Sunday, June 24, 2012

Obamacare and the Kaiser method - The time to come of Healthcare

Kaiser Medical - Obamacare and the Kaiser method - The time to come of Healthcare
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It is a rarely discussed secret, known the doctors, that most curative problems decree by themselves. In otherwise wholesome patients, most curative complaints are self limited, and improve with time with or without intervention. Colds, flu, back pain, headaches, fevers, abdominal pain, and muscle pain normally decree on their own. Blood tests, X-rays, scans, corporeal examination, and any rehabilitation given often make no incompatibility at all in the policy of the problem.

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How is Obamacare and the Kaiser method - The time to come of Healthcare

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This simple recipe has spawned the entire Hmo industry, perfected by Kaiser healthcare. If patients are forced to wait by delaying being evaluated and treated, their symptoms will decree spontaneously. When I was a radiology resident at Stanford, there was a two week waiting list to get an Upper Gi study for abdominal pain. By the time the appointment came around, up to half of the patients canceled their appointments because their symptoms were gone, and someone else third no longer had symptoms, but came anyway "to make sure". We rarely found anything.

Hence roadblocks to care are very sufficient in reducing the whole and costs of curative care. Patients get great or naturally give up. Kaiser perfected this concept, and used it to dramatically cut the cost of healthcare to its clients, while pretending to use "preventive" care and "efficiency" comprehend their cost savings. Other Hmo's have attempted, with varying degrees of success, to double this strategy.

Techniques such as not answering the phone, delaying appointments, finding nurse practitioners prior to physician visits, and development specialists hard to see, effectively filter out the self wee problems which oftentimes fill the schedules of many physicians.

The question with this recipe is that it only works on wholesome populations. If you comprise the truly sick, the old, preexisting conditions, the diabetic, or the chronically ill, such delays supervene in bad outcomes and real problems for the patients and the healthcare system. Kaiser realized this early on, and has successfully marketed to the younger, wholesome populations(mainly by offering uncostly maternity benefits). Hmo's that didn't effectively screen out the bad risk patients did not fare as well. It is a joke we used to tell that Kaiser is great healthcare insurance, until you get sick.

So what does this have to do with Obamacare? Obamacare makes its assumptions based upon the Kaiser model, pretending that utilization rates and outcomes can be extrapolated to much sicker cohorts of patients. When these older, sicker, and previously excluded patients are thrown into the curative system, all bets are off. The direct supervene will be long delays obtaining any kind of care, with population being sicker by the time they receive care.

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