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Wednesday, August 11, 2004

Broken Systems 

As we all know, the state of healthcare in the US is disastrous. Three articles today effectively demonstrate three reasons why this is so.

Many doctors and Republicans seem very happy blaming the costs of health care on malpractice suits and judgments (which occur only in a tiny miniscule fraction of suits filed), not to mention lawyers. This certainly has an effect, particularly on sole practitioners who get stuck with $150k per year premiums all alone, and doctors in Maryland are starting to join a slightly disturbing trend: going without. It's perfectly understandable...the costs are so high they can't afford to have insurance, and are willing to risk losing everything in a suit just to keep practicing. Yes, malpractice insurance is too high. But I don't like the idea of judgment caps...because while usually it's a just bad luck or poor communication of the risks of a procedure to patients, all too often negligence does occur.

You'd think, along with wanting to reduce their malpractice insurance costs, doctors would want to try to reduce errors (and thus suits), right? Not so much. Doctors are protesting Washington's Electronic Health Record (EHR) program, because it costs them money. Not hundreds of thousands of dollars a year, mind you, just two or three. It's proven to reduce errors, improve quality of care, and improve outcomes, all of which doctors are supposed to want. But as this article shows, and as I've seen doing work in this area docs often hate EHR. Because it cuts, ever-so-slightly (for most) into their bottom line. In fact, it only does that at first: once the systems are installed, they cost very little to run, and more than pay for themselves in improved payment rates, fewer mistakes, fewer lawsuits and (non-monetarily) healthier patients. Funny.

And, on the stupid-government side, Vermont is suing the FDA to make it allow reimportation of Canadian drugs. Go Vermont, I say. It would be better if our government would do something actually useful, like curbing drug prices in the first place, but hey, reimportation is a nice start.

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