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Healthcare Improvement Via An Imperfect Solution

My professional organization recently asked me to participate in an interesting meeting at the state capitol talking about healthcare payment reform and how to improve the healthcare delivery system. This was sponsored by the state of Ohio and their Health Care Coverage and Quality Council.

It was the first meeting that I’ve been to where there were physicians, hospitals, insurance companies, and patients — all trying to put our heads together — present our points of view and try to come to consensus. Did we come to consensus on solutions? Not really, only that we will continue the conversation. There is no perfect solution that will make everyone happy, but we will strive to try to get to that best imperfect solution.

When is comes to healthcare delivery and healthcare payment, there was a lot of discussion on physicians and hospitals — meaning healthcare providers. The motivating factor in these cases uses terms like payment, lack of payment, incentives, bonuses, and penalties. Read more »

*This blog post was originally published at Doctor Anonymous*

Medical Ethics And The Amish Bus Driver Rule

Rachel Maddow, in a discussion related to the provision of abortion services, once proposed that we (society) should invoke the Amish Bus Driver Rule (ABDR) whenever medical professionals invoke their personal convictions in refusing to provide legal medical services.

The ABDR goes like this: If you’re Amish, and therefore have religious convictions against internal combustion engines, then you have disqualified yourself for employment as a bus driver. (Presumably Ms. Maddow would not apply the ABDR to everyone, since it would disqualify, for instance, Al Gore from utilizing horseless carriages and other fossil-fueled contrivances.)

The ABDR would do far more than merely render it okay for doctors to perform abortions and other ethically controversial (but legal) medical services. The ABDR would obligate physicians to provide such services, whatever their personal moral or religious convictions.

The reason DrRich brings this up is not because he considers Rachel Maddow to be the giver of rules for the left, or for the government, or even for MSNBC. Rather, he brings it up because the ABDR is entirely compatible with Progressive medical ethics, and therefore it has a pretty good chance, sooner or later, of becoming the official policy of our new healthcare system. Read more »

*This blog post was originally published at The Covert Rationing Blog*

Congressman Paul Ryan’s Speech To Medical Bloggers At The National Press Club

Congressman Paul Ryan (R-WI)

Congressman Paul Ryan (R-WI)

*** Congressman Paul Ryan addressed the crowd at Better Health’s “Healthcare Reform: Putting Patients First” event. This is a transcript of his speech: ***

This event is a landmark in how we get discussion and debate going in the 21st century.  We are communicating with the grass roots, with medical bloggers here in this room and across the country.

Let me tell you this: I don’t want government interfering in the relationship between doctors and patients…and I don’t want insurance companies interfering either!  I want a vibrant health care market that lets patients choose the health care options that are right for them and their loved ones.  I want a free market democracy that puts patients first.  We can have this, and I’ll say something more about that in a minute.

Right now Congress is rushing through a health care overhaul that goes in the opposite direction.  It’s important to analyze the relative financial costs and benefits of these proposals, but our greater challenge is not the dollars and cents.  It goes to the issue of continuing the tradition of excellent health care that medical practitioners now provide.  It’s about the equal dignity of each human person…and the future of America as a free society.  The American character, and the principles of freedom & democracy which protect & preserve it, may be lost beyond recovery if Congress chooses the wrong path on health care reform—the path down which I believe the Obama Administration seems determined to lead our country.

Public health has always been a government priority.  Our Constitution’s Framers saw every individual as having a “right of personal security” which includes being protected against acts that may harm personal health.  This right is part of the natural right to life, and it is government’s very purpose to secure our natural rights to live, to be free, and to pursue happiness.

Now here is where believers in big government make their big mistake.  The right of each person to protection of health does not imply that government must provide health care.  The right to have food in order to live doesn’t require government to own the farms and raise the crops.  Government’s obligation is normally met by establishing the conditions for free markets to thrive.  Societies with economic freedom almost always have a growing abundance of goods and services at affordable costs for the largest number.  When free markets seem to be failing to meet this test – and I’d argue today’s health care delivery is an example – government should not supply the need itself.  It should correct its own interventions and liberate choice and competition.

We know from survey after survey that a vast majority of Americans are personally satisfied with the quality of their own health care.  The problem is really with health care delivery, which is growing too costly and leaving many people without coverage.  The proponents of government-run health care claim there are only two alternatives: either enact their plan or do nothing.  This is false. Government bureaucracy is not the answer to insurance company bureaucracy.

An authentic solution to the problem of affordability should be guided by the principles of moral and political freedom… respect doctor and patient privacy…restrain spending…and channel the energy of our free market system, not dry it up.   There is no lack of sensible alternative solutions proposed by Republicans to put patients first. Senators Coburn and Burr, and Congressman Nunes and I have offered one, called “The Patients’ Choice Act.”  It’s an example of how to eliminate government-driven market distortions that exclude many from affordable health care delivery.  More uninsured Americans can be covered by spending current dollars more wisely and efficiently than by throwing trillions more at the problem.  Our health care delivery alternatives are based on timeless American moral and political truths.

In essence, we believe that the dollars and decisions should flow through the individual patient, not from the government.  I want to see a market where providers truly compete against each other for our business as consumers and patients – not a bureaucratized system where health care providers vie for government favor as patients wait in line. Read more »

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