Sunday, September 14, 2014

Questions to Ask about Health Reform

What can I contribute?

Peter F. Drucker (1909-2005), The Effective Executive

A question not to be asked is a question not to be answered.

Robert Southey (1774-1843), Poet Laureate of England, The Doctor XII

Are you asking the right questions?

The management guru and social historian, Peter F. Drucker, was famous for saying effectiveness is not about doing the right thing but finding the right thing to do by asking the right questions.

Drucker said effectiveness was all about asking: What can I contribute?

• For patients and the public at large, the contribution questions might be.

How can I improve my health? Literally, what steps should I take? 10,000 walking steps a day? What foods should I eat? How much sleep should I get f? What weight should I seek to maintain? How do I lose weight? What bad habits should I avoid? What measures of my health should I seek so I can improve upon them?

• For physicians, the questions might be.

How can I best improve the health of my patients? By telling them that improving their health is up to them, not to me? How can I communicate with them better? By spending more time with them? By making access to me more convenient and more open? By sharing with them the limitations and risks and options of medical procedures? Is it socially and morally responsible for me to opt out of government and insurance programs in order to provide direct access and more time with me by becoming an independent direct pay physician? Should speak out against counter-productive government reforms?

As the midterms grow near, and as we as a nation ponder whether to keep ObamaCare or to change it, should I encourage patients and colleagues to be more open and vocal about asking these questions.

• After six years, have results of the health reform law meet its rhetorical promises?

• Have your health care premiums gone up or down?

• Is your health care more affordable than it was in 2010?

• Do you feel more protected against health care debt than in 2010?

• Have you been able to keep your doctor or your health plan?

• Are you experiencing difficulties in finding a primary care doctor?

• Do you have more or less confidence in the government’s ability to manage your health or protect you from medical debt?

• Who should be primarily responsible for maintaining your health – the government or yourself?

• Should government protect citizens against catastrophic health care debts?

• Do you think you should be able to choose your own health plan – and willingly pay for what you think you need?

• Do you believe that you ought to be morally obligated for paying for health care subsidies for those who do not have the means to pay for their own health care?

• Do you believe that those who do not take care of their health should pay the same premiums as more responsible citizens?

• Should health insurance be more like auto insurance – competitive shopping across state lines, high deductibles, based one one’s personal driving records?

• Do you believe health insurers should be forced to accept all comers and not ask questions about health status, even though these verboten things will raise health premiums for you and others?

. As a physician, do you feel the health reform law has improved your effectiveness as a doctor or has made your patients healthier?

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