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David Kibbe MD a family practice physician joins us here courtesy of Matthew Holt of The Health Care Blog....Dave is a well known writer on the subject of health IT. In this particular episode he takes us on a cross country tour produced by Scribe media.org I think you will like the music as well. Enjoy!
The overriding theme of the recent campaign season was and is “CHANGE”. The sea of jubilant Americans, young, older, all races, and backgrounds celebrating this victory of Obama for America demonstrates the power of democracy. Yes, democracy is more powerful than capitalism (run amok) and socialism.
We tend to think of black and white. Either left or right. During the campaign at times it was difficult to analyze the real deep meaning of either candidates proposals. There were many who feared this outcome, however the majority has ruled. It is obvious many of us have been left behind.
The outcome is not the death of capitalism, nor the onset of socialism, it is however the demonstration that capitalism and free markets have exceeded their inherent ability to balance the equation. One can argue that creeping entitlements have led us into this “dead end”. The normal market pressures have become dysfunctional.
George Bush’s policies and decisions ended when we invaded Iraq. We were caught up in a perfect storm of global events and economic turmoil.. and terrorism was the overriding theme for us.
Americans had never been attacked in the underbelly, or the heart of the nation’s highest peak (the World Trade Center). The events of 911 symbolized and unknowingly foreshadowed the events of the past several months. In reality these events were ongoing for considerable time. Our recent financial collapse has been blamed on the supreme mortgage meltdown. This is a smokescreen for what has been ongoing for the past ten or twenty years in real estate, credit markets, the consolidations of enterprises, the greed of the stockmarket, insurance industry, technology whether it was for the good, or for mindless entertainment among increasingly idle Americans, who had lost their direction.
We should have learned that actions should not always be based upon fear. We should also remember not to depend upon one person to lead us and/or save us from ourselves.
At the onset of the crisis I said “look in the mirror, there is the culprit”. Even those of you who are relatively successful depend upon inequality, and greed. How big a house, and how many do you need? How big a vehicle do you want? Is it based upon your life’s needs, or some other motivation. Some families with 2-4 children do need a larger vehicle. Why has the foreign car market exploded? Why have we had to export and/or outsource many of our vital functions?
I am not going to give answers here. I don’t know all of them, But we all, patients, payers, providers, and yes government need to assess what we have done. It has not been done to us. Look in the mirror.
While we have been counting the casualties, worrying about health care financing, the gradual and relentess increases in the cost of energy, and the innumerable eco- disasters the perfect storm arose and devastated capitalism as we knew it.
Our new leader is largely unknown, however he is extremely bright, a brilliant orator and politician. This inexperienced man defeated a powerful political machine, overturning the democratic party, just like a boat in the perfect storm. We must all row the boat together as a team to insure our success. We don’t expect a miracle, but more people now have hope.
No capitalism is not dead, nor is socialism taking over. It is not black and white.
President Obama is the perfect combination for our country, a man of color and white, an immigrant, a man who came out of nowhere, from a very modest background, raised by a single parent and grandparent. How familiar does that sound to you? It is not the American dream, but it is the American Reality.
Hope must come before prosperity. There is no prosperity without hope.
As I drive to work through endless homes
I always wonder, what is going on in each of those homes. Are they healthy? Do they have jobs? How many are living from paycheck to paycheck, unable to save or follow the advice of financial wizards? How many are sad? How many have dysfunctional families? How many alcoholics and drug dependent people are in those homes? How many don’t have insurance? How many live in fear of losing their homes and/or their transportation. How many have latchkey children?
There are many more questions than answers. Statistics don’t tell the real story. They indicate the enormity of our problems, however as I drive through the neighborhood I feel the pain.
We as providers face these situations on a daily basis, unable to respond effectively for our patients, unable to commit sufficient time to analyze problems of poor health based on economics, family structure, anxiety and/or depression, limited income in a country with supposedly unlimited financial resources. In truth it has not been this way for many years.
