jumping off one hamster wheel

[Guest guest]

i'm glad gordon has come to the conclusion that health insurance, in

it's current form, with all kinds of policies and procedures to be

followed, failure of which results in financial flogging of doctors,

and of patients by their doctor as the instrument of the insurance

companies, is in fact the enemy; any administrative burden which

prevents patients from receiving care is a barrier we must fight to

bring down.

megan lewis in colorado, and other similar models is the way to go for

any small practice currently. it alleviates the administrative burden

from the doctor and allows the chance for practice financial

viability. nonetheless it is only a bridging formula, because the

administrative burden continues to weigh on the patient, and only to

be given up at some financial cost to them. in addition, it does not

address the inherent conflict between prevention and cost savings, if

the cost for that prevention comes directly out of the patient's

pocket. there are too many other competing interests for that money,

especially in today's economy.

we can't forget that patients are our natural allies, and that any

formula for effective care must rely on family and other primary care

doctors, prevention, patient education and empowerment.

do we get it? do obama and daschle understand this? does anybody?

LL

[Guest guest]

I believe a big reason politicians and our patients don't " get it " is that we,

as a profession,

have not done a good job of leading on these issues. Our patients are, as Jean

rightly

points out, " passive " allies in all of this. They're allies because supporting

a viable primary

care system makes intuitive sense to them; they're passive because they expect

much

more from their doctors than reports of misery. We (just to be clear - I mean

primary care

doctors as group - this is decidedly not an editorial about IMPers) complain

that they don't

understand our plight. I believe they look at us and shake their heads,

wondering when

we'll start complaining less and leading more. They don't want to hear that

" 50% of us

would like to quit " - they want to hear that " 50% of primary care doctors are

prepared to

act boldly " to build a new healthcare system to replace one that is broken

beyond the

reach of " healtchare reform " efforts.

I believe that participating with insurance plans while hating the way they

treat us and our

patients isn't a solution. I believe direct care, cash-only models are the only

viable, long-

term answer at this time to the insurance cartel's (a description I

believe -

and one that I really like) systematic attack on primary care. However, I

applaud those

who disagree with me on this and are willing to go head to head with insurance

company

nonsense rather than refusing to fight with them directly - which in effect is

what I am

doing.

One final point - I would disagree with those who say that businesses are

against us on

these issues. Sure, insurance companies, big Pharma, medical device companies

and

others benefit greatly from the money wasted in this chaos. However, most

businesses

are struggling mightily with the inefficiencies inherent in a healthcare system

not rooted

in great primary care infrastructure. They, like our patients, are looking for

us to lead in

creating a higher quality, lower cost, more ethical healtchare care system.

Will we lead?

CC

>

> i'm glad gordon has come to the conclusion that health insurance, in

> it's current form, with all kinds of policies and procedures to be

> followed, failure of which results in financial flogging of doctors,

> and of patients by their doctor as the instrument of the insurance

> companies, is in fact the enemy; any administrative burden which

> prevents patients from receiving care is a barrier we must fight to

> bring down.

> megan lewis in colorado, and other similar models is the way to go for

> any small practice currently. it alleviates the administrative burden

> from the doctor and allows the chance for practice financial

> viability. nonetheless it is only a bridging formula, because the

> administrative burden continues to weigh on the patient, and only to

> be given up at some financial cost to them. in addition, it does not

> address the inherent conflict between prevention and cost savings, if

> the cost for that prevention comes directly out of the patient's

> pocket. there are too many other competing interests for that money,

> especially in today's economy.

> we can't forget that patients are our natural allies, and that any

> formula for effective care must rely on family and other primary care

> doctors, prevention, patient education and empowerment.

> do we get it? do obama and daschle understand this? does anybody?

> LL

>

[Guest guest]

I believe a big reason politicians and our patients don't " get it " is that we,

as a profession,

have not done a good job of leading on these issues. Our patients are, as Jean

rightly

points out, " passive " allies in all of this. They're allies because supporting

a viable primary

care system makes intuitive sense to them; they're passive because they expect

much

more from their doctors than reports of misery. We (just to be clear - I mean

primary care

doctors as group - this is decidedly not an editorial about IMPers) complain

that they don't

understand our plight. I believe they look at us and shake their heads,

wondering when

we'll start complaining less and leading more. They don't want to hear that

" 50% of us

would like to quit " - they want to hear that " 50% of primary care doctors are

prepared to

act boldly " to build a new healthcare system to replace one that is broken

beyond the

reach of " healtchare reform " efforts.

I believe that participating with insurance plans while hating the way they

treat us and our

patients isn't a solution. I believe direct care, cash-only models are the only

viable, long-

term answer at this time to the insurance cartel's (a description I

believe -

and one that I really like) systematic attack on primary care. However, I

applaud those

who disagree with me on this and are willing to go head to head with insurance

company

nonsense rather than refusing to fight with them directly - which in effect is

what I am

doing.

One final point - I would disagree with those who say that businesses are

against us on

these issues. Sure, insurance companies, big Pharma, medical device companies

and

others benefit greatly from the money wasted in this chaos. However, most

businesses

are struggling mightily with the inefficiencies inherent in a healthcare system

not rooted

in great primary care infrastructure. They, like our patients, are looking for

us to lead in

creating a higher quality, lower cost, more ethical healtchare care system.

Will we lead?

CC

>

> i'm glad gordon has come to the conclusion that health insurance, in

> it's current form, with all kinds of policies and procedures to be

> followed, failure of which results in financial flogging of doctors,

> and of patients by their doctor as the instrument of the insurance

> companies, is in fact the enemy; any administrative burden which

> prevents patients from receiving care is a barrier we must fight to

> bring down.

> megan lewis in colorado, and other similar models is the way to go for

> any small practice currently. it alleviates the administrative burden

> from the doctor and allows the chance for practice financial

> viability. nonetheless it is only a bridging formula, because the

> administrative burden continues to weigh on the patient, and only to

> be given up at some financial cost to them. in addition, it does not

> address the inherent conflict between prevention and cost savings, if

> the cost for that prevention comes directly out of the patient's

> pocket. there are too many other competing interests for that money,

> especially in today's economy.

> we can't forget that patients are our natural allies, and that any

> formula for effective care must rely on family and other primary care

> doctors, prevention, patient education and empowerment.

> do we get it? do obama and daschle understand this? does anybody?

> LL

>