The whole thing makes my head hurt…

Thinking about our healthcare system, that is. Which is why Overtreated: why too much medicine is making us sicker and poorer by Shannon Brownlee (Bloomsbury, 2007) caught my attention.

Overtreated, that is, with too many tests and medical procedures, in a fee-for-service system, which increases the chances of medical error as well; while we are undertreated in terms of good, basic care and education for everyone, which is also relatively cheap. A journalist with a biology degree, Brownlee makes the case for how bad our healthcare system really is and how it got that way with careful documentation, statistics and anecdotes. I was especially interested in the historical background on the beginnings of Medicare and the AMA’s long standing fight against “socialized medicine” (used as a hot-button term with a sneer in your voice).

What should we do? According to Brownlee, the Veteran’s Administration (VHA) has done a complete turn around since the scandals of the late 1980’s and should be a model for health care reform.

“Implement electronic medical records. Reduce the excess capacity in hospitals, the unnecessary beds and extra specialists, that drives a great deal of unnecessary care. Make sure that everybody has access to primary care physicians, and that they aren’t overwhelmed trying to handle too many patients. Give them the time to practice preventive medicine.... Use information technology to improve coordination among doctors. Make hospitals and doctors accountable by measuring their performance and the outcomes of their patients. and finally, gather evidence for what works and what doesn’t. We could call this strategy CARE, for coordination, accountability, electronic medical records, and evidence.” (pp. 277-78)

Did you know that the VHA uses a computer program called VistA, which is open source? I didn’t. Open source means it can be downloaded for free and adapted to a particular hospital’s needs. But according to Brownlee, there are at least 25 different proprietary electronic medical records systems being developed, and no standard for compatibility.  (Why am I not surprised?) So what would happen if Medicare decided that all systems had to be compatible with VistA?

I have never been much of a political person, but I feel I am being forced to look out for my own best interests and that of my family. Somehow I always thought that should be part of the function of government (gasp!)   something about ‘promote the general welfare.’ It is pretty apparent that I can’t do much by myself where the AMA and multi-national drug companies are concerned, in a “free market” system (reverential tones here, please), where Big Money is free to line their pockets and I am free to go broke trying to get quality health care.

The system is obviously broke’, and I sure hope someone fixes it and soon. In the meantime, my best advice is to try to stay out of hospitals and the courts, if at all possible.