If Humanistic Medicine (HM) is showing care and concern for the individual patient, certainly the way we pay for care has implications for HM. Should a patient worry about getting care because of financial implications, be it copays, deductibles, medical debt or medical bankruptcy, choosing between medical care or food or housing, or other consequences? If one believes that health care is like any other good or service in life, like buying a new television or deciding on a vacation, then one can justify financial consequences, including possible avoidance of care or medicines and choosing inferior treatments. But if one believes that health care is special, like having food to eat or housing to live in or education to get, then one is likely to be persuaded that facing more than small financial consequences of seeking care is inhumane.
If one thinks that removing financial consequences for a portion of the population (the middle of the population, because Medicaid applies to the lower income population and high wealth families and those with adequate health insurance will not face significant consequences) is essential to moderate demand, then one should remember that the main culprits for high costs in health care are prices and administrative overhead, not high utilization. In addition, if one really wants to use patient choice to put pressure on prices, it is far better to find an agent for patient choice, such as the primary care provider (PCP) for the patient to do the searching and choosing, since they are the ones with the requisite knowledge.
HM demands that financial implications for health care remain a minor issue for patients, and that medical decisions by families not have to take finances into account.
This should be the goal of all payment schemes for medical care.
No comments:
Post a Comment