Monday, March 8, 2010
Greetings
Now a freelance blogger, after10+ years at Harvard Pilgrim Health Care and 10 years (1989-1999) as Massachusetts Medicaid Director, I have one goal here, which is to continue a discussion on national health care reform that began in the pages of Let's Talk Health Care, the Harvard Pilgrim corporate blog. I hope my perspectives range a bit farther afield and that I can draw liberally on both a public-private health insurance background and twenty-year involvement in health reform efforts in Massachusetts. I have seen this movie from both sides of the aisle and am consistently amazed at how loudly the sectors talk past one another at the national level and how thoroughly the debate ignores the need to strike the appropriate balance between the sectors. Striking this balance is a complicated, time-consuming task filled with a lot of troublesome detail and trade-offs. It is helped by patience and good will, not the scoring of short-term political points or ideological arrogance. I would like to see us move forward, but do not think this will happen until a measured conversation takes place. I hope to contribute.
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Welcome (back) to the blogosphere, Bruce. I've linked to you and posted a short article here: http://runningahospital.blogspot.com/2010/03/new-blog-health-reform-musings.html
ReplyDeleteI am a physician (ob/gyn) and have practiced for about twenty two years. Currently I am employed by a hospital system but I have been in private practice and worked for Kaiser Permanente previously in my career. Having worked in different payor systems (ie salary, capitation and fee for service) I believe the Kaiser system works the best. If reform only mandates universal coverage without changing how providers are paid than it will have to result either in rationing of care or more money will be spent on healthcare. Capitation for physicians individually results in too much financial risk for basically a small business owner (ie physician practices) However, if partnered with a health system, I believe capitation rewards prevention rather than utilization. Healthcare reform must develop a system that rewards prevention of illness rather than paying for treatments that attempt to cure after the affliction has occurred.
ReplyDeleteBruce: can you add the option to your site of subscribing by email? This way your posts appear each day on Blackberries, etc along with regular email traffic. You can add an email subscription box quite easily--see Paul Levy's blog for what one looks like.
ReplyDeleteThanks, and good luck with your new effort.