We all know that a huge chunk of the
national spending goes to healthcare. Treatments and visits to physicians have
varying cost from region to region, but does that equate to different levels of
service and healthcare? The Dartmouth Atlas Project compared medical billing
records all of the country and found that there is a huge variation in how much
clinics charge patients yet the quality of healthcare they received were more
or less the same. The initial speculation is that many physicians give unnecessary
treatments to patients; they overkill the patients’ conditions to ensure that
they are treated (or, for some, so that they can reel in more money).
I think health is a right, and not
a privilege. The most basic general thing that humans have is their health. If they
don’t have health, nothing else matters, so if we were to give anything to
someone it would be health. Anyone is entitled to and has the right to have
better health just because that’s the most essential gift that anyone can
receive. How can we deny people of lower income from living their lives in good
health? The need for health is more basic than the need for food, sleep or
entertainment, because without health or life, food, sleep and entertainment
are irrelevant. Of course people of high socio economic levels would have more
options available to them in terms of treatments, but everyone is entitled to
basic healthcare.
In light of the Dartmouth Atlas
project, the documentary US Healthcare: The Good News showcases healthcare
systems around the country that has lower than average cost but higher than average
services. In Grand Junction, CO, the physicians in the county made a pact in which
they promise to charge all patients the same amount of money for the same type
of treatment. They do not discriminate between a patient with private insurance and one with Medicaid.
Moreover, a portion of the money received from patients are withheld and
distributed among physicians monthly. This system equalizes the cost to visit a
clinic, making it affordable for those of lower socio economic levels and
ensuring that the poor can get similar, if not the same, quality of healthcare
as do the rich.
In Seattle, WA, Group Health is a cooperation
of physicians. The physicians are paid a fixed alary and schedule their work
day around the patients’ appointments (not the other way around as it is
normally). Moreover, they keep electronic records for easy access for both
patients and the staff. Patients are given more time to talk with the physicians
about their aliments and can contact them by phone or email; this allows the physician
to really understand and keep track of the patients’ medical history. The best
thing about the fixed salary part of this system is that physicians have no
reason to prescribe expensive or unnecessary treatments for patients to make
more money, since they are paid the same amount of money either way. This also
allows them to take their time with each patient without rushing to maximize
the number of patients they see to get more commission. This system makes the lives of both the staff
and the patients much easier.
In Everett, WA, the Everett Clinic is
a huge clinic with over 300 physicians working together in it. They strive to
eliminate superfluous treatments and costs. They do this by creating strict checklists
to approve or deny expensive (and often unnecessary) treatments like CAT or MRI
scans. They also use generic drugs and drugs that are the most efficient. They
claim that they more money for the community this way by ensuring that the
people stays healthy for work.
I think any of these systems could
be implements nationally. The main problem is human greed and the lack of
strong initiative and leadership. I don’t think convincing all the physicians
in a region to voluntarily reduce their income would be easy; moreover, these
systems seem to only work if most, if not all, the physicians are receptive to
this system. These systems are all or nothing. Either everyone’s doing it in
the community or none. I think if we want to see systems like these implemented
nationally, it has to be done at a federal level and voted on in the Senate
(perhaps making it constitutional iilegal to knowingly prescribe unnecessary treatments).
I am sure that this is all possible just as we can evidently see in the cases
shown in the documentary, but scaling this up to a national or even state-wide
level would deem a challenge.