The Conservatives For Patients Rights (CPR) proudly defines four ‘pillars of patient’s rights.’   These rights are: Choice, Competition, Accountability, and Personal Responsibility.  This group defines the basic application of these rights in the following video.  We do not disagree with the four principles, but we take exception to the interpretation. Watch the video and we will debate the application on the other side.

Choice:

CPR suggests if the government gets involved in Health Care all of us will lose the right to chose our health care provider, including physicians and hospitals.

The problem is that most people with health care have few choices today.  Most health care is provided by employers.  The employers negotiate with insurance companies, including HMO’s, to provide a ‘package of benefits’ to the employees – the employees have no say in which insurance company is chosen.  The insurance company becomes the ‘gatekeeper to health care.’  Gatekeeper is the insurance company term, not mine.  The insurance company contracts with physicians and hospitals to provide care – if physicians or hospitals do not agree to insurance company terms then that physician or hospital is not included in the plan.  The employee is left to chose from insurance company approved health care providers.

The insurance company passes the ‘gatekeeper’ responsibility on to the ‘family physician.’  This means a referral to a specialist or hospital must come from the insurance company approved family physician.  The specialists and hospitals must also be approved by the insurance company.  Physicians who do not manage their patient costs to the insurance company are dropped as health care providers.

Specific treatment plans must also meet insurance company standards.  The family physician can be overruled by a nurse holding the purse strings at the insurance company.

Choice in the world of modern America applies only to the choice of the insurance company.

And we have not even talked about the 50,000,000 who are not insured.  What are their choices?

Health care is not like the auto industry, or any other industry.  People can choose to drive an old beat up car – or even use mass transit.  When a person has heart disease, or diabetes, or cancer, they cannot choose to have health care next year when their finances are more stable.  Choice is not just about which doctor to see.

Competition

Down the: road from us (we live in Punkin Center, Missouri) is the town of St. Joseph, Missouri.  Back in the 1970’s there were two competing hospitals in the town of about 70,000 people.  Every time one of the hospitals bought new technology the other hospital was forced to buy the same or better to keep up.  These new technologies, like CAT Scans and MRI’s, cost millions of dollars.  The result in St. Joseph was that the cost of health care in St. Joe doubled – each of the hospital’s new technologies had less than 50% utilization.

The Boards of the two hospitals met together and agreed to consolidate into one health care system so they would not have to compete.  The competition was killing both hospitals.

Farther down the road, in Kansas City, Mo., several hospitals have formed agreements to share some of the very expensive high-tech diagnostic equipment.  All of the hospitals agree that the key to cost benefits of the expensive equipment is in utilization.  They work hard to keep the machines busy to receive the most revenue for their investment.  This means that some patients are scheduled at all hours of the day or night to keep this expensive technology busy generating revenue.

The concept of ‘free markets’ is difficult to apply to health care precisely because people do not have a choice to have health care or not.  Health care is similar to public utilities – water, electricity, sewers, etc. – health care is a necessity of any thriving community.

Accountability:

CPR defines accountability as merely getting tax breaks for health care costs.  How about holding health care providers and insurance companies accountable for offering good service, or holding them accountable for offering available diagnostic testing.

What about those deductibles and co-insurance payments?  Staggering deductibles and co-insurance are designed to discourage the use of health care providers.  Those who are insured often bear the financial burden of contact with health care providers.  Insurance companies, with profit as their only motive, regularly deny claims for debilitating illnesses.

Who is holding the insurance companies accountable for serving their customers?  Sadly, the only recourse in America is through the courts.

Personal Responsibility:

Hold on to your hats folks because the roller coaster is about to take a dive.  The Conservatives for Patient’s Rights would rather have a corporate CEO define punishment for life style choices than have an elected representative of the people make the choices.

We are talking about direct health care cost penalties for those who are overweight, or those who do not regularly participate in organized exercise programs.  Insurance companies have taken this a step further – they want to punish a person with a genetic pre-disposition to a variety of chronic illnesses.  The insurance company would suggest that a person is personally responsible for being born into a family system which carries the genetic probability of future illness.

Conclusion:

The Conservatives for Patient’s Rights is correct in their definition of the ‘pillars of patient’s rights.’  They are incorrect in their interpretation of these rights.  The fundamental premise of CPR is that Corporate CEO’s of insurance compainies can make better decisions about individual health care than elected representatives of the people.