Wednesday, April 20, 2005

Three noteworthy items...

On call today, browsing on the internet, and I came across three reasonably related articles. The first two come by way of Kevin's blog, the first of which is this article written for Florida's Herald Tribune by Anthony DeSpirito, a retired academic pediatrician. He addresses the importance of malpractice reform in the ongoing debate about health care costs, stating:

True health-care reform cannot occur until the issue of medical malpractice is seriously addressed. A national health insurance will lead to loss of patient autonomy and an indeterminate delay in the provision of services. Honest legislative decisions, made with input from those intimately associated with the issues, can lower the cost of health-care delivery, thereby providing better access to care for the poor and underserved while lowering the cost of care for all -- providing choice in medical care for all our fellow citizens.
This perspective on universal health care coverage is often ignored by policy makers, but the current legal system costs all of us an inordinate amount of money which could be better utilized in providing care (see Overlawyered and Common Good for more information). Going farther down the road towards universal health care coverage is Vermont, where there are going to be wholesale changes in coverage.... but perhaps not enough primary care physicians to perform the work! This is a challenge in the era of high medical school debt, poor reimbursement, and fewer physicians training in primary care. There is a simple solution, along the lines of "Field of Dreams" --- if you pay them, they will come.

Last is a great look at what a socialized/universal coverage system means in the end. It comes from Mark Steyn, who is a great commentator on many political matters.
"Waiting" is built into the concept of a government health service: As my own non-government doctor put it, making idle chit-chat as his fingers explored my fleshly delights, "When the government runs the system, every time you get operated on, it costs the government money. So it's in their interest to restrict or delay your access. When you look at the overall budgets - salaries, buildings - it's not hard to understand that the level of service you provide to the patient is one of your few discretionary costs." The janitor and the janitorial services consolidation review consultant expect their cheques promptly on Friday; you're the one who can be postponed.....Britons expect "control" over the cars they drive and the DVD players they buy and the internet porn sites they subscribe to, yet they live with a health system frozen in 1945. It's a curious inversion of priorities to demand "control" over peripheral leisure activities but to contract out the big life-changing stuff to the government.

(Hat tip to Kitty Litter for the last bit)