This week President Bush has sketched out his broad vision of an "ownership 
society."  This is code for a broad attack on many of the social programs in 
the US including Social Security, Welfare, Medicare and Public Education.  In 
this week's New England Journal of Medicine, US Senator William Frist applies 
this vision to health care with the concept of "Consumer Driven Health Care".  I 
am attaching a notation from the list-serve of the Physicians for a National 
Health Program (www.pnhp.org). 

I think it is important for our non-US friends to see the direction the 
ideological winds are blowing here.

Best,
Matt Anderson
www.socialmedicine.org

The New England Journal of Medicine
January 20, 2005
Health Care in the 21st Century
By William H. Frist, M.D.

Consumer-Driven Health Care

The new system also must be responsive primarily to individual consumers, 
rather than to third-party payers. Most health care today is paid for and 
controlled by third parties, such as the government, insurers, and 
employers. A consumer-driven system will empower all people - if they so 
choose - to make decisions that will directly affect the most fundamental 
and intimate aspect of their life - their own health. This empowerment gives 
people a greater stake in, and more responsibility for, their own health 
care. Health care will not improve in a sustained and substantial way until 
consumers drive it.

Affordable Health Coverage for All Americans

Tax-free health savings accounts (HSAs), adopted in 2003 as part of the 
Medicare Modernization Act (Public Law 108-173), will help speed the 
movement to a more consumer-driven health care market. It is estimated that 
half of all employers will offer HSAs to their employees within the next two 
to five years. HSAs, coupled with affordable high-deductible insurance 
policies, give individual consumers more control over their health care 
choices and hard-earned dollars. HSAs give people a greater stake in their 
own health care.

Conclusions

American health care is at a crossroads. Rapidly advancing forms of 
technology are dramatically improving lives. Simultaneously, U.S. citizens 
face enormous inefficiencies, escalating costs, uneven quality, disparities 
in health care, and rising numbers of uninsured people. For decades, 
policymakers have debated and rejected a variety of solutions. What we have 
never done in the health care economy, however, is foster the kind of 
competition that has made other industries the most successful, prosperous, 
and advanced in the world.

http://content.nejm.org/cgi/content/full/352/3/267


Comment:  Sen. Frist uses rhetoric that makes every free market enthusiast's 
heart pound with sheer joy. But those who understand the current policies 
that have resulted in our extravagantly expensive but perilously 
underperforming health care system, also understand the policies behind Sen. 
Frist's rhetoric. Not only is he implicitly supporting financial hardship 
and personal bankruptcy, but, worse, he is supporting policies that can only 
increase suffering and death.

Tragically, Dr. Frist is allowing political ideology to trump beneficial 
health policy. It is difficult to reconcile this with his role as a 
colleague in the healing arts.


-------------------
Problems/Questions? Send it to Listserv owner: [log in to unmask]


To unsubscribe, send the following message in the text section -- NOT the subject header --  to [log in to unmask]
SIGNOFF SDOH

DO NOT SEND IT BY HITTING THE REPLY BUTTON. THIS SENDS THE MESSAGE TO THE ENTIRE LISTSERV AND STILL DOES NOT REMOVE YOU.

To subscribe to the SDOH list, send the following message to [log in to unmask] in the text section, NOT in the subject header.
SUBSCRIBE SDOH yourfirstname yourlastname

To post a message to all 1000+ subscribers, send it to [log in to unmask]
Include in the Subject, its content, and location and date, if relevant.

For a list of SDOH members, send a request to [log in to unmask]

To receive messages only once a day, send the following message to [log in to unmask]
SET SDOH DIGEST

To view the SDOH archives, go to: http://listserv.yorku.ca/archives/sdoh.html