What Spain Gets Right on Health Care

cp418

https://www.nytimes.com/2017/05/11/opinion/health-...

What Spain Gets Right on Health Care

kcat2013

Hmm, interesting. I've long thought that expanding community based health care centers would do more to benefit the poor and/or underinsured. Having primary care easily accessible and affordable would be very good. In my area many primary care doctors are not accepting new medicaid patients because of the insanely low payout that medicaid pays to providers. This in turn forces more of the poor to the emergency room for non-emergency conditions, continuing the upward spiral of healthcare costs. And leaving these people without good follow up on their health problems, since that is what primary care docs do, not ER docs.

cp418

I totally agree with what you said about PCPs turning away medicaid AND medicare patients. It does put the burden on the ERs which are not meant to provide non-emergency care or patient follow-up. Also, don't forget there are some hospitals who are for profit vs non-profit and an appendectomy might cost $10K in the non-profit but $30K in for profit. Insurance will pay extra to the hospital for profit. The whole health care system needs to be re-examined including the insurance companies and drug costs.

I could see these community based health care centers staffed with Nurse Practitioners (NPs) and not by Primary Care Physicians. Hopefully they would be overseen by an MD in charge to confirm/approve the medical care and medications dispensed by the nurses.

kcat2013

Yes, I think everything needs an overhaul--like charging accurate prices for services. For example either my Lupron shot truly costs 1500.00 or it costs 250.00--my MO's office would bill for my Lupron and my old insurance would pay 1500, my new insurance deems that the "reasonable cost" for it is 250.00. Which is it?? Is the 1500 inflated or is the 250 underpaying??