Decision time on health care; take the five question challenge

1. Let’s say there is a drug ABC that treats BCA disease. It costs $500 a month. Along comes a new drug XYZ which also treats ABC but is 10% more effective, but costs $1000 a month.

Q. Who are you willing to let decide if you can use the new XYZ drug?

2. Your health plan assigns you to a local hospital. If also allows you to pick a family doctor, a pediatrician and a OG/GYN. If you want to make changes, you must seek approval first.

Q. Are you comfortable asking permission to make these changes and who would you feel comfortable making that decision?

3. You are in need of a hip replacement but you are overweight (your BMI is 32) and you smoke; your surgery is denied.

Q. Do you think this is fair? Who should make this decision?

4. You are going into the hospital for treatment of pneumonia, you assume you will be in a semi-private room or maybe even by yourself. When you are placed in your room, you find there are three other people.

Q. How does this make you feel?

5. You want to schedule a doctor appointment. It used to take about a week to ten days, now you are told it will take over three weeks. At the appointment you are told to get an MRI. Normally that takes ten days to schedule but you find it’s now 54 days.

Q. How satisfied are you with this scheduling? What will you accept to make wait time shorter?

All of the above situations are drawn from the operation of universal health care systems in other countries. They are typical of the things necessary to attempt to manage costs. Number 5 is a reflection of demand and growing physician shortages.

You may find all this perfectly acceptable as a trade off for universal coverage and that’s fine, but just understand you are handing off decisions about your health care to government agencies and future congresses and they will be faced with managing budgets and spending.

And no, it’s not the same as insurance companies or your employer self-funded plan making decisions.

One comment

  1. Just ask the families of veterans who died, waiting for an appointment at the VA, if single provider / payer healthcare is a good idea. Why do the VA doctors see 50% less patients per day, than other doctors. Healthcare is not a right, it is a service or product, just like a brand new car. Not everyone can afford a new car. But, our system does provide healthcare at a very low cost to the poor. That will all change under M4A, everyone will pay more for less.


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