Another hellish work week. My head meats are generally scrambled due to overworked synapses, and I’ve not had time or free neurons to expand much on this topic. I did want to post something, though, to keep the thoughts as current as possible and to perhaps continue the conversation. I hope to address SckGrl’s comments in short order as well, but I make no promises. The topic of health care is so vast and varied that – sweet Jebus in a jumped up Jaguar – I couldn’t hope to get all my thoughts together in one or two or a thousand blog posts, even given limitless time and energy to do so. Despite that, it’s important to keep talking about it, and picking away at the details.
In my previous post, I was unintentionally too black and white when I stated, “the physician should be directing care, not the individual.” The idea I meant to convey is that the physician should be directing care in terms of advising the patient with regard to the testing and treatment options available, based upon the evidence of illness the patient presents. As Crommunist rightly stated in his comments, the methodology for establishing a mode of treatment needs to first be addressed at the policy level. At this level, specific illnesses would not be addressed; rather, the criteria with which to determine how to move forward sensibly with testing and treatment are codified. Of course, both the patient and the physician require discretionary leeway to make “on-the-ground” decisions, but a policy that establishes reasoned, evidence based approaches to health care would certainly ease the current strain on the system as a whole. This process is of particular importance in the realm of emerging treatments as a way to determine when a particular treatment is ready for the general public – or, ready to be funded, as it were.
In the US, I’m not sure a high level policy like this is possible as we don’t actually have a health care “system” per se. As most of the health care and insurance providers are profit driven, the economics of the thing becomes too big a distraction. As such, we will remain over-treated, over-tested, and over-medicated; costs will continue to climb, pricing more of us out of our health insurance. While I’m hopeful that the current health reform legislation will get us started on the right path, as it stands, it simply does not do enough.