jj3044 wrote:WILLIAMS5232 wrote:jj3044 wrote:This means that the provider gets x to treat a patient with diabetes. If the doctor does a bad job helping the patient manage the condition, the patient comes back many times utilizing more of the doctor's resources, which he is not getting paid more for. It is in the best interests for the doctor to provide better care and FOLLOW UP with the patient, which has been lacking previous. Then, if the doctor makes a set of benchmarks as far as outcomes, they get paid a bonus.
i have trouble thinking this will do much. my mother has diabetes because she drank about a gallon of coke a day. ( i'm not a doctor, this is my opinion ) so 5 or so years ago she gets diabetes and the doc tells her she needs to really start managing her sugar intake. but she doesn't do it. no matter who all tells her to she still eats honey buns and pancakes with ms. butterworths syrup. she drinks coke with every meal. a few months ago they had to up her medicine because it's getting worse. similarly i have an aunt ( no blood relation to my mother ) that is in very bad shape due to taking the same course as my mother not managing here sugar consumption. i can not in any way see this as the doctors fault. punishing/rewarding the doctor for this will only create less/worse doctors and a lower standard. just like the school system blames teachers for a students inability to learn creates poorer education.
i think the doctors job is to diagnose, treat and give advice. and at some point people are going to have to accept that their choices determine their consequences.
There will always be people that just don't care about their health and eat/drink themselves to death. It is the doctor's job to make sure that the proper treatment is available, and the proper resources are available to the patient however, and that is what improves with this model. Where before a patient was on their own to find a dietician to help them with nutrition for example, now the nutritionist works for the provider and the patient has access to them for a lower/no cost. We are trying to eliminate barriers for patients in this model as well as incent the doctors to follow up better and not waste resources.
There is nothing wrong with using some market principles, as well as rewards for good outcomes, etc.
However, these workable solutions are very specific and look at very particular situations. Even though they use the ideas of competition and gain, its not really the market-driven scenario being touted. In fact, for these things to work we would need massive amounts of data and some definite directed planning. It requires a planned system, not just a free and open market. The really key point is that just providing patients with the information and allowing their payments to decide the outcome is not going to work.
Your mother is not going to freely choose the doctor who will put her on a diet.. chances are she will quickly run to another doctor who will be “more sympathetic”, even if the directions given are really not as medically sound. BUT… understand the other part. There is a game to play here. Your mother is an adult and moreover has grown up in a world where she is allowed her free choice, has been taught that eating what she wants and enjoying it are “rights”. That sense of entitlement comes very much from the market-driven economy.
Funny, isn’t it.. the problem here is a market and yet, the market is supposed to be the ultimate solution?