Bioethics Discussion Blog: Personal Responsibility in Healthcare Reform Costs (Monetary and Scarce Resources)

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Wednesday, August 12, 2009

Personal Responsibility in Healthcare Reform Costs (Monetary and Scarce Resources)

It is apparent by listening to all the current comments on the issue of healthcare reform measures in the United States that there is a missing point of discussion. We hear about all the bad stuff which might be coming out of our government in the proposed reform and all the bad stuff that has been created by the medical insurance industry and the pharmaceutical industry but have we heard any of the folks in the Town Hall meetings with the government or on the media talk about each and every citizen’s responsibilities to reduce both the monetary cost of healthcare but also the cost of utilization of scarce resources as part of the healthcare reform? Don’t the people of the United States have to sacrifice some things so they can stay healthy and allow the healthcare dollars to be spent on diseases and disorders of which the patients have no control in their onset or course? The smoker, the obese person, the alcoholic or drug addict, the “non-compliant patient” … and maybe even the terminally ill patient have some responsibility to others in our society besides themselves. Shouldn’t they be aware of the costs they are loading onto our healthcare system? Now, with 50 million more citizens planned to be added on to the system, beyond dollar burdens to our society how about the costs of attempting to utilize scarce resources such as organs, blood, limited technology and very importantly another scarce resource in this influx: physicians.


To get an idea of both sides of this public responsibility issue go to this link and this link and finally this link and then come back and write us your opinion. Whether when my visitors happen to read my blog thread there has been a healthcare reform bill passed and signed into law or not, I suspect the issue of personal responsibility will still provide controversy. In any event, I would like continue a discussion here. I am not taking a side as yet, I want to learn. ..Maurice.

6 Comments:

At Thursday, August 13, 2009 12:09:00 PM, Anonymous Michael Kennedy said...

Maurice, I think I left a comment the other day but here is another. I have a couple of blog posts on the whole subject of health reform. One thread is an analysis of the French system, which I think should be a model. That is here:

http://abriefhistory.org/?p=400

Another has some thoughts about primary care. As it happens, I may get involved in geriatric care here in Tucson in the next year.

http://abriefhistory.org/?p=880

 
At Sunday, August 16, 2009 3:40:00 PM, Blogger Michael Kirsch, M.D. said...

Amidst the din of the health care reform debate, there is barely a whisper for personal responsbility. Regretably, there is a feeling of entitlement. Cadillac health care for all at Chevrolet prices. While the issue is complex, if the public bore a more direct financial obligation for their medical care, it would markedly disrupt the equilibrium for the better. There would be more public skepticism and fewer unnecesary tests and treatments. Throw in some tort reform and we're well on our way. www.MDWhistleblower.blogspot.com

 
At Sunday, August 16, 2009 4:16:00 PM, Blogger Maurice Bernstein, M.D. said...

Michael, how do you look at colonoscopy as an example of personal responsibility in the matter of keeping medical care costs down and better utilization of resources? What I mean is whether the value of colonoscopy is so high as a screening tool (the ratio of the number of patients needed to be examined being low relative to the numbers of patients discovered by colonoscopy with significant or potentially significant colon lesions which can be removed) that for a patient to avoid screening colonoscopy when advised by the physician and then develops frank colon cancer and it's associated monetary costs and resource use would truly represent a gross abandonment of "personal responsibility" in healthcare? Or is colonoscopy screening simply providing an easy additional monetary income to the physician and is not related to patient "personal responsibility". Just wondering. ..Maurice.

 
At Monday, August 17, 2009 12:27:00 AM, Anonymous Elli said...

I think the french system is one of the best in europe...

 
At Monday, August 17, 2009 7:45:00 AM, Blogger Michael Kirsch, M.D. said...

There is a legitimate argument that excessive numbers of colonoscopies are being performed. While it is our hope that the large scale screening effort underway, benefits the public, its value has never been confirmed in a rigorous controlled study. Objectively, I am not certain how cost effective the procedure truly is. Perhaps, if an individual is offered a screening study, and would face personal financial risks of the disease ultimately developed, that this might lead to a more 'responsible' decision.

 
At Thursday, August 27, 2009 4:24:00 PM, Anonymous Anonymous said...

Many Americans have this impression
that health care is free which is a
concept that I find extremely irritating. Just visit your local
emergency room and see who checks in for care. People actually come
to be seen just for a refill on
their existing medication.
Or worse, they are there because
they are drug seekers. Then there are those who are there once a week
for anything and everything. They
have no idea what PCP stands for
let alone has ever been to one.
For every 8 er patients thats referred for a surgical consult
only 2 may have insurance of which
one is usually welfare insurance.
Munchausen syndrome as well as
by proxy are common with er visits
and I've even heard patients say
they in the er since their ac at
home dosen't work.
Combine this with the vast influx of illegal immigrants who
visit er's and somewhere the system
is going to break!


PT

 

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