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Where I Am Coming From

Posted Nov 26 2012 12:20pm

Stanley

Feld M.D.,FACP,MACE

I realize that many people read my blog by just glancing at it. It is difficult for a casual reader to grasp my hypothesis.

The devil is always in the details. The details expose defects and unintended consequences.

Yogi Berra once said, "You've got to be very careful if you don't know where you are going because you might not get there."

Many readers believe I am very critical of President Obama’s plan to reform the healthcare system. This impression is correct.

To my chagrin many of my non-physician friends, who are President Obama lovers, hold it against me.

The basic goals of President Obama’s healthcare reform plan are correct.

In my view his philosophy and methods are wrong. I have pointed out the faults with his philosophy and methods and why they cannot work.

President Obama wants universal access to healthcare that is affordable and is delivered using best medical practices.

I have the same goals.  

I have outlined a consumer driven healthcare system which emphasizes freedom of choice, individual independence and personal responsibility.

President Obama is imposing a government driven healthcare system emphasizing a lack of freedom of choice, mandates, penalties, dependence and entitlements.

I appreciate that President Obama can only visualize accomplishing his goals by government decree, regulations and enforcement.

I believe Americans are smart, want freedom of choice, personal dignity and can assume responsibility for their choices.

I believe government control will result in increased waste, inefficiency and corruption at the expense of effective medical care for consumers.

President Obama thinks government control is the only way to control costs. I believe the more government control is imposed on consumers the greater the costs.  

President Obama wants bureaucrats to make medical decisions for consumers and physicians. If physicians do not cooperated he is willing to substitute “healthcare providers” for physicians.

President Obama does not respect consumers’ ability to make the right choices.

I believe in consumers’ intelligence. The government’s responsibility is to provide tools for consumers to make intelligent choices.

It is difficult to find an effectively functioning, centrally controlled healthcare system. The statistics are questionable. I recently   described the Canadian healthcare system.  

Consumers and physicians can get used to centrally controlled healthcare systems. They learn to tolerate it. However, these healthcare systems are not as affordable as many contend. 

Innovation and vibrancy comes from a healthcare system in which the major stakeholders have the incentives to be innovative.

Obamacare has caused secondary stakeholders (healthcare insurance industry, hospitals and hospital administrators, drug companies, medical device companies and information technology companies) to position themselves to take advantage of the centrally controlled healthcare system.

Obamacare is not aligning all the stakeholders’ incentives. It is further misaligning incentives. Obamacare will cause a rapid demise of the healthcare system. 

A more centralized government controlled healthcare system will result in greater dysfunction of the healthcare system, increasing cost and less effective medical care for the majority of consumers.

If America evolves to a single party paye r healthcare system, which I believe is President Obama’s goal, the achievement of his goals for affordable care for all using best practices will become more elusive.

On May 11, 2006 I published my first blog. This was pre President Obama. President Obama wasn’t the first president who has contributed to the dysfunction and ultimate demise of the healthcare system.

I thought it would be fun to see “What I Was About” on May 11, 2006. 

 

Stanley Feld M.D.,FACP,MACE

Preamble

This blog is about Stanley Feld M.D., FACP, MACE’s studied view for repairing the health care system.

There is been much written daily about the defects in the health care system. All stakeholders are to blame for the severe distortion in today’s healthcare system including consumers (patients).

Unfortunately, few healthcare policy wonks have asked practicing physicians what they think the healthcare systems’ problem are. Neither has anyone asked the practicing physician what an acceptable solutions would be.

Persons not affected by the distortions and dysfunction in the health care system pay little attention to the broken system. Fortunately 80% of the population are not sick. They are not in need of an effective and functional healthcare system.

People not immediately affected by any system do not pay attention to the defects in those systems.

However, the healthcare system is vital to every citizen both in the short term or long term.

Our broken health care system cannot be ignored any longer. Our personal health and the health of our citizens is the most precious asset we have as individuals, and vital to the country’s success and well being in the future.

In my view, we are going through a process similar to the slow boiling of a frog. We are noticing the rise in temperature little by little, but are too lethargic to take action and jump out of the pot. The effort is much too difficult.

However, we must take action now!!  Soon, we will all be cooked.

What is the solution to America’s dysfunctional healthcare system?

Americans live in a free consumer driven economic environment for most goods and services.

The only way to get us out of this increasing hot water is for consumers to understand the structural defects in the broken healthcare system. Then they must act.

Someone must outline an effective and easy plan of action that aligns all the stakeholders incentives.

In reality, all of the stakeholders are to blame for the distortions in the system. The stakeholders need to be answerable to consumers. Consumer (patients) can exert power only after understanding the structural defects in the healthcare system.

The goal of this blog is to explain reasons for these defects, as well as the potential solutions. In my view the solutions I will propose will ultimately fix the system.

Presently most of the stakeholders’ incentives are misaligned. The proposed solutions are aimed at aligning all the stakeholders’ incentives. All previous solutions have served to misalign incentives even further resulting in our present dysfunctional system.

The previous governmental adjustments have resulted in a system that is much too expensive, has much too much waste, is inefficient, and almost unworkable.

The result is that all of the stakeholders are very stressed and unhappy.

Over the next weeks or months, I will outline the problems in the healthcare system and the solutions to creating a functional healthcare system."

I said the above in May 2006.I am continuing to point out the increasing problems as well as my solutions. The key to the solution is a healthcare system in which  consumers’ drive the healthcare system and have responsibility for their health and healthcare dollars.

As the incidence of obesity continues to increase and as the baby boomers continue to retire, a system must be developed to create independence and responsibility and not entitlement and irresponsibility. 

  The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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