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Politics : A US National Health Care System?

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To: skinowski who wrote (6728)	5/1/2009 1:12:50 PM
From: i-node	Read Replies (1) of 42652

There seems to be a strong trend towards using PA's and nurse practitioners in place of MD's. This trend, obviously, will continue. I doubt, however, that costs will be much lower as a result - and I can't see how quality could be better. Totally agree with you. One of the points we're hearing a lot is that you can save tons of money by gaining efficiencies, and I would be the first to say you can almost always find efficiency gains somewhere. But we're not going to get the kinds of savings merely by making things more efficient. You hit the nail on the head a couple weeks ago when you discussed tiered health care. Those who can't afford their own can get a reasonable level of care from a PA; those who can afford to see a physician of their choosing can do that. I'm not sure how you implement this in the context of facilities and medications. The trend toward outpatient facilities surely would continue. Would the "lower tier" health care be restricted to generic meds only? One thing is certain. You are not going to cover another 20 or 30 million people with "free" health care and cut costs at the same time unless you're willing to make some pretty hefty sacrifices in the overall quality of care.

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