Thursday, August 11, 2011

MORE ON HEALTH CARE


Just as one of the causes in the recent stock market crash was government spending more than its income creating a mounting debt that our future generations will be unable to redeem. The lesson that we have not learned the was the cause of the 2008 major recession; people spending more than they earned with increase unplayable credit card debt and home mortgages. This applies to governments as well as individuals and the latest evidence is a crisis in your involving Greece, Spain, Italy, and yesterday France.

One of the present biggest expenses and government aside from the military is the governmental sponsored health care mandates. Among them is the fallacy that digital records and physicians office as well of hospitals will guarantee better health care at a savings.

The lack of attention to realities while increasing the demand expenses of theoretical procedures that are supposed to save money while increasing quality and availability [?] of Health care will actually have a contrary response.

Aside from the fact that despite assurances, no electronic records system is safe from compromise from invasion by hackers. Medical records contain vital information personal including Social Security numbers and addresses age marital status credit card numbers etc.

Moreover, if they are to be stored in a “cloud server” location there is no guarantee that a failure could results in a complete loss of all data. The expensive reconstructing this material will be tremendous and may have to be borne by the "patient provider" since the government has not taken the possibility into account and made appropriate provisions.

Another problem with the digital records concept is that there may be too much information to be scanned to make practical to use. Furthermore, there are numerous proprietary systems at present in operation and there is no guarantee that they can speak to each other. There is no standardization.

The government has required that all physicians digitalize their records to fit the system concept. There are some monetary benefits promised for quick compliance.

On the other hand in order to enforce digitalization, physicians will be penalized by reduced Medicare/Medicaid reimbursement. The deductions will be increased each year. No attention is given to the costs that the physician must meet.

One large medical group, who has four separate office locations, has estimated that it will cost them $1 million just to install a system. Software upkeep annually will be in the neighborhood of $100,000. Their numbers are large in part because of the number of offices and individual patient records, but there are basic vendor costs that must be met. Therefore, it will be disproportionate larger for smaller groups and impossible for the individual practitioner to meet these requirements.  That is why the practice of medicine is consolidating into multi-physician groups that run as businesses and rely on productivity to be profitable. More about this in another blog.

A recent article has reported another problem with the digital process as follows:
“The results also show that organizations responsible for coordinating the digital exchange of patient records are rarely financially viable, and only a few support the type of information exchange that the government deems necessary.
"Part of meaningfully using electronic health records is the ability to send and receive data between systems," Julia Adler-Milstein, one of the study's authors from Harvard Business School, told Reuters Health. "A lot of the value comes from having complete patient information at the point of care, and not all patients see the same doctor for their whole lives."
One way to address that, she said, has been through government-funded regional health information organizations, or RHIOs, which sign up doctors and hospitals in a specific area and coordinate the transfer of electronic patient information between providers.”

If the government is to finance these regional organizations the money has to come from funds available to providers. As you reduce their income they will either opt out of the system or delegate much of the care to less qualified practitioners and see the patient only and a summary executive role. This is been the trend for the last decade or so and it will only get more perfect

How can this all result in better health care more people and be affordable for all? There comes a time when all of us must stop believing in Santa Clause.

1 comment:

  1. Also electronic data is not as safe and secure as conventional paperwork.

    ReplyDelete