Friday, October 15, 2010

As should Salem and Marion County

Plastic bottles before processingImage via Wikipedia
9. Oregon county bans bottled water
Multnomah County became the first in Oregon to ban bottled water from all county meetings and functions. From now on, the county will serve pitchers of cool liquid from the tap -- and save itself thousands of dollars. Oregonian 10/14/2010

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Word: Recognizing the elephant in the doctor's office

From The Lund Report:

It‚s Time for Doctors to Reclaim Ownership of Their Profession We can't sustain rising healthcare costs and, more urgently, we can't sustain the aftershocks of a healthcare bubble bursting

By: Dr. Kris Alman . . .

It must be understood that doctors no longer own their own shingle. When post-World War II America ceded healthcare to employers, insurance companies inherited a cash cow. Individuals, families and businesses now realize that insurance companies cannot deliver a product that can be consumed for their benefit when profits are involved. The conundrum is very basic. Health is a societal investment and not a commodity that can be consumed and marketed as healthcare. For-profit healthcare creates perverse incentives for those who profit from the unhealthy and the worried well. Employers, tired of insurance companies profiting from their employees, are marketing a new paradigm of managed care through self-insuring. Consumers should be wary of "roadmaps" for employer health management and value-based benefit designs. Values will be compromised for the sake of value. Market-based healthcare demoralizes the doctor. I left my career as an internist and endocrinologist over ten years ago, when I was at my prime. My integrity was too compromised by the compromises the market demanded of me. Many of my physician friends envy my good fortune married to a radiologist who gives me that choice. But I still mourn the loss of my career especially since I know there are critical needs for primary care doctors. Market-based health care won't work. Quality healthcare depends on a trusting relationship between the doctor and patient, an art that that is unquantifiable. Yet we're reassured that healthcare reforms will be evidence-based. Even a spoonful of sugar doesn't help swallow "evidence-based" research cooked by PhRMA and medical device companies. Healthcare reforms were adopted from the evidence-based playbooks of No Child Left Behind. I assure you doctors will be treating to the HEDIS test. This approach is impersonal and non-specific. . . .

We already have rationed care. The question is who should who should determine how we ration care: doctors or employers and insurance companies? Doctors must reclaim ownership of their profession and demand full transparency of healthcare costs. They'll better grasp the inherent inequities that arise from the multiple payers and deniers of employer-based healthcare. In doing so, doctors can reassert true value to the care they give and to healthy values we, as patients, must embrace. We can't sustain rising healthcare costs and, more urgently, we can't sustain the aftershocks of a healthcare bubble bursting. ================== Dr. Kris Alman retired from healthcare to become a citizen activist for a healthier democracy. She advocates for fair taxation to invest in our common goods--prioritizing education, renewable energy, campaign finance and healthcare policies and laws.