Monday, May 11, 2009

Update: First Do No Harm........Health Care Reform


Update: First Do No Harm........Health Care Reform
by Ron Powell

AP - Hospitals, insurance companies, drug makers and doctors are planning to tell President Barack Obama today that they'll voluntarily slow their rate increases in coming years in a move that government economists say would create breathing room to help provide health insurance to an estimated 50 million Americans who now go without it.

In my post regarding profit and the profit motive and the health care system, 22 April, I started out with the following:

"First, do no harm...." is the primary moral and/or ethical imperative of the medical profession. It means that the interests and needs of the patient are to be placed above the interests and needs of the physician or caregiver. Profit driven corporate medicine has taken over American medical practice. Corporate models and methods of industrial competition have eliminated clinical expertise and the notion of care in the delivery of medical services. The result is that corporate profits are more important than patient prognosis. This is not only tragic and mistaken, but also unethical and immoral.

Here is an update on the subject which makes my post appear to be somewhat prophetic:

By RICARDO ALONSO-ZALDIVAR and PHILIP ELLIOTT, Associated Press Writers Ricardo Alonso-zaldivar And Philip Elliott, Associated Press Writers

WASHINGTON - When President Bill Clinton took on health care reform, industry leaders fought back, killing the White House proposal before it could gain any traction.

Now those industry leaders are trying to help President Barack Obama find a solution to the problem of uninsured Americans, offering $2 trillion in spending reductions over 10 years.

Hospitals, insurance companies, drug makers and doctors planned to tell Obama on Monday they'll voluntarily slow their rate increases in coming years in a move that government economists say would create breathing room to help provide health insurance to an estimated 50 million Americans who now go without it.

Although the offer from the industry groups doesn't resolve thorny details of a new health care system, it does offer the prospect of freeing a large chunk of money to help pay for coverage. And it puts the private-sector groups in a good position to influence the bill Congress is writing.

Six major groups plan to deliver a letter to Obama and pledge to cut the growth rate for health care by 1.5 percentage points each year, senior administration officials said Sunday. They spoke on the condition of anonymity in order to sketch the offer before full details are revealed at a White House event scheduled for Monday.

The industry groups are trying to get on the administration bandwagon for expanded coverage now in the hope they can steer Congress away from legislation that would restrict their profitability in future years.

Insurers, for example, want to avoid the creation of a government health plan that would directly compete with them to enroll middle-class workers and their families. Drug makers worry that in the future, new medications might have to pass a cost-benefit test before they can win approval. And hospitals and doctors are concerned the government could dictate what they get paid to care for any patient, not only the elderly and the poor.

Obama has courted industry and provider groups, inviting their representatives to the White House. There's a sense among some of the groups that now may be the best time to act before public opinion, fueled by anger over costs, turns against them.

It's unclear whether the proposed savings will prove decisive in pushing a health care overhaul through Congress. There's no detail on how the savings pledge would be enforced. And, critically, the promised savings in private health care costs would accrue to society as a whole, not just the federal government. That's a crucial distinction because specific federal savings are needed to help pay for the cost of expanding coverage.

Costs have emerged as the most serious obstacle to Obama's plan. The estimated federal costs range from $1.2 trillion to $1.5 trillion over 10 years, and so far Obama has only spelled out how to get about half of that.

Apparently even leaders in the health care industry recognize the simple truth: Health care reform requrires a reduction, if not an elimination, of profits in the equation. It is clear from the AP report that the health care industry is trying to get out in front of what even they see as inevitable, by offering a proposal that 'voluntarily' limits or reduces profits over the next ten years. Evidently they've made so much in the past ten years that they feel that they can afford this "generous" proposition. What they seem to be doing is attempting to head off full government control or participation in the delivery of health care by taking a 'half a loaf is better than none' approach to "reform" of the system.

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