Sunday, March 30, 2008

First, Blame the Patient

Here's a prescription for health care reform in case some of us are not aware of the fete accompli that we have reached in the policy world with the upcoming election - here's a quick summary of what's coming:
1. First, blame the patient.*

2. Do not, under any circumstances blame:
  • the relentless bureaucracy hell-bent on continued expansion
  • the rising cost of technology
  • the lack of tort reform
  • overtesting occurring because of defensive medicine
  • the annually increasing percentage of administrative overhead for healthcare delivery in the US, now approaching 30% of the entire healthcare bill
  • direct-to-consumer advertising
  • the un-checked hospital construction industry
  • the increasing median age of our populace
  • the lack of transparency of true costs within the system
  • No restriction on healthcare delivery in futile situations
3. Next, assemble an impressive array of like-minded and highly gifted individuals who sincerely believe the patient is the problem.

4. Assemble lots and lots of "partners" with financial conflicts in this debate to stand by your side.

5. Build a very fancy website at significant cost.

6. Spend lots and lots of money on "new media consultants" to be sure the blog-o-sphere learns of this website (h/t: Thanks, Chris)

7. Pat yourself on the back for defining "the problem."
We appreciate the detailed spreadsheets of costs provided by the Partnership to Fight Chronic Disease. Given their apparently extensive talent bank and funding for this type of analysis, we look forward to seeing comparable line-item analyses for the costs of ever-burgeoning healthcare bureaucracy.


* Of course, do not CALL it "the patient," instead, call it working to "fight chronic disease."

ADDENDUM: Lisa Emrich at Brass and Ivory blog adds her perspective as a patient with chronic disease.


The Happy Hospitalist said...

As long as insurance picks up the tab, it will get paid for.

All of it.

Ian Furst said...

Slow down -- you're not going to have anything left for Grand Rounds

Anonymous said...

It baffles me that as acute disease has decreased as a cause of death, people look at the "growth" of deaths due to chronic disease. All people die of something. N=everybody. If the portion of N that dies of acute disease goes down, the portion dying of something else, eg, chronic disease, goes up. And the more learned about treating chronic diseases like hypertension, the more people will have them for a substantial period.

Anonymous said...

Why does anyone need the blame? I mean, why can't people just get sick? I understand that there are some things that can be done with some illnesses, I'm not saying no one is *ever* to blame. Just, sometimes people get sick. They can't be helped, the fact that they got the illness can't be helped, it just happens.

John A said...

"Blame the patient" - the associated article states

Overweight rates have been climbing over the past few decades among children. About 9 million (or roughly one in six kids ages 6–19) were overweight in 2004 – more than triple the number of overweight children in 1980.

But does the author consider, at a minimum -

In 1985 a consensus conference convened by the National Institutes of Health (NIH) recommended that men and women be considered “overweight” at BMIs of 27.8 and 27.3, respectively. In 1996 an NIH-sponsored review of the literature found that “increased mortality typically was not evident until well beyond a BMI level of 30.” Yet two years later [1998], the NIH yielded to a World Health Organization recommendation that “overweight” be defined downward to a BMI of 25, with 30 or more qualifying as “obese."

And while I certainly accept that tobacco use can have profound health consequences, I am less sure about diet and exercise regimes - most seem extreme, and dieting ineffective.

bob said...

fait accompli - an accomplished fact, a thing already done

fete accompli - a party already finished

Curiously, both work in the context of this article, you clever man.