Sunday, February 7, 2016

Payment Reform is Costly and Misguided: Except for Direct Primary Care

Some of my thoughts after reading the Health Affairs Blog about the Conundrum explained in the link below.  We're headed toward a government only health system. Now doctors get incentives to be employed, penalized to remain in a Fee for Service model (which has been twisted to maximize profits for employers of physicians, which only took 9% of GDP with mostly independent physicians while now,  with mostly employed physicians, it's 18% of GDP- read the comments with the article, too, they're very thought provoking and no one starts name calling- they politely give their opinions).   The mandated models aren't proven, cost more in reality, are only successful where prices had been extremely high, drive physicians into becoming shills for industry and are ignoring Patient Autonomy- one of the principles of medical ethics, other than that they feel good to many non-physicians.

This will probably be my last year in any insurance plans.  I have a Direct Primary Care Track (called Direct Family Medicine the way I do it).  That new part of the practice is called Neighborly Family Medicine.  We're open for uninsured families in our Beavercreek office.  Those who can act should act in the next couple years.  None of this is fast, but it's deadly.

Over-testing is almost mandatory as is over-prescribing for so-called quality bonuses.  Physicians of 90 year olds are starting them on statins in spite of no scientific support to do so and knowing that cognitive dysfunction is one of the side effects of statins that every Family Physician has seen.  We're (The Medical- Industrial Complex) in a steady decline for medical quality and shamelessly bankrupting America in the name of "Quality".  I see evidence of this daily.  Daily. Not in a philosophy column by a health planner or government official or a political rant, but in person in my medical office daily.

Health Policy and Payment Reform Conundrum

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