Saturday, January 27, 2007

Health care

I posted this puppy largely verbatim over on Fester’s Place, in response to his post on the difference between US and over developed nations health care costs.

There was an article in the NYTimes a few days ago; the guy who created the “South Beach Diet” turns out to have been a cardiologist for years before he created the SBD. He opened a practice after his books first came out, and in it his doctors and nurses actually spend a lot of time with patients, work with them on diet and exercise, in other words, those low cost things that help us stay healthy, statistically speaking. And in his practice, according to what he tells the Times, there is very little uncontrolled heart disease (he is claiming rate something like point three percent of his patients had a heart attack last year). And he finds that his practice loses money in a big way.

Private medicine turns out to have little incentive to push preventative care. Your doctor makes a lot more money if he talks to you only for a moment and otherwise interacts with you through expensive tests, procedures and drugs. The people who do have the incentive to push preventative care, unfortunately, have no traditional role in health care: the government and your employer.

Health insurance companies, to some extent, certainly do have an incentive for you to pay premiums and not submit claims. And the best preventative care program I ever saw was at Blue Cross (now Highmark) offered to employees when I worked there. But I suspect that Blue Cross and Aetna and UPMC and so on would be worried they would eventually have to reduce premiums if fewer claims were submitted.

I personally would like to see a candidate for City Council (hint, hint) incorporate these ideas into his platform; that city employees and retirees would be put on an aggressive wellness program, to reduce costs across the board. Not only would the city benefit, but it could serve as a showcase plan for what is possible.

No comments: