PATIENTS ARE NOT CONSUMERS

Last week I wrote that I was going to comment on today's an d the near future's health care picture. Today being Earth Day  besides the holy day< "Good Friday", it is time  to act on my  good intentions. This has been a  3 meeting week, two of which I did attend plus two sick 14 year old cats  has interfered with my resolve. Besides that  since we are closing in on the June Primary Time which is the most important election in local politics we have been supplied with more than enough material to write several post a day. hey would be more pertinent to Plainfield than one on Health C are.

Today (4/23/11) in the OP-Ed page of the New York Times there appeared a  column  by Paul Krugman           ( http://www.nytimes.com/2011/04/22/opinion/22krugman.html?_r=1&ref=opinion ) disputing the notion that patients are "Consumers". He rejects the concept that Health Care is a commodity like a loaf of bread. Only briefly does he mention  that Doctors and Hospitals and Nurse are "Providers" a term applicable to the Baker. We are not  dealing with a profession but instead  a service which many feel that it is a right.

That of course is the problem. Once the social planners and politicians decided that Health Care was an entitlement although nowhere in the Constitution or the Amendments is it so written then the relationship between Doctor and patient began to change as it became a business especially with the arrival of the HMO concept. The third party payers be it the insurance companies or the government began to limit payments and ease of access. The patient began to over use the system and available resources if the cost was not coming out of  his pocket.

The Third Part Payer if a non-government enterprise  (insurance company)  was in business to make money.  That could be done by reducing payments to "providers" (not physicians or hospitals) and limiting by various means deliverable services. The patient (consume r) did not care as long as it was costing him nothing. The insurers began  to assemble panels of physician who would  accept reduce payments and once the doctors  became dependent the carriers would squeeze them by reducing fees.

The hospitals also became victims of the Insurance companies. Muhlenberg for instance was denied a contract with Blue Cross although JFK was granted one. In part this was over payments. Many patients (consumers) accepted the fact that they no longer had a choice in who was delivering their care, as long as they did not have to pay for it

The day of doctor/patient relationship has past. To survive physicians need  to be in big groups and to delegate much of the care to assistants. Volume to provide profit not quality is the driving force of care. To reduce costs by what ever means can be use d is the goal of the Third Party Payers. Government sponsored  programs find that cost  have gone out of control. therefore they also go through methods  of limiting services
That we  go into in another article.

What  shape the reformation in Health Care will take  be it "Obama Care" or one  of the Republican voucher programs must wait until after the 2012 elections. This is on e of the provisions of the Obama Health Care legislation that  has just been cancelled.(http://www.medscape.com/viewarticle/740898?src=mpnews&spon=18 )
(to be continued)

This being a holiday weekend of major religious importance, reading blogs will be an unimportant pursuit.There will  be no posting until Monday unless there is a major  story.