What We Need Now Is True Medical Care Reform

The current health care reform legislation is, more precisely, health coverage reform. The intention is to cover more people through changes in the health insurance system. It will do little to control costs. In fact, the cost of the legislation will be much higher than touted.

The problem that has not been touched in the current legislation relates to how we provide medical services. The main driver of increases in medical costs is our technology-based medical service system. This causes an economic squeeze in health care that has already required rationing of medical services. Even with health insurance reform, the cost of medical care will continue to rise, and the need for rationing will increase.

Having an independent primary care physician at the heart of the patient’s medical care is a proven effective and ethical method of monitoring the care process. This reduces unnecessary and expensive tests and procedures, and the quality of care is higher from the patient’s point of view. On the financial side, there is much less waste and costs are controlled.

Cost control will always require rationing of care, but the current legislation creates broad methods of rationing that are built into the payment approval process for care providers. The rationing process is hidden from the public. These methods of allocating resources and deciding who receives what services should be openly addressed and discussed. They have not been.

The new health insurance reform legislation is just a beginning. As it stands, the US healthcare system will continue its wasteful and ineffective medical care practices.

If the patient-doctor relationship is recognized as essential to our health system, however, medical care will be humanized and unnecessary spending will be greatly reduced. We will then have a society that is not only happier and healthier, but also more financially capable of affording broader coverage for a greater number of people.

Norman Makous, M.D.

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