September 2009
1 post
Ration Healthcare? Of course.
Yes. There will be rationing of healthcare. There always has been. Individuals and families used to ration their consumption of healthcare. If the cost of care was greater than their savings, they went without. Since healthcare has been financed through social insurance schema, rationing is now performed by middle management. Healthcare delivered via government programs is rationed by...
Sep 11th
July 2008
1 post
Born Autonomy
I delivered a baby 4 days ago. Gideon was 10 pounds, 1 ounce and 22.25 inches long. He and his mother are doing great. I’m not a health care professional. I’m Gideon’s father. My wife and I chose to have our 3 boys at home. Her third labor was so quick that our midwife arrived 5 minutes after the baby. Apart from my fumbling with the umbilical cord, which was looped about Gideon’s neck, the...
Jul 20th
June 2008
2 posts
An Employer Health Solution
I’ve found some very good information in Dr. Nortin Hadler’s new book, Worried Sick. For instance, when considering an individual’s risk of dying early (before the average life expectancy), 75% of the risk is accounted for by socioeconomic status and job satisfaction. 25% of the risk is accounted for by all other risk factors. In the U.S. we spent about $2.3 trillion on healthcare in 2007. I...
Jun 17th
Cardiac Stents, Angioplasty, By-Pass…virtually...
My readings on individual autonomy and decision-making have been interrupted by the arrival of: Worried Sick: A Prescription for Health in an Overtreated America, an elegant guide for the medical layperson and an excoriating refutation of most of medicine’s modern “miracles”. Many of the conclusions in this book would be easy to ignore, if the author were some anti-establishment quack or a...
Jun 16th
May 2008
2 posts
Problem 3: Rapacious Temerity of the Insurer
So far, we’ve seen the reduction of an individual’s life to discrete functions he/she wishes to control. From there to the physician, where discrete functional deficits are corrected, in exchange for society’s dollars and the individual’s autonomy. However, it is inside the insurers where de-individuation is completed. Once reduced to a claim number, all pretense of patient care may be dropped....
May 7th
Problem 2: Unmitigated Gall of the Physician
Woe to the physic, caught between the role of healer and the role of dealer. The individual’s reduction of the life experience is subsumed and amplified by a medical community that offers an escape from every corporeal challenge. This criticism is not directed at the medical profession, in general, only at the irresponsible purveyance of unproven and unnecessary ‘cures’. The grand theft of...
May 5th
April 2008
3 posts
Problem 1: Colossal Hubris of the Individual
Problem 1: Colossal Hubris of the Individual by batkinson on April 30, 2008 In August 2006, the National Association of Health Underwriters issued a white paper listing key current and future healthcare cost drivers: Aging Population Pharmaceutical Costs New Technologies Behavioral and Lifestyle Choices System Inefficiencies Medical Malpractice Cost-Shifting Increases Utilization Such...
Apr 30th
Epistemological Foundation for Healthcare Reform
To effect change in America’s healthcare system, stakeholders must address deeply-rooted beliefs and behaviors. Without change at this level, all manner of novel financial schema, medical nostrums and patient consumerism will lead to neither higher quality nor lower costs. Our current crisis evolved as our culture evolved, and no governmental fiat will reverse this course. To increase access to...
Apr 29th
The Starting Point: Patient Autonomy
Let’s reform the “Club of Cos”. First, we must understand Ivan Illich’s meaning when he identified the Club of Cos. He coined the epithet to describe the complex of provider, payer and pharma. This club is built upon systems that reduce the individual’s autonomy. Without restoring autonomy to the individual, no effective healthcare reform will take place. So, this diary of...
Apr 28th