David Hogberg at Investor’s Business Daily has written a nice critique of the so-called “medical homes” pushed by ObamaCare (HR 3590). A “medical home” sounds comforting, but if politicians are forcing you, or nudging you, into one with legislation, then you should be wary. A few excerpts from the article, Medical-Homes Model Pushed By Health Bill Is Still Unproven:
A medical home emphasizes teamwork among physicians. Primary care doctors coordinate patient care among specialists, but they don’t act as gatekeepers. Patients have relatively unrestricted access to care.
Electronic medical records provide easy access to information, helping doctors spot redundant services and monitor patients with chronic problems to make sure they follow proper treatments. Physicians and patients alike can track the results of care. The goal is to cut costs while boosting quality of care.
Sounds good, right? But,
“It becomes more bureaucracy than health care,” said Greg Scandlen, an independent health care consultant. “Congress got together and said, wouldn’t it be great if we could create something that could lower costs and improve quality, and they called it a medical home. Politicians come up with swell terminology for something that won’t work and that we’ll spend a lot of money on.”
Hogberg reviews research on the effectiveness of medical homes in improving quality and decreasing costs – the results are mixed.
Don’t forget the big picture: regardless of their merit, politicians should not tell doctors how to run their practices and how to relate to their patients. As Michael Cannon at Cato has noted, government already does this:
Rather than allow a level playing field for all payment systems, so that competition forces them all to improve, government tips the scales toward fee-for-service. Medicare is the largest purchaser of medical services in the U.S., and it operates largely on a fee-for-service basis. According to former Medicare chief Thomas Scully, “in many markets Medicare and Medicaid comprise over 65 percent of the payments to hospitals, and more than 80 percent in some physician specialties.” No wonder a recent New England Journal of Medicine study found that only 1.5 percent of non-federal hospitals use a comprehensive EMR system. Name any quality innovation that might save money by avoiding unnecessary services — EMRs, bar-code scanners for prescription drugs, surgery checklists. Medicare blocks them all. The Left bemoans the resulting quality problems, yet is desperately trying to subject even more of the market to the very stagnation Medicare introduces. Massachusetts, with its commission to develop a single payment system for its entire health-care sector, is diving head first into the cement. It makes no difference if government chooses a different payment system than Medicare’s. The problem isn’t the particular payment system, but the lack of competition from other systems.
(IBD article via FIRM)
