The Post Office Version of Patient-Centered Care
Did you know that “patient-centered health care” means having a medical home? With electronic medical records? Being treated by a “care team” rather than a doctor? Or did you know that who pays the bill is too insignificant to even mention? Ditto for patients controlling their own health dollars?
Did you know that helping patients make choices between health care and other uses of money is not really part of patient-centered care? Nor is helping the patient get the best value for dollars spent. Did you know that doctors competing for patients based on price is not really part of patient-centered care? Or on quality?
More on the Commonwealth vision for patient-centered care here.
“Did you know that helping patients make choices between health care and other uses of money is not really part of patient-centered care?”
Sure John, that’s a great model for health care. In a country with the median income of 40 or 50 thousand a year, and the typical surgeon making ten times that amount, you want people to choose between cancer care and feeding their children. Perfect.
I love this post. Commonwealth’s view of health care is as far away from real patient-centered care as we are from the out edges of the universe.
Very good post. Appropriately cutting, without being too insulting to people who really have no idea what patient-centered care is all about.
The ultimate goal of mandating comprehensive coverage; forcing employers to provide coverage; and having government pay for half of all health care expenditures is to insulate people from the financial consequences of poor health. The problem is: if our society decides that the each person deserves, say, $300,000 worth of lifetime medical care, on average, then lifetime consumption of non-medical goods and services necessarily must fall by the same amount. Furthermore, if something is unaffordable for most individuals, then it cannot be any more affordable if funded collectively. That is the reason patients need to act more like consumers, control their health care dollars and ration their own care based on their preferencees. Otherwise, medical spending will crowd out all other forms of consumption. Calling medical care “patient centered” only if it ignores the cost leads us in the wrong direction.
The problem with people like artk is that they really believe there are no choices to be made. (Your Children or Your life Hospital offers a special today only!) Therefore, there is no room for economics at all.
Artk, of course is wrong. As the international marketplace is proving every day, you can have low cost, high quality care without bankruptcy. (You can have your children and your life!) But only in a market in which providers compete for patients based on price and quality, instead of becoming the agents of third-party payers and government bureaucrats.
That is real patient-centered care.
Bruce,
If there were a listing of standard costs one could refer to you would be correct. Currently, when you go to the doctor or hospital when sick or injured, you are not presented with a cost list for the treatments you are going to receive or a listing of all labs/facilities in which you can choose from with prices listed per procedure. Services are performed and you are billed without cost consent or knowledge.
Based on these facts alone there is no medical market place as there is no mutual knowledge or consent.
There are medical silos in which doctors and hospitals create their own marketplace and charge whatever they want which has led to the vast differences in cost. Doctors and hospitals get away with it because of the intense stress and immediate need of the patient.
If there was a standard price on services, such as $50 for a chest x-ray (for example), docotors could them compete for business by offereing the chest x-ray for $45 or $50 with a Coffee Latte’. That is market economics.
What we have now is “Take what you can get, Market be dammed.”
Bruce sez: “As the international marketplace is proving every day, you can have low cost, high quality care without bankruptcy”
Sure Bruce, why don’t you have your wife travel to India to have her breast cancer treated. The vast majority of medical care is local, and will remain so for the foreseeable future.
A lot of people do travel for care, artk. And I predict that the only way we are going to get competition in medicine is if a lot more of them do so. People will not have to go as far as India, however. Just anywhere across the US border in any direction will do.