ObamaCare says that health insurance must cover the tests and procedures recommended by the U.S. Preventive Services Task Force. It will be interesting to see which tests are suggested--for example the Task Force opposes PSA testing for prostate cancer screening despite the fact that virtually everyone who knows anything about prostate cancer encourages it. What would the currently approved tests and procedures require of the existing medical system? According to a report in the American Journal of Public Health from Duke, arranging for and counseling patients about all those screenings would require 1,773 hours of the average primary-care physician's time each year, or 7.4 hours per working day. Just for screening.
How will such a volume be managed?
The common answer is that instead of patients' being funneled into the medical system through a financial screen it will now be a screen of time. Think of medical clinics in the military or local health department infectious disease clinics. Or a more expensive, smaller second tier system might emerge which prefers higher paying patients. (Although this type of evolution was specifically prohibited by the Hilliary plan as total medical cost was the target.)
But people willing to wait and fiddle does not solve the basic question: How can all these promises be met by a limited number of people and within a restricted budget when everyone knows that increasing demand with frozen prices is a scenario for shortages?
The obvious answer is to increase the number of people willing to do the screening at a lower cost. The answer is to substitute lower echelon medical personal for physicians. First nurse and PA's, then MA's, then....
How will such a volume be managed?
The common answer is that instead of patients' being funneled into the medical system through a financial screen it will now be a screen of time. Think of medical clinics in the military or local health department infectious disease clinics. Or a more expensive, smaller second tier system might emerge which prefers higher paying patients. (Although this type of evolution was specifically prohibited by the Hilliary plan as total medical cost was the target.)
But people willing to wait and fiddle does not solve the basic question: How can all these promises be met by a limited number of people and within a restricted budget when everyone knows that increasing demand with frozen prices is a scenario for shortages?
The obvious answer is to increase the number of people willing to do the screening at a lower cost. The answer is to substitute lower echelon medical personal for physicians. First nurse and PA's, then MA's, then....
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