Isn't it amazing how strange things happen . After posting today's blog I what I feel is going to be the impact on the delivery of "Health Care". I then started to read today's NY Times and ran across this article which I have posted (here) the link to the online edition.
Of importance is the description of a new "delivery modality" called "accountable care organizations". to be a joint venture between hospitals, doctors. nursing homes and home health agencies. The object "to coordinate care and cut costs". As they reduce billings the organizations will be offered financial rewards. Read between the lines. As I wrote you can bet the hospital will be the managing partner and allocate receipts since it will do the billing.. In one way or another there will be by controlling tests or in patient stay or medications a compromise in patient care.
In a comment to today's posting Nat refers to a comparison to the praised "Canadian system". It is an apples and oranges matter. For many years Canadians living near an American medical center would cross the border for their care even though that had to participate in their local plans. It was a fact that there is no "Canadian system per se since each Province has its own plan and benefits vary. There was a long wait for procedures and operations since in some Provinces there was a "dollar" quota on how many could be done in a time period.
There also in the early 90s a marked difference in availability of up to date tests. The city of Seattle has more MRIs then the Provinces of British Columbia or Alberta.
As to differences in life expectancy; figures can make a meaningless point. Differences in life style or ethnic populations will impact on the overall results. If the population mix is almost the same in the two countries than the comparison could be valid. . I would submit that in this case it is more "political" than meaningful.
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Old Doc, I didn’t know I was going to be put under such close scrutiny. Otherwise, I would have submitted a more detailed proposal showing how you could compare apples to oranges. It’s done all the time in the social sciences. In fact, the reason I chose Canada is it is most like the US and it would be a simple matter to statistically match cohorts for comparison.
ReplyDeleteMy only point was that we are spending almost twice as much for health care as Canada (Germany, Austria and several other countries), they cover everyone, we don’t and our people don’t live as long. This from the country that is supposed to have the best health services in world. Something is wrong and it would not hurt us to understand and even implement the ‘best practices’ from some of these countries.
Health care is rationed, today and in the future it will be more rationed as science provides more and solution to improve and extend life. Soon insurance companies will be telling you that if you want that operation, you will have to go overseas for it because it is cheaper and as effective as having it done in the US. Be advised, the rich and the well connected will always find a way to game the system.
As to whose leaping borders, what about all the Americans going to Canada to get their prescriptions filled. I’ll bet they spend more dollars for their prescriptions than Canadians spend for medical services in the US.
My brother and his family live in Canada. They do pay more taxes, but he doesn’t have to worry about being bankrupted by medical expenses or sending his kids through college or his retirement.
Test comparing the performance of kid’s indifferent countries showed Canadians as performing the 5th best. Where was the US, oh somewhere towards the bottom.
Communism, Socialism and Capitalism are all Utopian economic system s, each with major flaws. But, I’ll take Capitalism within the bounds of a Keynesian construct and with a hint of Socialism.
PS: How many MRI’s can sit on the head of a pin?