Wednesday, May 11, 2011

Health Care Solutions: Market (Same-day House Calls) vs. Government (36 Days to See Family Doc)

 
1. Here's a market-based approach to health care (watch video above), where nurse practitioners make house calls and come to your home or office, so you can avoid all of the  costs typically associated with an appointment at a doctor's office: gas, travel time, waiting time, parking, child care, time off work, etc. 

"WhiteGlove House Call Health is focused on changing healthcare on a national level by lowering the cost of healthcare while improving the consumers’ healthcare experience. As a medical care provider, we offer our members access to affordable, high quality medical care at your home or work, 365 days a year, 8 a.m. to 8 p.m. WhiteGlove members enjoy a comprehensive primary care experience, now including chronic care."

 HT: John Goodman, who refers to this "mobile medical care" approach as "Minute Clinic on Wheels." 

 2. In contrast, consider the situation in Massachusetts, after five years of government-managed "Romneycare," which is frequently mentioned as a model for how "Obamacare" will operate nationally.  According to the recently released  study "2011 Study of Patient Access to Health Care" from the Massachusetts Medical Society (press release here, full report here):

a. "Access to primary care physicians is becoming more restricted, as more than half of primary care practices – 51% of internists and 53% of family physicians – are not accepting new patients.  These figures remain close to those of last year’s survey which showed 49% of internists and 54% of family physicians not accepting new patients.

Medical Society officials say the percentage of practices closed to new patients reflects the persistent shortages of primary care physicians in the Commonwealth. For five consecutive years, the Medical Society has recorded critical and severe shortages of both internists and family physicians. 

b. Long wait times continue for the primary care physicians of internal medicine and family medicine who are accepting new patients. The average wait time for an appointment for internal medicine is 48 days, five days shorter than last year, and the average wait time for family medicine is 36 days, up 7 days. Internal medicine was the only specialty reporting a shorter wait time, yet at 48 days it has the longest wait time of any of the seven specialties surveyed.

All four specialty care categories reported longer wait times: gastroenterologists, 43 days, up from 36 days; obstetricians and gynecologists, 41 days, up from 34 days; orthopedic surgeons, 26 days, up from 17 days; and cardiology, 28 days, up from 26 days."

17 Comments:

At 5/11/2011 3:19 PM, Blogger Mike said...

Wow. Thanks for posting this, MP.

They're up and running in Houston and I've never heard of them. I'm going to check it out.

 
At 5/11/2011 4:14 PM, Blogger Hydra said...

Let me know the first time you need four guys to carry you out of the house for $25 k of emergency knee surgery during a blizzard, and you call these guys.

 
At 5/11/2011 4:26 PM, Blogger Larry G said...

virtually every other industrialized country pays appro 1/2 what we do for health care, has a longer life expectancy, and a lower infant death rate.

And they cover ALL of their people not just some.

Health Care consumes 16% of our GDP and is projected to double in a decade +/-.

http://en.wikipedia.org/wiki/Health_care_system

see cross-country comparisons

now.. be polite in your responses.

 
At 5/11/2011 4:52 PM, Blogger bob wright said...

The government-monopoly education system is a disaster. "Just 31.9 percent of Detroit students graduate in four years, according to the first major study in Michigan conducted using a method now mandated by the federal government."

The government-monopoly first class mail system is losing business and losing money.

The government-sanctioned cable monopolies in most municipalities are the bane of most people I talk to. Ever increasing rates and poor service.

So now the only solution for the uninsured many people can imagine is another government monopoly.

Only 10M to 15M people are uninsured at any one time in the U.S.

A hostile take over of the health insurance industry by the federal government is not required.

The uninsured could easily have been added to the Medicaid rolls while leaving alone the health insurance plans of the remaining 280M people in this country.

"...I'm from the government and I'm here to help...."

People never learn.

 
At 5/11/2011 5:10 PM, Blogger Hydra said...

