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