Democracy gives us Hope
The overriding theme of the recent campaign season was and is “CHANGE”. The sea of jubilant Americans, young, older, all races, and backgrounds celebrating this victory of Obama for America demonstrates the power of democracy. Yes, democracy is more powerful than capitalism (run amok) and socialism.
We tend to think of black and white. Either left or right. During the campaign at times it was difficult to analyze the real deep meaning of either candidates proposals. There were many who feared this outcome, however the majority has ruled. It is obvious many of us have been left behind.
The outcome is not the death of capitalism, nor the onset of socialism, it is however the demonstration that capitalism and free markets have exceeded their inherent ability to balance the equation. One can argue that creeping entitlements have led us into this “dead end”. The normal market pressures have become dysfunctional.
George Bush’s policies and decisions ended when we invaded Iraq. We were caught up in a perfect storm of global events and economic turmoil.. and terrorism was the overriding theme for us.
Americans had never been attacked in the underbelly, or the heart of the nation’s highest peak (the World Trade Center). The events of 911 symbolized and unknowingly foreshadowed the events of the past several months. In reality these events were ongoing for considerable time. Our recent financial collapse has been blamed on the supreme mortgage meltdown. This is a smokescreen for what has been ongoing for the past ten or twenty years in real estate, credit markets, the consolidations of enterprises, the greed of the stockmarket, insurance industry, technology whether it was for the good, or for mindless entertainment among increasingly idle Americans, who had lost their direction.
We should have learned that actions should not always be based upon fear. We should also remember not to depend upon one person to lead us and/or save us from ourselves.
At the onset of the crisis I said “look in the mirror, there is the culprit”. Even those of you who are relatively successful depend upon inequality, and greed. How big a house, and how many do you need? How big a vehicle do you want? Is it based upon your life’s needs, or some other motivation. Some families with 2-4 children do need a larger vehicle. Why has the foreign car market exploded? Why have we had to export and/or outsource many of our vital functions?
I am not going to give answers here. I don’t know all of them, But we all, patients, payers, providers, and yes government need to assess what we have done. It has not been done to us. Look in the mirror.
While we have been counting the casualties, worrying about health care financing, the gradual and relentess increases in the cost of energy, and the innumerable eco- disasters the perfect storm arose and devastated capitalism as we knew it.
Our new leader is largely unknown, however he is extremely bright, a brilliant orator and politician. This inexperienced man defeated a powerful political machine, overturning the democratic party, just like a boat in the perfect storm. We must all row the boat together as a team to insure our success. We don’t expect a miracle, but more people now have hope.
No capitalism is not dead, nor is socialism taking over. It is not black and white.
President Obama is the perfect combination for our country, a man of color and white, an immigrant, a man who came out of nowhere, from a very modest background, raised by a single parent and grandparent. How familiar does that sound to you? It is not the American dream, but it is the American Reality.
Hope must come before prosperity. There is no prosperity without hope.
As I drive to work through endless homes
I always wonder, what is going on in each of those homes. Are they healthy? Do they have jobs? How many are living from paycheck to paycheck, unable to save or follow the advice of financial wizards? How many are sad? How many have dysfunctional families? How many alcoholics and drug dependent people are in those homes? How many don’t have insurance? How many live in fear of losing their homes and/or their transportation. How many have latchkey children?
There are many more questions than answers. Statistics don’t tell the real story. They indicate the enormity of our problems, however as I drive through the neighborhood I feel the pain.
We as providers face these situations on a daily basis, unable to respond effectively for our patients, unable to commit sufficient time to analyze problems of poor health based on economics, family structure, anxiety and/or depression, limited income in a country with supposedly unlimited financial resources. In truth it has not been this way for many years.
Democracy gives us Hope
I have to give Barak Obama and John McCain a great deal of credit for their ceaseless energy in campaigning. Whether you agree or disagree with either of them, admit that they have 'charged' the electoral process. For the first time in my memory we have a real choice.
