Or, if not China, it seems there's India, Brazil, Taiwan, Poland and even Canada and some other places. Interesting. Well, if that's where the jobs are ...
LOVE it when Frank Rich goes after our 21st century American version of, well, let's call them the Stalinist anarchists, if there can be such. (Rich likens them to 'the barflies in “Star Wars.” ')
THE Sun magazine has an interview with a doctor, Pamela Wible of Eugene, Oregon, who has her own vision of healthcare reform. This online version is not as complete as the print version, but here's a quotation anyway:
I trace the industrialization of medicine back to two programs: employer-sponsored healthcare, which started just after World War II; and Medicare, which started in 1965. Before those programs, doctor-patient relationships were more transparent and more personal.
Then major employers started going with complex insurance programs, such as health-maintenance organizations [hmos] and preferred-provider organizations [ppos]. The physician was put in a position of either signing on to work in a big group or else losing any patients who worked for, say, Ford Motor Company. The preferred-provider system was also sold to doctors with a promise of more money for less work, because of less overhead. Doctors wouldn’t have to worry about staff and business and paperwork. There were slick brochures and free trips to Hawaii when you signed up. You can see how doctors got seduced.
There’s an element of prestige when one belongs to a big group and can say, “I’m a preferred provider.” We doctors basically want the American dream like everyone else. After all the effort and expense of our education, we generally feel we deserve some comfort in life. So when these third parties promised us the world, it was pretty easy for us to fall for it. But then some administrator on the fourth floor turned up the speed on the assembly line, and before we knew it, we were churning patients through and skipping bathroom breaks.
And with the big providers came an increasing complexity that, it seems to me, was created by bureaucrats to justify their own existence. At a certain point you had more complexity and headache than service being rendered.
Now, instead of walking or biking to see your neighborhood doctor, you have to drive across town to a big clinic, park in a parking garage, and sit in a cafeteria-sized waiting room. This isn’t what people want. People want home visits. They want it to be the way it used to be. And there’s no reason why we can’t have that now.
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