Posted by Christopher M. Shoffner.
“If we are going to fix our ineffective and unsustainable healthcare “system” the only real cure is a vibrant, diverse and independent Primary Care provider base. The only way to get that is to change the way people pay for primary care (giving everyone equal means). Everyone needs primary care and preventive services, not necessarily insurance. I even found SCOTUS making the statement that the only way to buy healthcare was to buy insurance; a false and somewhat scary assumption. By giving everyone the same means to purchase primary care and introducing pricing transparency into primary care, costs will go down and quality will improve. Why? because the patient is now the payer (the only single payer system I agree with) and they can hold the Practitioner/Practice accountable for wait times and interpersonal skills (are they listening to me?) This also alters the economics for the Practitioner; for the better. Reducing the administrative burden thrust upon each practice by the antiquated CPT Code based billing system. We are working diligently in NC (other states are waiting for the template) with all major parties to create the next major “pilot project” for meaningful reform (Medicaid, State Health Plan, Private Payers). This is not a political effort, but an effort by one state to do what is in the best interest of its residents. This is why/how decisions should be made in the political realm.
Author’s Comments: (Health Train Express)
The terms left and right are counterproductive to the process and usually create a solution that is unpalatable to each side. One alternative would be to expand our little known service, NHS, National Health Service (the former public health service) See my blog at http://healthtrain.blogspot.com .This would in the short run offset the PCP shortage. ACOs will be a disaster except in already formed organization that are large and comprehensive. They can form an independent ACO
Peter,as a retired specialist (Ophthalmologist) and ex-PCP (ER and general practice for five years) I am on a mission to support Primary Care (the name of which I disagree intensely). I believe all specialists should strive to eliminate the RUC since it is not truly representative of PCP and places all principals in an adversarial position. PCPs have a far greater challenge in dealing with the bureaucracy that specialists avoid. In fact that is a primary reason why young physicians chose to specialize. I agree with all of your ideas and will continue to promote them in my writing, travels and speeches
Posted by Christopher M. Shoffner