I don’t really blame you, Linda. To do naught opens the doors to unopposed policy manipulation. However, you lessen your effect on the unaligned reader by clouding your rebuttals to Ms. McCaughey with replies that reek with bias.

acavale’s post should be the driving point derived from this particular thread. If HCR insists that EMR is the key to efficiency, then the cost of that efficiency should not be placed on the caregiver’s shoulders. In an arena where we are expected to see 30+ patients a day simply to sustain a viable practice, while our peer subspecialists easily see half as many patients with twice as much reimbursement for precedurally-oriented care, it is no wonder that only 2% of primary care graduates are choosing to not subspecialize.

IT is a good thing. EMR should be a good thing for patient care. However, from a practical standpoint, it’s already turning into a thoroughbred racehorse expected to run with almost no preparation. He’ll look great coming out of the gate, but with no good trainer, no endurance and no proper nutrition, he’s going to break his legs long before even the first quarter-mile is complete. Sadly, like any competitive breed, he will not stop running even if he knows his legs are breaking.

If you are going to support this particular “form” of reform and fight against those that oppose it, please try not to lose sight of the real people counting on you and those like you to effect beneficial change.

The whole purpose of comparative effectiveness research is to provide the kind of evidence that can improve treatment. Not because the government dictates to the doctor, but because research lays out the options. However, it is not just evidence that we need. It’s compliance — by doctors and of course by patients. This article points out the lack of evidence for using antibiotics to clear up sinus infections. But how many patients, after suffering for a week with a painful sinus infection, can resist asking for an antibiotic? And how many doctors can resist giving one?

Birthing pains: Paying for mothers’ hospital stays; [2 Edition]Washington Times. Washington, D.C.: Nov 3, 1995. pg. A.18 Full Text (216 words)
Copyright Washington Times Library Nov 3, 1995

In her Oct. 24 Op-Ed article, “Don’t send babies home so soon,” New York Lt. Gov. Betsy McCaughey blasts health management organizations for ordering women to leave the hospital after childbirth within one day. She wants Congress to pass a law requiring insurers to cover hospital stays of at least 48 hours.

In support of this, she approvingly cites the socialized health insurance systems of Canada, Japan, Great Britain and Germany, which pay for new mothers to stay in the hospital from 2.5 to seven days. While those countries control health care costs more aggressively than does the United States, she writes, “even they draw the line at discharging newborns too early.”

Two years ago, this same Betsy McCaughey wrote an influential article in the New Republic trashing President Clinton’s health care plan for its supposed rationing of care, crushing government regulation, price controls and lack of patient choice. Now she’s telling us that countries with systems similar to the dreaded Clinton model handle childbirth more humanely than our free-market system does. She even favors government intervention (gasp!) to correct this.

Being in government for one year and facing the real-life problems of our health care system must have corrupted Ms. McCaughey’s thinking. Look out, Betsy, it’s a slippery slope to socialized medicine.

DEBORAH MIHM

Chicago