I know I am still on vacation, but I could not resist.
I listened to Obama's Press Conference on health care reform while I was on the treadmill at the Y in Phoenix. Again I was impressed by his apparent intelligence, his "down to earthiness" and his logic.
But once one drills down a bit, one sees the problem I have with the President. One of Obama's favourite rhetorical tricks is to set up a "straw man" and then shoot it down. For example, he compared his health care reform ideas with the current situation where a doctor who sees a patient with a sore throat is "incentivized" (an Obama made up word) to perform a tonsillectomy rather than treat the sore throat ( which may be caused by an "allergy", according to Doctor Obama) because a tonsilectomy pays more. Who the heck is this unethical doctor?? Do doctors actually perform surgeries because they "pay more"??? Does Obama have evidence of this or has he just made it up? We should not be "incentivizing" this doctor, we should be suspending him.
Oh, Obama. You just break me up.
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As a Canadian ENT specialist I can assure you that if you have a "National Healthcare Plan". You will not have to worry about tonsillectomies, since the wait time for access to hospitals will be so long the tonsils will atrophy. In Canada our group jokes that the best tonsillectomy is a cancelled tonsillectomy.
ReplyDeleteI was riveted when Obama used the example of sore throat patient really needing allergy treatment rather than tonsilectomy as this exact scenario played out with a child of ours. After one surgery (tonsils) did not improve the health of this four year old, adenoids were going to be the next to go. I made an appointment for our daughter with a naturopath. Could hardly afford the appt as it is not covered by our insurance. Naturopath begged me to try a completely cow's milk free diet for one month before going ahead with surgery. Life-long health since that remarkable help from the naturopath. No more ear aches, ear tubes, strep throat or surgeries. This is real. The 'system' supported the conventional medicine that cost so much, but wouldn't pay for the advice that has given this 22 year old pre-med student life-long health. Guess why she's headed into medicine?
ReplyDeleteProf. Klar,
ReplyDeletePresident Obama was referring to the many studies which have shown that parts of the country are spending much more per-person on health care than the average and not getting better patient outcomes. Mainly because the doctors in those jurisdictions own interests in diagnostic and boutique facilities, and so have an incentive to order unnecessary treatment.
You can read about all that in Atul Gawande's excellent New Yorker piece, which the President has reportedly made mandatory reading in the White House.
Hope you're having a good vacation,
Scott
You don't think the billable hour contributes to unnecessary litigation? Financial incentives are funny that way ...
ReplyDelete