Saturday, March 27, 2010

Gut Check on HealthReform

To which camp do you belong?

1) Do you believe it is the function of government to insure the health of all citizens against the vicissitudes brought on by sickness, aging, and misbehavior? Do you believe government has the power to force all citizens and all businesses to buy insurance for themselves or their employees? Do you believe government has the competence , resources, and knowledge to implement, administer, and control costs and decision-making at the level of the patient-doctor relationship, and to remotely micromanage that relationship at the individual level? Do you believe a paternalistic government knows more about what’s good for the people than the people themselves? Do you believe the Internet and interoperable electronic systems containing full information on your medical histories , and monitoring doctors’ clinical decision-making will improve care and quality? Do you believe more rules and regulations will correct health care abuses, bring down costs, bolster quality, and improve the health of the American people?

2) Do you believe it is the function of government to stimulate private health care markets and to oversee those markets to prevent abuses and monopolies? Do you believe markets and private enterprise are the source of most employment? Do you believe most health care innovation comes from the bottom-up rather than the top-down? Do you believe ordinary citizens, given health care tax relief, like employees of corporation, would have the common-sense to choose what care is best for them, especially if they were spending more of their own money? Do you believe doctors have the best interests of patients or their own self-interests at heart? Do you believe computerized systems at levels of care may have human limits and are over-rated? Do you believe market competition based on value is effective at bringing down costs and improving quality ?

3) Do you believe a government- centered system, which now pays for roughly 45% of health coasts, using payment based on performance and therapy based on data-driven comparative effectiveness, with government paying 90% of the bills and deciding what to pay, is the best way to control costs?

4) Do you believe an employer-based market system, which now pays for roughly 45% of costs with patients paying 10% out of pocket, based on competition between providers and informed patients making mutual decisions based on value, is the best way to control costs?

Check here (1) or (2)or(3), or (4)a combination of the above, to indicate to which camp you belong or (5) don't know.

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