September 7, 2009

"It will send us back to the Middle Ages"

Good stuff on health care, from Clark Judge:

...In recent weeks I have talked with people on the cutting edge of health delivery. There is a tremendous amount of experiment going in health care delivery. At least some of these experiments will transform health delivery and, if public policy allows it, solve the problem that is driving health overhaul: inflation of costs.

One such experiment is with what is called direct primary care. Think of Minute Clinics, only bigger and broader. For a modest and fixed monthly fee ($40 to $80/month), these facilities assume responsibility for all of a patient's routine care. Appointments can be same day. Time allotted per patient is extensive.

How? By taking fees directly from the patent not the insurance company or the government. These firms estimate that 40 percent of the costs of health providers (not insurers, providers) are incurred in the processing the paperwork that government and private payers demand. Much of the productivity boost allows higher care for a lower price is derived from cutting out these costs.

Another set of experiments is with a new approach to pharmaceuticals. I asked a former senior official at the Food and Drug Administration what he thought of Obamacare. It will send us back to the Middle Ages, he replied. His reason? The administration's embrace of comparative effectiveness standards would cut off the most promising experiments in medical science.

Comparative effectiveness standards are, he explained, based on population averages — greatest good for the greatest number. But born of the mapping of the genome and other biochemical advances, the changes he saw coming would lead to medicine that is specifically tailored to each patient's unique makeup. Comparative effectiveness panels, he said, would effectively end the ongoing research and development in patient specific care.

The widely understood alternative to the president's government-centered reforms is patient centered reform — including giving the consumer the same tax preferences when buying insurance for themselves as companies now receive and expanding Health Savings Accounts.

HSAs put those receiving care in charge of all normal health choices, cutting out both government and insurance companies. With HSAs, the usual questions consumers ask — in particular how much value am I receiving for the money — consumers are now asking for the first time in decades in the American health world. ......
Posted by John Weidner at September 7, 2009 9:50 AM
Weblog by John Weidner