Friday, February 11, 2011

The Doctor Patient Relationship

The present health care reform law euphemistically called The Patient Protection and Accountable Care Act (PPACA) is deeply flawed. It pays lip service to the fundamental problem in American medicine; the lack of time patients and physicians have to spend with each other developing a long lasting therapeutic relationship. The diminution of this core value has driven medicine to the over use of technology and a lack of coordinated care for the chronically ill.
Our nation's excessive health expenses are a large factor causing us to lose our competitive edge in manufacturing, straining the standard of living of millions of Americans. The PPACA will needlessly add to our national health care expense and will exacerbate this problem. Our increasing Medicaid expenses are causing states to scrimp on public education, just the opposite of what we need for our future.
Other advanced societies care for all their citizens costing them much less than what we spend. We can and must do better. For starters, I suggest a $2,000 federal tax credit for all adults and $1,000 for all children per year creating health savings accounts for most outpatient care and high deductible catastrophic health insurance for more expensive items. Reverse tax payments on a sliding scale for those who do not pay taxes. From this account choose your doctor; spend at least 30 minutes at each visit.
Have a system in place by which doctors help each other practice high quality efficient medicine. At each hospital admission have patients, their families and doctors decide what would be appropriate care. Do not hurt people by providing care that is of no value. Physicians and patients together can practice excellent medicine at a cost that unlike the present will not put our country into financial ruin.

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