Thursday, September 10, 2009
Barry / Politics A GOP Idea on Health Care Worth Thinking About
Posted by Bruce Barry on Thu, Sep 10, 2009 at 1:33 PM
Absurdly restrictive licensing barriers to providing even rudimentary care make health care very, very expensive. Any parent can tell you children's ear infections are about as common as weekends. And they're about as hard to diagnose, too. Yet, instead of just picking up the amoxicillin over the counter and giving it to the crying child (20 minutes, tops), parents have to spend a very substantial portion of a day trying to see the doctor (and kids never have ear infections during regular doctor's hours) and getting a prescription filled. That's insane. It doesn't take a decade's worth of medical training to diagnose an ear infection. So let's have a more graduated licensing system, with vocational schools teaching the lower-level diagnostics and treatments. Let's expand the Physician's Assistant and Nurse Practitioner classifications (a good start), so that more people can provide more health care options (supply) at lower prices.When my kid was at that ear-infection stage, I wondered why pediatricians didn't just tell their patients that every day at a specific time one of the docs would hang out in the parking lot with an otoscope and a prescription pad. Parents could drive in, lower the window, let the doc look in the ear, snag a prescription, drop a co-pay, and be out of there in minutes. But that would make way too much sense.
Comments (12)
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I remember living off of amoxicillin from about 2 to 4 years old. My mom was lucky in that my grandpa was a doctor and he trusted her to diagnose bacteria-ridden head, so getting a scrip took just a phonecall. As a smug childless person, it's never even occured to me that for most people such a common problem could take many hours (or a couple of days) to deal with.
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I think that's a great idea but good luck getting it past the AMA, which is very VERY protective about their profession. I did a post about this back in July after watching the documentary "The Business Of Being Born" (I posted the doc's trailer on my blog). It's an old documentary, from 2007, but addresses this very issue.
Home births and use of midwifes and such actually end up saving a lot of healthcare $$, but many in the medical profession seem to view this as stepping on their turf and there is now a cultural backlash against midwifery and home births. It's viewed as some kind of hippie thing to do, not something that much actually be safer and better for mother, baby and the overall healthcare picture.
Let me add however ... and I realize the amoxicillin/ear infection thing was just one example (and when I was at the ER 2 weeks ago at 9 pm there was a poor distraught mother with an infant screaming its head off because of an ear infection so I realize it's a very GOOD example) ... but I think in general we have learned it's risky to overprescribe antibiotics because we are basically breeding stronger, more dangerous, bugs.
I wonder if anyone has figured out a better way to prevent ear infections? I don't have kids and as a youngster I never had chronic ear infections either. But my dad was one of those health food nuts who crammed wheat bran and Vitamin C pills down our throats all the time. What can I say, we never ever got sick. I still have my tonsils, even.
Quite right, SB, on overprescribing antibiotics, but I imagine that the pink stuff is still the standard of care for an ear infection, so it would be nice to have a system where diagnosis and rx is quick and easy.
Superbugs are ridiculous of course, but I quickly looked at the antibiotic resistance page on CDC website and they're putting a lot of emphais on the fact that antibiotics are for bacterial infections and don't do anything for viruses. Um, no shit. Is that what's causing overuse? People using antibiotics to fight a cold? This makes no sense to me.
Are Americans really so ignorant about basic biology they don't know the difference between a virus and bacteria?
Well at least the GOP has an idea for once. But if the above commentator is correct in saying that the AMA is opposed, I would think that would give the GOP pause before they readily endorsed the idea. The AMA is largely pro-GOP.
http://tomoveanation.com
It's already in HR 3200 - and it's already happening. Minute Clinics are springing up in drug stores and strip malls. Call-in 24/7 help lines are staffed by RNs who can assess whether you need to be seen or not. Web-based resources can help you to self-assess.
I think Pediatricians are different because 1) it's a kid, and they can't self-diagnose or report symptoms accurately, and 2) you're a parent, and you don't want anything to happen to hurt your kid. Malpractice concerns go up considerably ... which leads to defensive precautionary medicine.
I will say that my kids' pediatrician is awesome and would recommend to anyone. Part of this is an art - learning to manage a practice. You have to be trustworthy but you have to be responsive ... but you have to be thorough, but still prompt.
Great Idea... BUT!
My experience with Nurse practioners has been extremely disappointing. Curt to the point of rude, ordering questionable tests and office visits are more expensive than those at a FP office.
Before going to one of the Minute Clinics, there are several. Be sure NOT to choose those run by Rick Scott's company. His last health care endeavor was fined millions of dollars for Medicare fraud and he was forced to step down.
All of this is interesing. If mothers would keep theit little ones out of day care for a couple of years then the ear infection thing would be considerably less common. As would other various illnesses that are, if nothing else, unpleasant to the child.
As an aside, as for licensing, I'm not sure why anyone needs the gov't's OK to cut my hair for a fee. That applies to the cosmetologist and I'm sure other endeavors we could think of.
TMP:
I agree with you about Rick Scott, one of the biggest scumbags ever to become a business leader in Nashville. Remind us of the name of his clinics so I can avoid them.
"The AMA is largely pro-GOP."
Better keep up with the news cycle - Obama has already co-opted them along with the pharmaceutical industry and most of the same health insurance industry (that he is now pretending is the "enemy") by arm twisting and bribery.
