Thursday, July 23, 2009

A genuine confusion regarding President Obama and health care reform

On 13 June, President Obama said this of his objectives in health care reform:

"if doctors have incentives to provide the best care, instead of more care, we can help Americans avoid unnecessary hospital stays, treatments and tests that drive up costs."

Now here's my confusion: There are several reasons advanced for the need for health care reform, the primary of which are generally:

1) Millions of uninsured or under-insured Americans

2) Soaring premiums

3) The refusal of health insurance companies to authorize necessary tests, treatments, or hospital stays.

Number three accounts for [by my rough estimate] nearly 75% of the anecdotal horror stories about health care in America: refusing meds, nixing treatments, demanding that you leave the hospital early.

But it was Tom Baker in his highly regarded The Medical Malpractice Myth who argued that neither HMOs nor malpractice threats are causing physicians to order too many tests or engage in too many procedures. Instead, Baker argues, there actually aren't enough tests or procedures being done:

There is lots of talk about the heavy burden that “defensive medicine” imposes on health costs, but the research shows this is not true.

Yet what Mr. Obama appears to be advocating is fewer tests, fewer procedures, and fewer hospital stays.

I realize that he is making the best practices argument, but it seems to me that there is an inherent contradiction in his position.

Maybe it's just me.


Nancy said...

The confusion stems from the redundancy within the insurance system. I think he is talking about fraudulant practices.

Have had several family question why such and such was done or overdone etc...

There is no reform without revamping process and questioning fraud. Nor should we let the malpractice problems and tort go uncapped.

God forbid we go forward with a government plan that doesn't catch how physicians and insurance companies scam the consumer... especially those with medicaid and medicare.

tom said...

This is a bit off topic, but has potential to make the Senate debates on the Health Care bill a bit more interesting:

Senator Tom Coburn proposed an amendment, which was adopted by the Senate Health Committee, to require members of Congress to switch from their current health insurance plans to any government provided insurance scheme that's created as part of proposed health care legislation.

I think it should be a general requirement that members of Congress "eat their own dog food" instead of routinely exempting themselves from the laws they impose on the rest of us.