Archive for February, 2010
Anyone who has seriously studied the health care system in the United States knows that we spend more money and get worse results than many other industrialized nations. The stalled health care reform legislation in the Congress has been criticized by some on the right for not controlling costs. Medicare, which now pays for more than half of the health care delivered in the U.S. and whose lead private insurers follow, is slated to go bankrupt in less than 10 years if we do not make some real changes. Experts estimate that up to one-third of health care spending goes to waste.
In my last post (somewhat of a confession of my deficiencies) I raised a concern about my capacity to be an activated patient, and the implications that might have for what we’re expecting of our patient population. It appeared to strike a chord, and I do appreciate several comments I received expressing confidence that I might be more qualified for a “mortgage” in a health care home than I credit myself for.
“I just had a minor surgery last fall and was once again reminded about how stunningly dysfunctional the system is – especially for people like me with high deductibles who basically pay for their own health care. For a $4,000 procedure, I got 14 invoices from four different providers spread over a four-month time frame. And no one in the system could give me any idea what the (very standard) procedure might cost – even though they offered a 20% discount if I paid within 48 hours. Paid how much? To whom? I think Franz Kafka is still behind the curtain…”
In the past several weeks, I’ve had occasion to experience two events which have elevated my angst regarding much of the hype around the PCMH (patient-centered medical home) model. Understand, I conceptually get it. It’s totally in line with my philosophies, principles, and beliefs. A team-based approach, with leveling of the hierarchy in which I’ve practiced, the attention to evidence-based medicine, the patient-centered focus all resonate. Indeed, my hopes for some sanity to the payment model are often enhanced by the evolving whole patient approach envisioned in the PCMH model.
I am writing to invite you to next week’s webinar on the inner workings of the Archimedes Model. This webinar, entitled “How the Archimedes Model Works and is Validated”, will be led by David Eddy, M.D., Ph.D., co-creator of the Model and leading authority in the theory and application of evidence-based medicine and mathematical modeling in health care.