Thursday, September 04, 2008

Too cynical?

Political prognostication is a risky business, but here is one that might be elegant and accurate. As the country prepares for a new President, a colleague of mine offered the following analysis as to why neither Barack Obama nor John McCain will be successful in obtaining legislation that would reduce the nation's expenditures on health care:

One person's costs are another person's income.


e-Patient Dave said...

Not at all cynical, in my view - it's economics 101. If we're not willing to notice it, problems will seem intractable for no apparent reason.

Anonymous said...

Very well put, but in this case, even the person making the income has to have health care him/herself, in the same broken system. In that sense it affects all of us even if some people don't recognize it. And it's not primarily even the costs, but the quality and safety are declining rapidly.


Anonymous said...

Just a trifle, but I notice that you've twice now misspelled Senator Obama's first name in your posts. It's Barack, not Barak. When I noticed the second misspelling I went online and donated an additional $20 to his campaign.

Anonymous said...

Thank you. I have fixed it. Glad I could help out with the fund-raising!

Kedar said...


Well, first of all, congratualations on the blog of note and be prepared for an avalanche of visitors!

That is the case all over the world. In the US, it's healthcare. In India, we go through this debate everytime - what is most important? Education, food, health? A rich man asks, "Why should I pay a third of my salary to the governemt as taxes when I all I get in return are bad roads, power shortages and no healthcaer? Too many people, not enough dough with the exchequeror..

Anonymous said...

This seems obvious, but I have seen this be a key turning point in conversations between employers and physicians - when the employer looks across the table and tells the physician "your revenue is my cost". Too many physicans think they are paid by the insurance company. This seemingly obvious statement is critical to expanding the conversation about how we work together to address health care issues.

Paul said...

well really it is not so much even about cost as it is about value. If we paid twice as much as anyone else in the world as we do in the USA and we got well just a little bit better than ave OK. But we do not we are dead last 19th out of the 19 developed economies and still pay twice as much. The key to what our nation needs at the very foundation of its healthcare are physicians who are committed/dedicated to deliver comprehensive integrated care built on powerful doctor patient relationship. And are paid to do just that. When one looks at the field of medicine it is split into two major part those who can provided comprehensive care and those who sub specialize in a part of the body Part -cialists. for sure both are needed but what happens today is so out of balance. Now if the Part –cialists was more expensive but better ok no problem but it is not turns out we need some who will focus on comprehensive care - we just have not set it up in a way that we are paying for that.

Unfortunately we lost or way as buyers of care. No longer should I as a buyer of healthcare face the situation where it is easy for me to buy an amputation for my diabetic but darn near impossible to have the kind of doctor patient relationship that prevents the amputation. And, the situation today in healthcare sure does not allow me the kind of relationship that prevents my patient from getting diabetes in the first place. So fact is we need to work together the providers of care and the buyers of care to fix that and at the we are trying our best to do just that.

Kedar said...


The Government of Tamil Nadu (a state in India) is spending an equivalent of $5,868,550 to provide colour television sets to families in the state. It's hard to believe, but you can verify it here.

The problem is that healthcare is not that high in the priority list of most people who can change things!

Thus, it is left to the laity to provide for his own healthcare. It is right for the Doctor to charge as he pleases - he deserves a luxorious life after all the hard work he put in to get where he is. But, that is where a wise government steps in and helps the common man by providing him some ways he can afford the healthcare.