I go into surgery for a new hip on the 29th. With so much talk on health care reform in the election, I want to give a few links to a series of articles I wrote in 2010 about The Committee on the Costs of Medical Care which was published in 1932. I provide these links because the issues are nearly the same—cost, quality and the need for patient centered care!
This was not government funded report. It was funded by private foundations such as Rockefeller Fund and Milbank Memorial Fund, among many others. The members were health professionals, business leaders and consumers. This issues? Costs were bankrupting American families; quality was uneven; fee for service billing raised costs; insurance model raised costs; lack of preventive care increased costs and failed to meet community health needs. The Committee believed the best care was when it was a collaboration between doctor and patient.
The Committee was formed at the behest of the AMA but it was finally killed by the AMA because a major recommendation was to have salaried doctors working with hospitals. The AMA so hated salaried physicians that they took the issue to the Supreme Court to prevent it. It was not until 1943 that the Supreme Court ruled that physicians could be salaried. (see my last blog on history of health reform).
I know the election depends on many things, but if we throw out the Affordable Care Act, we are throwing away one of the last chances we have to fix the very same issues the Committee on the Costs of Medical Care addressed in 1932. Here is what was said in 1932:
The Committee recommends that medical service, both preventive and therapeutic, should be furnished largely by organized groups of physicians, dentists, nurses, pharmacists and other associated personnel. Such groups should be organized, preferably around a hospital, for rendering complete home, office and hospital care. The form of organization should encourage the maintenance of high standards and the development or preservation of a personal relation between physician and patient. 10/31/1932
Comment: This could easily be read as “Accountable Care Organizations” in the Affordable Care Act.
“The problem of providing satisfactory medical services to meet all the people of the United States at costs which they can meet is a pressing one. At the present time, many persons do not receive service which is adequate either in quantity or quality, and the costs of the services is inequitably distributed. The result is a tremendous amount of preventable physical pain and mental anguish, needless deaths, economic inefficiencies and social waste. Furthermore, these conditions are….unnecessary. “(CCMC, Page 2).
“The possibility of providing medical care for all depends in part on education which is frequently a prerequisite to change. The most satisfactory solution of the problem … is found only when the leaders of the public and the professions join hands on a basis of mutual understanding, respect and confidence.” (CCMC, op.cit.).
If we lose the Affordable Care Act (Obamacare) we can be sure to have another report on our lack of quality and patient centered care once again. We cannot afford that as a nation or as a moral people.
France, Canada, England and others don’t need to hold fundraisers to cover children’s cancer care. Seniors don’t go bankrupt or lose their homes from pharmaceutical and medical costs. Veterans in England are automatically covered by their national insurance with added benefits for war service. We still have too many uninsured and gaps for those who have insurance. We have turned too many blind eyes for far too long on what we fail to do. We cannot continue to do so. Here is a glance about what was said in 1932 by a non-government study:
The report itself is out of print. For those who wish a condensed summary, I can send you my report when I am back up and running in August.
I hope you found this of interest.
Kathleen O’Connor © July 28, 2016