Article Round Up II: Medicine and Healthcare Policy

Here is another round up of articles I’ve found interesting and telling about modern medicine and Affordable Care Act (ACA) or Obamacare. As I ponder the ACA, potential changes I hope the new president will make and especially the new politicization of healthcare and the all-encompassing ethics associated with that (such as conscience protection and service for the poor), these are some of things I’m thinking about.

The Atlantic – Medical Problems: Patient Responsive Happiness. problems with ACA

“Joshua Fenton, a University of California, Davis, professor who conducted the study, said these results could reflect that doctors who are reimbursed according to patient satisfaction scores may be less inclined to talk patients out of treatments they request or to raise concerns about smoking, substance abuse, or mental-health issues. By attempting to satisfy patients, healthcare providers unintentionally might not be looking out for their best interests.”

This takes some background. Pieces of the ACA reward hospitals for higher patient satisfaction, but patient satisfaction surveys don’t correlate with better outcomes. This is why we see hospitals now with brand new furniture and state of the art entertainment. Granted, we patients matters. There are a lot of cogs going into healthcare now as the government works to incentivize the practice of medicine, as they do with the tax code, and we are starting to see some glaring distortions.

http://www.theatlantic.com/health/archive/2015/04/the-problem-with-satisfied-patients/390684/

The Atlantic – The Erosion of the Dr/Patient Relationship

“Today’s physicians, he tells us, see themselves not as the “pillars of any community” but as “technicians on an assembly line,” or “pawn[s] in a money-making game for hospital administrators.” According to a 2012 survey, nearly eight out of 10 physicians are “somewhat pessimistic or very pessimistic about the future of the medical profession.” In 1973, 85 percent of physicians said they had no doubts about their career choice. In 2008, only 6 percent “described their morale as positive,” Jauhar reports.”

http://www.theatlantic.com/magazine/archive/2014/11/doctors-tell-all-and-its-bad/380785/

Carrie Kovarik, M.D. in the Washington Post, Defending her Trump Vote in Academia

“Putting insurance in the hands of people in this country is a small part of the equation that leads to increasing access to care. Once they have access, the bottleneck to care is moved down the line we don’t have more doctors, specialists or hospitals so we need to plan for innovative solutions that will help to provide them care….

Right now, this is not happening to a significant degree so when my counterparts look at me with disdain, I say, “Why not give change a chance?””

https://www.washingtonpost.com/news/grade-point/wp/2016/11/17/its-a-lonely-place-a-conservative-ivy-league-professor-counters-faculty-calls-for-trump-to-denounce-attack/?wpisrc=nl_highered&wpmm=1

Mother Jones – Trump Care Likely to be more Confusing and Costlier

“According to the state [Kentucky], most of those savings would come from people dropping out of the program because they couldn’t manage the premiums and complexity—18,000 people in just the first year.”

http://www.motherjones.com/politics/2016/11/trumpcare-likely-be-more-costly-less-efficient-and-more-annoying-obamacare

This analysis strikes me as largely true–some reforms will probably be aimed at making requirements too complicated so that lower-income people drop out. That is a problem.

There are also however other problems such as a legitimate scarcity of resources that the ACA deals with currently by having enormous (such as $13,000.00) deductibles on the low-premium plans which effectively leave people uninsured. Another glaring problem are the bureaucratic and reporting requirements such as online patient portals and the electronization of medical records. These have some good sides, but doctors’ non-clinical duties have increased substantially, as have the number of administrative work required in offices, which has bloated costs immeasurably. Colleges have entire majors now dedicated to Health Care Administration–not medicine, not nursing, but medical office work.

 

Your thoughts and direction towards other resources are always appreciated!

 

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