One-stop shopping comes to American medicine

Congressional fireworks over health insurance legislation may ultimately seem a minor footnote compared to a subtle, but seismic shift toward something reformers have long yearned for–one-stop shopping.

The idea is to combine insurance, where the economic incentive is to spend as little as possible on care, with medicine, where money’s to be made by providing maximum treatments. One such iteration is a health maintenance organization, like Kaiser Permanente, which Washington has been relentlessly pushing a resisting system toward since the Nixon Administration.

Continue reading One-stop shopping comes to American medicine

Recasting the Medical Morality Play

Doctor and patient Many Americans have an unhelpful habit of viewing the health reform debate as a morality play where those who treat us, usually doctors and hospitals, are viewed as the good guys and those who pay for those services, generally insurance companies or government programs like Medicare, are seen as villains.

When a physician suggests another test, we assume that they’re trying to be helpful rather than merely increase their income. When an insurer refuses to pay for a test proven unreliable or has a less expensive alternative, we assume that the decision comes from heartless profit-maximizing bean counters. Continue reading Recasting the Medical Morality Play

What Would Mitt Do?

Repeal of the Obama reforms will be a return to a fiscally untenable status quo. There will be a continuing need to do something to constrain health spending, particularly at the government level which makes it appropriate to speculate on what Mitt would do. Continue reading What Would Mitt Do?