This column does not pretend to be unbiased, either in my pronouncements or opinions. It is the culmination of 65 years on the third rock from the sun, and as a physician for 40 years. There are many of you out there that are older, younger, but few wiser than me. I admire Barak Obama for energizing his "base"
I did not like the way Obama at the last minute decided to waive campaign financing in lieu of fund raising. He obviated the careful thinking about removing finances from the equation. Most of us pay one dollar to fund campaigns. So much for Obama being the voice of the people HYPOCRISY
I admire John McCain for his life and experience. Young politicians can be gifted and wise beyond their years. Obama's lie story is compelling and appeals emotionally to many, but his real world experiences are limited....He is much like the academic who is smart, but has limited real world experience and speaks from two polar opposites....academia and the poor of Chicago. I am suspicious of his origins in Chicago, his affiliations, his glib statements, and his denial of being a very left politician.
He cannot extract a list of accomplishments compared to McCain. He is not even a proven academic. Where is his list of papers. What happened during his college years? Being head of the Harvard Yale Law does not prove much unless he practice law and perhaps it allow him to be in a certain circle of elite friend in the law.
It has been said he will govern from an oligarchy of four associates.
John McCain did not have the 'handlers' nor the organization of Obama...He also started too late. Obama was at this fully committed for two years. McCain all but dropped out a year ago.
Political handlers do not run our country, they stage Roman festivals, go door to door (paid to do that). Tell the candidate where and where not to go. Obama has kept his handlers well hidden. I don't see him as having any original thought...great oratory in a hypnotic manner of delivery.
Yes, I have a bad feeling. There is a great deal of emotion and anger in Obama and his wife. His wife and friends harbor these feelings, which may be justified. He is supported by millions of disenfranchised citizens.
Anyone who would use the phrase, "my program will allow you to buy more of those 'iTune' songs says it all.
For a presidential candidate what cultural and sociologic or even true inspirational aspects are present??
My vote does not depend upon either candidate's proposals for healthcare reform...There are much bigger issues to consider.
I have a MCCAIN-PALIN bumper sticker on my car in a heavily OBAMA neighborhood. My son, age 22 told me I should take it off if I don't want my windows smashed. The fact that he felt some intimidation surprise me. He however is much more in touch with young people. I took it off....he is a very good judge of character.
SO I WILL VOTE FOR JOHN MCCAIN, AND IF YOU HAVE SOME LOGIC AND REASON YOU WILL SEE THAT OBAMA PLAYS TO OUR EMOTIONAL NEEDS....IF YOU VOTE FOR OBAMA TODAY YOU WILL GET WHAT YOU DESERVE...LOSS OF FREEDOMS,much higer taxes, more entitlement programs and further movement of businesses to foreign countries.A SLAVE TO THE 'PEOPLE'....SOUNDS LIKE MARXISM, SOCIALISM AND THE DREAD WORD WE HATE TO SAY "COMMUNISM"
YOUR VOTE HAS BEEN BOUGHT BY MILLIONS OF DOLLARS, AVERAGED OUT TO 18.75 DOLLARS PER VOTE.
SORRY SID, YOU ARE BEING PLAYED BY SOMETHING THAT SOUNDS WONDERFUL BE CAUSE YOU ARE SUCH A GREAT GUY, PHYSICIAN AND CARE SO MUCH FOR PEOPLE.
Here is how the last minute polls show the Presidential Race::::How will America go??
All commentary is taken from The Heritage Foundation
It's been some time since we have had such a clear choice in our selection for our President and the leader of what we call the free world.
Obama---black, young,liberal,inexperienced,
McCain--white, old,conservative, experienced
Both men tempered by their life's stories, both credible, neither with a good plan for our present crises, which are ECONOMIC, NOT POLITICAL. The same pertains to HEALTHCARE.
Medicare and other payors are mandating a conversion to the new coding standard, ICD-10 from ICD-9. Now what's in a number? Well, the new standard will allow for over 155,000 unique identifiers for diagnostic coding, whereas the current standard only allows for something over 9,000 diagnoses.
