Would you sacrifice choice this time around?

In the ’80’s and 90’s, when HMOs first became widespread, we all experienced lower costs but less choice- we had to choose from a list of doctors and hospitals, i.e. “in-network providers”.  But costs did stop rising, and in some cases actually fell.

Then came the managed care backlash and insurers allowed a much broader choice of doctors and hospitals.

Health care costs have nearly tripled since 1990 and now, the federal budget and nearly every state budget is threatened by extremely high health care costs.  Of the many methods being used to try to contain costs, limiting consumer choice of providers is once again a common approach.

The way this works in practice is that health plans offer one set of prices for using “in-network providers”.  If we use “out-of-network” providers, the amount we have to pay out of our own pockets is higher.  Sometimes much higher.

Here is the question: How do you feel about having a limited choice of doctors and hospitals in return for lower costs?

Is limiting our choice of doctors and hospitals fair, if costs are significantly lower?

View Results

Loading ... Loading ...

Should wealthier people receive more and/ or better health care?

As health care costs threaten more and more of our economy, various methods of addressing the challenge have been proposed, the Ryan plan for Medicare being one of the best known.  In this plan, the Medicare system is revised to provide seniors with a fixed voucher to cover insurance premiums purchased through the private sector.  When the voucher is used up, patients will have to pay out of personal funds.

Clearly, the well-off will be able to afford more care after the voucher is gone.  Is this right?

This blogger believes that the quality of some things should vary with wealth:

  • the well-off should drive nicer cars
  • the well-off should wear nicer clothes
  • the well-off should eat at fancier restaurants

But some things should not vary with wealth:

  • fire protection
  • water quality
  • food safety

So here is the question- should the amount and quality of health care a person receives vary with wealth?  What do you think?

Should financially well-off people receive more and/ or better health care than those who are not well-off?

View Results

Loading ... Loading ...

Health Care for persons in this country illegally.

What should we do about providing health care for people in this country illegally?

On the one hand, persons here illegally may put a strain on the system (I say “may” because ironically, many illegals do pay taxes).

On the other hand, to ignore the health needs of a large group of people has public health implications- diseases may spread within that population and then affect “the rest of us”:

  • tuberculosis
  • HIV
  • flu and related conditions

Also, for the purposes of this question, please assume that “sending all illegals back home” would take years, so we still have to deal with the issue, at least temporarily.

So here is the question- please select only one answer:

Until the day when there are no illegals, should persons in this country illegally have access to the health care system?

View Results

Loading ... Loading ...

Scope of practice for non-physicians

There are many clinical professionals in the health care industry other than physicians, including:

  • Nurses
  • Respiratory therapists
  • Physical therapists
  • Pharmacists

The laws are generally clear on what these other professionals are allowed to do and what they cannot do. 

  • Who can prescribe drugs
  • Who can perform specific procedures

However, in the broad discussion about health care costs, the issue of what various professionals can do becomes relevant:

  • A shortage of physicians affects access and waiting times.
  • The supply/ demand balance affects the cost of services- if there aren’t enough physicians, thay can raise their prices and there is no alternative.
  • Physicians threaten to refuse Medicare patients if rates are cut, and even Medicare has no alternative.

So here is the question:

Should non-physicians be allowed to do more in the direct care of patients? What do you think? Please select one answer.

In general, should licensed health care professionals who are not physicians be allowed to do more in the direct care of patients?

View Results

Loading ... Loading ...