1. An article in Slate about physician incentives and their relationship to salary, all in the context of health care reform. The punchline: health care reform likely won't make a dent in physician reimbursement given the power of the doctor lobby and that fact that the government cannot interfere easily when much of health care is funded privately. I think the former point is true, and very sad, since doctors need to realize they respond to incentives just like anyone else. The latter seems like an overstatement: a fair amount of health care dollars (45%) come from public sources. Not a typo.
2. Another interesting piece in Slate, measuring up the US health care reform against our nation's deepest core economic and social values. The juxtaposition is interesting because it is at once jarring and at once perfectly consistent. I will let you read the piece to see what I mean. It's completely worth it: I haven't seen the health care reform debate phrased in this manner and it's definitely a refreshing perspective.
3 comments:
The only idea I have to fix the physician lobby is to abolish the AMA. It almost seems like a union.
"All advanced, wealthy countries have structures that are more egalitarian and cost-effective than ours. Each also has its quirks, which tend to reinforce familiar stereotypes. Britain, land of the stiff upper lip, rations care explicitly, providing what to us would seem shockingly minimalist treatment. It doesn't cover many procedures we regard as standard, such as PSA tests for men in their 50s or even regular physical exams for adults. That's what you get when you spend 8 percent of your GDP on health care (versus our 16 percent). The Japanese, on the other hand, venerate doctors and visit them 14.5 times per year on average, three times the U.S. rate. They do this in an orderly, ritualized way, usually bringing a bottle of sake or cash in an envelope as a gratuity."
I thought this was an interesting point from #2 (in part because the PSA test and regular physical exams are both, in point of fact, probably worthless),
Good article as a whole, and the final point regarding the removal of the tax exemption is very well taken indeed.'
As for Jeremy's point, it's also well taken, though the AMA has done a good job of abolishing itself (<50% of all MDs, likely more ~30% or so at best). Now the politicians just need to stop listening to them-the Starr book referenced in the articles is replete with examples of the AMA blocking healthcare reforms, in many ways leading us to the situation we are in now.
I agree with James regarding the AMA: most physicians I'd say do not belong to this group or subscribe to their policy preferences.
That said, the AMA does have a great deal of political power, whether the speak for doctors or not. And sadly, they have started throwing around the term they coined in the 50s - "socialized medicine" - to lay the groundwork to defeat the new plan even before it gets the honest discussion it deserves.
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