Converting from one to the other is a big deal since current fields in computer programs do not allow for the added field size.
What's more important to most providers is that the 'unfunded mandate" will cost a three man physician group 80,000 dollars to convert. KevinMD and DrVal point out this conundrum in the face of decreasing reimbursement, the push for EMR and the present economic meltdown.
The Dr. House podcast fan club also has as medical consultant extraordinaire, Dr Anonymous, whose weekly show can be seen on Thursday evenings at 6PM PDT or 9PM EDT on blog talk radio.
I participate in SERMO quite a bit (a physician only blog) and I came across an enlightening story about a german OB/GYN who immigrated to the U.S. after falling in love with a woman he met in N.Y. while visiting. He tells this story on Sermo (ABC1530). Fragments are quoted here, and although his writing crosses much territory not directly related to medicine and health care, here are some of his observations and experience.....comparing, contrasting and teaching what is the difference about U.S. healthcare.................
"Flashback a few years, I am 18 and graduating from high school. I am considering architecture, because I would like to "produce something that I can touch, that I can show", but I end up choosing medicine. I trust my ability to study and memorize more than my artistic talent. And the promise of a good life and social standing help to change my mind. At the time admissions to medical school in Germany were strictly by grades and you needed something between A/B or A-. In Germany you have to decide on your career when you graduate from high school, typically at 18 or 19."
In the meantime the admission criteria for medical school have been expanded to include a lottery (based on the thought that performance in school may not be such a great criterion), a personal interview, a waiting list (the longer you wait and the older you are, the more likely are you to be admitted, and finally the good old grade average. They also reserve 2 % for foreigners - e.g Americans and 1-2% for "social cases" where you can be admitted after providing proof that your grades were unfairly diminished or you were impaired by circumstances beyond your control.
There is nothing comparable to the American "college" years where you look around and decide what you want to do in life. Medical school takes 6 years and The first two years are "preclinical", meaning you study medical terminology, chemistry, physics, biology, genetics, physiology, biochemistry and anatomy and histology. You take an exam after the first two years, passing is required for continuation. The following year is "introduction to clinical medicine" and includes pathophysiology, pathology, pharmacology, medical statistics, clinical examination and history taking and some introductory course in internal medicine and surgery. Again exam.
Then two years of clinical courses, which include "bedside teaching" and demonstration of actual live patients. course include all fields of medicine - internal medicine, surgery, obgyn, dermatology, neurology, urology, radiology etc. Another exam. The German exams pretty much resemble the USMLE 1, 2 and 3 in style and difficulty.
Courses usually have a "practical part", small group teaching, where attendance is checked and lectures in large lecture halls, where attendance is not controlled.
Overall there is much less control, supervision and guidance. You are free to do and not to do whatever you want. as long as you show up in the courses, pass the course exams and the USMLE equivalents, you are fine. There is no grading, ranking, no recommendation letters from faculty or from deans. You get out of medical school what you put in in terms of activity, participation, commitment and desire to learn.
You can start in fall and in spring. Medical school is...free.
Suvarov asked me about the expectations when you start?
Could you clarify the question? Expectations of the medical students, the parents, society?
I expected to learn a lot, have a challenging career, work quite a bit later in life and be rewarded with good social status and a stable income which is at least average, if not better.
The expectations when entering medical school are certainly not as high as here, at least not now. After a continuous decline in income and consequently status and power physicians are just another group of white collar workers. Much like physicians in America if the present trend continues (and, guys, here we go into the "conservative" issues you correctly expected).
Physicians in Germany were making excellent income with fee for service payments by the quasi government Allgemeine Ortskrankenkasse (General Local Sickness Fund), which was established almost immediately after the "Iron Chancellor" Bismarck
passed a law in 1883 to establish such funds and make health coverage mandatory for every German. Some speculate that it was a political move to ward off the socialistic tendencies at the time. The general health insurance worked very very well for almost one hundred years - and then the money ran out. The money ran out due to a combination of rapidly increasing health care costs across the board and the doubling of the number of physicians within a short time - thanks to our friends the lawyers. In the 70s it was one of the main ways to get into medical school. Peoples checked at the bottleneck places in medical school - usually the anatomy courses - and claimed that there were still unused spots. Meaning if there was a group around a cadaver of only 7 students, an additional student immediately sued and got in.
