February 17, 2009
Rational, not rationed, health care
Conservatives want to focus on cutting health care spending and progressives want to focus on constraining health care costs — that simple difference underlies much of the political discussion on paying for health care.
Cutting health care spending primarily involves kicking people off of public programs. Constraining health care costs involves better coordination of care, an increase in the use of primary care physicians, and determining which new medical products on the market offer some improvement in health outcomes.
Cutting health care spending does little to stop the spiraling cost of health care in our country, which is driven by expensive new drugs, new medical technologies, and the overuse of specialists. Constraining health care costs makes public programs more affordable and helps reign in premium increases for those people covered by self-insured employers or private insurance.
Conservatives, along with medical device makers and the pharmaceutical industry, are attacking the idea of “comparative effectiveness research,” which is favored by progressives. The stimulus bill includes funding for this type of research. The idea is to conduct head-to-head tests of medical devices and drugs to find out how new, more expensive technology compares to existing technology and pharmaceuticals on the market. The political rallying cry of conservatives is that such research will lead to “rationing” health care.
Not so. We can all agree that physicians need to practice evidenced-based medicine. But first we need to produce more evidence. Physicians currently rely on a mix of journal articles, peer advice, and marketing hype to sort out what device or drug works best. Instead, we need to conduct empirical research to get solid answers. That’s how we build a rational health care system.
Everyone is afraid of rationed care because of the HMO horror stories that accumulated in the late 1980s and 1990s. The original idea of the HMO was for nonprofit organizations to help coordinate care and use primary care physicians to treat the whole patient instead of relying on a hodgepodge of specialists.
But conservatives, beginning with Ronald Reagan, pushed to privatize HMOs. That is when profit, and not evidence, began to drive health care decisions. There was a massive backlash against the HMO-style of denying necessary care.
Now industry spinmeisters are cleverly invoking bad memories of rationed care and attempting to identify progressive proposals with the profit-driven HMO system that conservatives created. But coordinated care networks that use evidenced-based medicine are nothing like the insurance industry practice of denying as many claims as possible.
If health reform is going to work we need a long-term solution to control costs, not short-term cuts to spending. So don’t believe the sloganeering: more research will lead to more rational, not more rationed, care.
Search
Previous Posts
- Six Ways Health Reform Will Lead to Better Care For Breast Cancer Patients (And Other Patients)
- Moving Ahead
- Gratitude is My Attitude
- Mejia: Rethinking those perks and incentives
view full archive » subscribe to feed
Web Links
- BlueNC
- Capital Beat (Greensboro News-Record)
- Capital Commentary (Wilmington Star News)
- Capital Letters (Asheville Citizen-Times)
- Deathwatch (Death penalty updates)
- Equality NC blog
- Exile on Jones Street
- Isaac Hunter’s Tavern (WUNC Radio)
- Leftyblogs
- Let’s Talk Politics (Hickory Daily Record)
- NC Conservation Network Blog
- North Carolina Economics
- Orange Politics
- Public Policy Polling
- Say Ahhh!
- Stop NCAR (Realtor’s Assn. watchdog)
- The Arc of North Carolina Policy Blog
- The People’s Business (Fayetteville Observer)
- This Old State (Charlotte Observer)
- Triangulator (Independent Weekly)
- Under the Dome (News & Observer)
- Watauga Watch
10 Comments Add yours »
[...] Read the original: Rational, not rationed, health care [...]
[...] post by LedgerGermane – links about politics, cover ups, mind control and really weird shit and software by Elliott Back Categories: Uncategorized Posted By: Last Edit: 17 Feb 2009 [...]
[...] PoliticalGroove Forums – Powered by vBulletin wrote an interesting post today on Rational, not rationed, health careHere’s a quick excerpt Conservatives want to focus on cutting health care spending and progressives want to focus on constraining health care costs — that simple difference underlies much of the political discussion on paying for health care. Cutting health care spending primarily involves kicking people off of public programs. Constraining health care costs involves better coordination of care, an increase in the use of primary care physicians, and determining which new medical products on the market offer some imp [...]
[...] fredflare.com / blog wrote an interesting post today on Rational, not rationed, health careHere’s a quick excerpt Conservatives want to focus on cutting health care spending and progressives want to focus on constraining health care costs — that simple difference underlies much of the political discussion on paying for health care. Cutting health care spending primarily involves kicking people off of public programs. Constraining health care costs involves better coordination of care, an increase in the use of primary care physicians, and determining which new medical products on the market offer some imp [...]
[...] The Progressive Pulse – Rational, not rationed, health care [...]
[...] PNHP’s official Blog placed an observative post today on Rational, not rationed, health careHere’s a quick excerpt Conservatives want to focus on cutting health care spending and progressives want to focus on constraining health care costs — that simple difference underlies much of the political discussion on paying for health care. Cutting health care spending primarily involves kicking people off of public programs. Constraining health care costs involves better coordination of care, an increase in the use of primary care physicians, and determining which new medical products on the market offer some imp [...]
[...] Adam Linker put an intriguing blog post on The Progressive Pulse â [...]
[...] Adam Linker added an interesting post on The Progressive Pulse â [...]
What’s with the funky comments ,Adam? Looks like there are gremlins in the Tubes here. Nevertheless, this is a wonderful article and is spot on. Having been in the healthcare industry on both sides of the fence as a provider AND as a managed care professional, you can bet that the “best practises” approach is scaring the Bejeezus out of physicians and other allied groups. I would especially like to see a prohibition come down on physician provider groups who also own onsite (or offsite) imaging facilities. There’s too much incentive to drive up costs. Docs are not going to like making $75,000-$100,000 a year instead of $1.5 -3 million and will fight like hell to stop this. AMA and Big Pharma will flood the media with such feartalk. Buckle your seatbelts.
The funky comments are links. I’m not sure why those show up as comments.
You make some good points. The Certificate of Need office at least keeps a check on the proliferation of physician owned imaging facilities in our state but it’s still a problem.