25 April 2013

Primary Care Watch (American Edition)

Media critiques of circumstances for primary care providers are on the rise, doubtlessly as a result of the soon to be implemented A.C.A. Here is one illustration:
 "Primary care is highly respected here. That's not the case anymore in America," said [Grady] Snyder. "In the United States, health care has become more about the business of making money. The personal side of medicine is going away." In fact, Snyder said he wouldn't be surprised if more primary care doctors in the U.S. look for opportunities elsewhere. His own contract expires at the end of June but he's renewing it for another two years.
Much of the critique seems to be directed at hospital profits, regardless of quality care. The Washington Post, for example, observes in a blog post:
The study underscores how ludicrous the incentives are in the American health care system, generally paying doctors for each medical service they provide, even if some of that care is the result of a surgery gone wrong. “If you personalize this and a relative is having heart surgery, which gets complicated by pneumonia, I don’t think we would want a hospital’s profit to go up as a result of that pneumonia,” said study co-author Barry Rosenberg, a partner in Boston Consulting Group’s health care practice. The study does not imply that hospitals intentionally complicate surgeries to bring in more revenue. Most surgeries, about 95 percent, go off without a hitch. What it does suggest to the surgeon, writer and Harvard professor Atul Gawande is that hospitals now see little reason to invest in technologies that would reduce complications when the only prize at the end would be lower income.
Steven Brill's essay "Bitter Pill" publish by Time Magazine is yet another example - and a very good one at that. But maybe - just maybe - there is another question we should be directing at media outlets. Where were you before this? Oh, sure, there were some opinion columnists who took stands on these issues. And the medical and scientific press have been discussing these problems for decades. But the sad reality is that these healthcare problems have been recognizable and growing for decades. Sociologists, historians of medicine, doctors and surgeons, and medical consumers have been talking about these issues for decades. But how often have major media outlets stated "our healthcare is the best in the world for those who can afford it" or "healthcare access and quality in America when compared to other nations declined again" without bothering to go deeper. If you don't remember, just revisit commentaries and analysis of Michael Moore's Sicko to see how willing mainstream and non-mainstream media outlets were to address in a rigorous way points raised in Moore's documentary. Recall these remarks?  

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