With those tricks the number of medical school students doubled within a few years - with disastrous consequences as you might expect. Within a few years there were unemployed physicians driving cabs and everybody was earning less - the pie, the pot of money available through the AOK obviously never increased, never changed. The pot of money is strictly limited by those 12% health taxes!
Consequently there was less money for everybody.....
The physicians representing the other physicians returned every year from the contract negotiations with a helpless shrug and the comment "we achieved to increase reimbursements for blablabla, in exchange for some cuts at blablabla. The cuts always were much bigger than the small pieces of candy the docs were thrown.
Pretty much the same as the negotiations with HMOs and Medicare (if there are any negotiations with Medicare!).
Those representing physicians were the same breed as the AMA people:
politicos who do not care about those whom they represent, and just enjoying their feeling of "importance", the travel, the cocktails etc.
Residents are picked by personal connections. Medical students that are interested in one particular specialty volunteer in that specialty, get to know the attendings, the chief etc.(PANDERING) They might help out on the floor, volunteer for overnight shifts etc. Then they might do a research project in that field, preferably in the hospital they would like to work and train in. (that works very well in university hospitals). Having good grades in the final test, the USMLE equivalent helps as well. Adn the rest is just timing, meaning you apply at the right time and you get in.
There is a significant difference to the US: While here all residents start on July 1st, in Germany you may enter medical school in Spring and fall and therefore people graduate in Spring and Fall and may apply all around the year. There is no such time as the July 1st. People start and graduate the whole year. So you never know when a position is going to be available.
Residences are not as scheduled, they are not as predictable as here. A residency may take you more time than the minimum. Your Department chief pretty much has the power to keep you and to delay your graduation for quite some time.
You can graduate when you have fulfilled your "numbers". For example in ObGyn you have to document 100 deliveries, 35 cesareans, 30 hysterectomies, 20 laparoscopies etc. Yes, these nunmbers are a guess, but they are about right. I do not remember them exactly, but they are VERY LOW compared to American standards.
AZdrydoc Family Medicine
Posted Oct 25, 2008 at 4:28 PM
<The pot of money is strictly limited by those 12% health taxes! > 12% of what? Income? Sales? When you said "medical school is --free" I immediately thought, well, yeah, but who is paying for the "free"?
AZdrydoc, it actually is (now in 2008) between 13 and 15% of your income - of the gross (!) income! The employer and employee each pay about half of this. Yet,
this is total coverage, eyes and dental included. You have complete choice of doctors and hospitals.I obviously have thought quite a bit about the differences between my German and my American residency. Conclusion: you guys are very lucky to have trained here. While Germans tour "academic freedom" - nowadays or at least for me just another label for "laissez faire", the Americans are much more regimented in their training, it is more scheduled, more supervised, more controlled, more defined.
Just one very important point: In Germany you have to fight for your desirable times in residency - in obgyn it is the operative floor. You try to cut your time short in places where you do not learn much, e.g "postpartum". In Germany I actually had a few months where I was responsible only for the postpartum floor. This seems utterly ridiculous for an American obgyn resident, who is used to taking care of the postpartum floor between 5 AM and 7 AM before going to labor and delivery - where, by the way, he or she also takes care of the "emergent Ob Clinic" or triage etc.
German physicians have to draw blood and start iv s in the morning! I can hardly believe it now that I am used to iv teams and respiratory that comes and draws blood gases etc. What a waste of physician time in Germany.
But then, my German Department chief said he did not want to upset the nurse by having them draw blood, because "you can get a doctor any time, but good nurses are hard to find"
The nurses really got on my nerve in Germany. I heard by far too often "You have to do that yourself Mr. (!) Abc1530,
I do not have time". Brought my blood to a boil every time. They would draw blood for the attending though....