Polite? On this board?

 
At 5/11/2011 5:10 PM, Blogger Mike said...

Larry,
I'd like to see more in-depth comparisons, featuring all costs (such as wait time, quality of doctors, taxes and availability of treatment options).

Secondly, the IMR is a bit misleading based on the country's definition of 'alive" and the number of complicated attempts to rescue a troubled fetus.
I believe doctors in the US try to bring more complicated pregnancies to term and lose many of them. That would also push life-expectancy down a bit.


Oh, Hydra, would you have made an appointment to see your G.P. when you needed leg surgery?
Right. But does that mean he's no good for a sinus infection and a check up?

 
At 5/11/2011 5:54 PM, Blogger hal said...

This doesn't solve the doctor shortage. To fix that, we need more medical schools. We only have 133 M.D. schools, the market requires at least 500. Special interest is obstructing medical school construction.

 
At 5/11/2011 7:28 PM, Blogger Larry G said...

" The government-monopoly education system is a disaster. "Just 31.9 percent of Detroit students graduate in four years, according to the first major study in Michigan conducted using a method now mandated by the federal government."

what about all the other industrialized countries govt systems that outrank us?

 
At 5/11/2011 7:35 PM, Blogger Larry G said...

@Mike - the data is pretty consistent from multiple sources.

I provided you with a good one and I'd get more but it won't change the basic facts.

We spend way more on health care in this country PRIMARILY because the people who are not covered do not have primary care physicians and disease is discovered late in the game and then requires heroic efforts by ERs and other urgent care facilities.

It's the fact that we don't cover 30-40 million - until it is too late.

Other countries that cover everyone catch disease earlier and can treat it far cheaper as a result.

On the pregnancies - same church different pew - moms who do not have insurance, put off seeing doctors who also, in turn, don't want complicated pregnancies where who is going to pay is problematic.

The best health care system in the world in terms of cost-effectiveness is our own totally govt-run VA system.

It has a 99.99% accuracy rate on prescriptions in part because each patient has an electronic record.

 
At 5/11/2011 7:40 PM, Blogger Larry G said...

http://www.nationmaster.com/graph/hea_phy_per_1000_peo-physicians-per-1-000-people

 
At 5/12/2011 8:46 AM, Blogger Paul said...

"The best health care system in the world in terms of cost-effectiveness is our own totally govt-run VA system."

Uh, have you ever been in one?

 
At 5/12/2011 9:21 AM, Blogger Larry G said...

haven't been in 99% of them here or overseas ... but pretty sure I'm typical

 
At 5/12/2011 11:58 AM, Blogger Hydra said...

Is this free market, or just cherry picking? I don't see such a service meeting much of a need. And no, I don't go to my gdp for a sniffle. But if I go to the er, he may be there covering his shift.

 
At 5/12/2011 12:00 PM, Blogger juandos said...

"Let me know the first time you need four guys to carry you out of the house for $25 k of emergency knee surgery during a blizzard, and you call these guys"...

Well instead of calling White Glove a or similer service shouldn't you actually be calling a regular ambulance service to take you to a real hospital that has orthopedic surgeons instead hydra?

Just a thought...

 
At 5/12/2011 12:16 PM, Blogger juandos said...

"irtually every other industrialized country pays appro 1/2 what we do for health care, has a longer life expectancy, and a lower infant death rate"...

Still buying into that socialist myth, eh Larry G?

"see cross-country comparisons"...

Well Larry G if you want real comparisons look at what your socialists pay in taxes versus the US...

How do you think those socialist paradises pay for the supposedly 'good medical care'?

 
At 5/12/2011 12:42 PM, Blogger Paul said...

Larry G,


I figured that. I wouldn't let the VA treat my dog.

 
At 5/13/2011 12:07 PM, Blogger juandos said...

Friday May 13 @1206 hours CDT and I see all the comments fell off when Blogger had their problems...

 

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