Primary care, generalism, and the "cognitive" specialties have been taking it on the chin for quite a while. Most politicians seem to have been more interested in the more glamorous aspects of high-tech care, regardless of their actual effectiveness or costs. So, I was happy to note some support of primary care voiced nearly simultaneously by politicians from two different US states.
Our own Rhode Island Governor Donald Carcieri unveiled some health initiatives, explained in more detail by our new health insurance commissioner Christopher F Koller. He proposed that the state, as a health care purchaser, push for more and better primary care, working "with patients and providers to develop a standard defining what constitutes good-quality primary care." He argued that "health palns will do what their purchasers tell them do to. The purchasers are not [now] saying 'support primary care.'..." (See the story in the Providence Journal.)
Meanwhile, Representative Bobby Jinday (R-Louisiana), proposed rebuilding New Orleans' health care in a commentary in the National Review. He noted, "everyday... bureaucracy impedes the delivery of high-quality health care." Thus, "it is critical to ask: who do we want to be in charge of making health-care decisions? Do we want the same bureaucracy that botched initial relief efforts? Or empowered patients working with their physicians to personalize health-care needs?" So, "as we rebuild, we should concentrate on increasing access to out-patient and primary care."
It's much too early to call this a trend, but maybe some of the more perceptive players in the policy world are starting to wake up to some of the end results of the currently dysfunctional health care system, and are thinking about alternatives.
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