When I left in 95, they were just introducing the ordering in the chart.....
Here in the US I write the order and bam, it get's done. If it does not get done, I am not blamed, but the nurse. If I really want, I can write her up. I have never done that though. Nurses are very good here.
Much better system here
Level of talent entering the door in medical school.
I am not sure if it differs. There is a study that medical students have an average IQ of 125 in Germany. I am not aware of a similar study here.
But I am absolutely sure there is a gigantic difference in ambition. American physicians are DRIVEN. Holy cow! I could not believe the push, the umpf, the stamina, the energy Americans put into their training.
Sorry, my liberal colleagues, but I believe that this is the result of two things: you have to pay for medical school! It is expensive, so it is dear to you, it is hard to get in, so you have to and you want to make the very best of it.
And, there is the promise of the big reward at the end, a reward to big that it is worth staying up late, going the extra mile, doing the whole 9 yards....
No such thing in Germany. Hey , medical school is free, yes, you heard it, free. So, it can't be worth THAT much, right? At least that's how you feel. And you do not earn that much afterwards, so why struggle! Let's live now, let's go out tonight, let's have a party..residency takes so long anyway, and hours are controlled, so youa re never exhausted, so why work your behind off?
I have seen so many slackers in my German residency, it was disgusting. I was very satisfied (sorry to say that, I aoplogize) to see that a resident who exhibited the typical slacker behavior of too many of my German colleagues in one of the American residency programs - was fired.
You either want good doctors or you don;t.
Yes, German physicians are more relaxed and pretty trusting, especially when they hear that someone has trained in the US. American medicine has a great great reputation almost all over the world. Americans and Sermoans may not fully realize the extent of this. You guys are the top, the best, the cream of the crop, welcome and admired all over the world. Not surprising at all that the anesthesiologist handed over the patient to you!
You grew up here, you trained here, you take the American efficiency, quality for granted!
You are the best! Become aware of it!
If I would return to Germany, my future would be secured just by spreading the word that I am board certified in the US and have actually trained and worked there.
Don't underestimate how good American medicine is! How respected it is...
In Germany we say "the prophet is ignored at home".....OUr colleagues are so used to the high quality of medicine here that they take it for granted and consider it "normal". Yes, thank God it is normal, but..... only for the US.
And , thank you for pointing out the probloem with "fixing" health care just to make it resemble the system in those countries that admire us.
On EMRx
Hi Mohican! Guten Tag!
I am using General Electric's "Centricity", formerly know as "Logician". Was programmed 20 years ago, and you feel it. I started using it 1.5 years ago. The part that is most useful is the ability to fax prescriptions directly to the pharmacy
Click-e-ti-clack and the Rx is on it's way, pt does not have to carry a piece of paper around, drop it off, wait, come back, pick it up. Now they drive by the pharmacy on the way home and it is ready.
Besides that it is a big drain on productivity. Everything takes longer, many things are hard to accomplish, such as sending a letter to the PCP that referred the patient to me.
The good side is that all docs in our health care "system" are using it and this actually saves duplicate entries and less things fall through the cracks. I can see the lab reports, the path, the radiology, the ER visit notes on my computer - and - nice too - in the office, at the hospital or at home, with equal ease. Just click and ...wonder...
But the damn thing does not even have a spell-checker! )(&!@^(%#()!
So, it has good and bad sides, overall it takes more time to work with it, but it wil surely get better over the years. When I retire the system will be just as I imagined it to be the first day when they told me about it---- ;-)
There is more, much more that you can gain access to on Sermo. Join, log in and search for user abc1350
- Only I can change my life. No one can do it for me.
- Carol Burnett
US actress & comedienne (1936 - )
What blog subjects are the most popular? My recent review of the Blog Catalog, in order are:
1. Blogging
2. Arts & Entertainment
3. Technology
4. Humor
5. Health
So health is in the top five, but just barely. It is tied with Politics, and ahead of all the rest, law, business,financial,beliefs, social, and believe it or not social media.
