More issues concerning our health care system

Once again it shows how broken our system is today. Here is the history and down side to contractual agreements.

While fee-for-service benefited doctors financially, it led to significant increases in the overall cost of medical care. Public concern over these costs grew throughout the 1950s and 1960s, culminating in the passage of Medicare in 1965. This legislation resulted in increased profits for health care providers, thereby making medical management attractive to investors and giving rise to large-scale corporate involvement in medicine. In order to limit medical expenditures and thereby increase profits, many corporations have implemented systems of managed care, in which doctors receive a fee directly from the corporation with which they are contracted. Oversight is high, and most doctors are limited in the number and type of procedures they may perform, and in the drugs they may prescribe. The introduction of cost management controls has meant decreased economic independence for many doctors, and while the cultural authority of the profession remains strong, its autonomy in diagnosis and treatment has been eroded as a result of corporate involvement.

I do not think it is just about money, but this control on doctors raise ethical questions as well. I being a Doctor could not live with anything that would promote less care for my patient because it is more cost effective. Thus I would open my own practice, not for financial gain but for ethical reasons. As long as we live in a society that promotes health care for profit our system will continue to be broken.

In a universal health care system like they have in England the Doctor’s are contracted by the Government, they are paid the same way fee-for-service. However the emphasis is not on profit but quality and productivity. The average wage is $200,000 per year. Our national average for an ER Doctor is $214,000 per year.

I do not find any up side to a contractual agreement as long as big corporations have their hands in the mix.

Reference:

http://www.npr.org/news/specials/healthcare/healthcare_profiles.html

Frabotta, David, 'Up in Smoke,' Managed Healthcare, September 1999, p. 42.