April 18, 2004


Now Can We Talk About Health Care? (HILLARY RODHAM CLINTON, 4/18/04, NY Times Magazine)

First, the way we deliver health care must change. For too long our model of health care delivery has been based on the provider, the payer, anyone but the patient. Think about the fact that our medical records are still owned by a physician or a hospital, in bits and pieces, with no reasonable way to connect the dots of our conditions and our care over the years.

If we as individuals are responsible for keeping our own passports, 401(k) and tax files, educational histories and virtually every other document of our lives, then surely we can be responsible for keeping, or at least sharing custody of, our medical records. Studies have shown that when patients have a greater stake in their own care, they make better choices.

One reads that and for the most fleeting of moments thinks that maybe she's figured out that the solution to our health care problems is re-empowering the consumers and bringing market forces to bear, but in shiort order she refutes her own point:
Some people believe that the only solution to our present cost explosion is to shift the cost and risk onto individuals in what is called ''consumer driven'' health care. Each consumer would have an individual health care account and would monitor his or her own spending. But instead of putting consumers in the driver's seat, it actually leaves consumers at the mercy of a broken market. This system shifts the costs, the risks and the burdens of disease onto the individuals who have the misfortune of being sick.

Consider what she's saying here what she's saying here: sick people shouldn't face "the costs, the risks and the burdens of disease". This is Second Way Think--similarly the New Deal/Great Society types argue that the unemployed shouldn't be responsible for finding jobs, the elderly for paying for their retirements, welfare recipients for pretty much anything. It's the most anti-market, anti-consumer driven system you can imagine. It's as if she (and John Kerry, Ted Kennedy, and company) learned nothing from the 20th Century. Their goal is still to make us all wards of the State.

When you place their desire to defend and extend the disastrous statist policies of the past few decades against George W. Bush's vision of an "Opportunity Society" you can see that this is the most significant election in American (and therefore world) history.

Posted by Orrin Judd at April 18, 2004 11:50 AM

it has been my experience that when patients are included in health care decisions (required by law and ethics, so this happens 100% of the time) they 1) grant paternalism to the health care provider (and become compliant or non-compliant) or 2) spout off some stuff they read on e-medicine, being about 1% correct, thereby causing the doctor to waste time unteaching 99% incorrect info before attempting to teach the right stuff.

patients have control over charts; it takes a simple request to gain access.

HSAs are a good idea, but only if all insurance companies support the HSAs, drop minor coverage, and offer catastrophic coverage @ a decent rate. the last one will be hard to fulfill since the loss of minor-coverage premiums will lower their bottom line/profit margin/etc. next few years should be quite interesting.

Posted by: poormedicalstudent at April 19, 2004 12:46 AM