At this time Health and Politics go together, entrenched in the economy as top talking points in the presidential campaign for the world's most powerful office.
An interesting observation from the Wall Street Journal by Robert Carroll points out the tax realities of each candidates. It gives a clear endorsement to John McCain's health policy proposals. Would I put it in the arena of Health Care Reform?
NO. This is merely a poorly conceived financial manipulation to have more people in the 'insured category'. Both Obama's and McCain's Health Reform amount to a wallet biopsy.
Other issues, such as propositions in Arizona would ban programs such as universal payor or universal health plans. Would Federal law pre-empt state law??
They aren't talking to one another, while they chew their food.
Sometimes a whisper is more powerful than a shout. Here's a cartoon from Modern Medicine that shows a Medical Home counseling session between a primary care physician (PCP), a specialist and the health plan. The PCP looks forlorn, while the specialist and the insurer have their backs turned, fuming. It is perfectly true.
American primary care is a shambles, and it is now clear that it will not be viable in the future unless significant changes occur in our national attitude about its value and in the way we pay for it.
So what should we do?
The National Committee for Quality Assurance proposes a plan
Another interesting, and perhaps more far-reaching proposal (Download finalpcppaper.doc) has been made by Norbert Goldfield MD and his colleagues. Dr. Goldfield is a highly respected health care innovator,
The articles go on to elaborate how this would work, and how PCPs would be rewarded for acting as the fiduciary and patient advocate, unlike the gatekeeper model, which fails miserably.
Collapse, a book which discusses how societies choose to
suceed or collapse is a worthwhile read.
Given the current crisis, and quick fixes proposed by both Presidential candidates it becomes patently obvious the internal mechanisms of patient care need to be 'fixed'' before any more money is thrown into medical care. Physicians and educational programs need to climb on board the new Health Train.
Quote of the day:
Committee--a group of men who individually can do nothing but as a group decide that nothing can be done. - Fred Allen
************************************************
The High Points:
A family physician shares her ideas on fixing our health care system. Someone better put Elizabeth Pector in charge of something, because her ideas need to be instilled stat. Like this one, explaining why physicians deserve equal rights:
When it comes to equality, doctors get the short end of the stick in our health-care system.....duh !!!
In short, as part of restructuring the health-care system, physicians need to be put back on a level playing field with the rest of the health-care players, so they can provide input prior to implementation of supposed cost-saving measures that often only transfer costs to doctors.
Another must read from KevinMD---how about just writing it out?
Point of Law (you best believe it)
Perhaps we should emulate the Chinese in revising our health care system. Long considered primitive regarding health care, China is taking a bold step toward caring for it's billion or more people.
The Chinese however may have an advantage that much like building a home, it is much easier and less expensive to start from scratch. The United States is faced with disassembling a system that has grown over the past 100 years or more and transitioning to a better means of financing health care. We see that a large barrier to transitioning lies in the financing. Converting to a new system will be disruptive financially, and old habits are difficult to break.
The Wall Street Journal reports that China is aiming for universal heatlh care.
The proposed plan would be quite a shift for China. The draft plan’s overall goal is to cover 90% of the population within two years and achieve universal care by 2020. It aims to return to non-profit national health care, an idea that was largely abandoned in the country 1980s.
This all stands in contrast to China’s current system, which provides little government funding to government hospitals and requires patients to pay heavy out-of-pocket expenses. The WSJ notes that out-of-pocket payments made up more than 60% of health spending in China at the end of the 1990s.
The plan — drafted in consultation with groups including the World Health Organization, the World Bank, consultant McKinsey & Co. and a few Chinese university-based public health experts —-----The government also aims to set pricing standards for medical services.
Other news about Chinese health care, Pharma,Western style hospitals is in the Wall Street Journal. And what does Heparin have to do with hot dogs?
