that discourages us from spending time with patients.
Of course, I am most worried about patient care, not budgets. I believe that attending to patient care in a proper fashion will decrease costs.
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Bravo Db. spot on once again….
if only the politicians would read your blog
seriously, I have real worries that the AMA does not represent the majority of physicians and doctors are not on capitol hill voicing ANY opinion about the reform.
Doctors!! we are supposed to be the healthcare leaders of this country and we are sitting on our butts while the Insurance companies are in the senator’s offices convincing them that THEY are the real healthcare leaders of the country.
how could we have let that happen???
Agreed. Once everyone thinks they are thinking outside the box, aren’t they all by definition back in the box? I try to get my clients to color outside the lines. I find that works better especially since most people fear drawing.
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