Senate Republicans left their last lunch meeting before a weeklong recess optimistic that they can at least start working on their own version of a health care bill, with something on paper to discuss when they return in June. Any half-reasonable health care reform proposal, including mine, provides some system of charity care; whether via medicaid, government run hospitals (VA for everyone, county hospitals), premium subsidies or vouchers, support for charity hospitals, and so forth; and in our society the government will have a big part in this; I do not appeal to private charity alone.
Today, most governments recognize the importance of public health programs in reducing the incidence of disease, disability, the effects of ageing and health inequities , although public health generally receives significantly less government funding compared with medicine.
Physician advice, if given in the appropriate context, such as through motivational interviewing and considering the patient’s environment (moving beyond the health belief model into the social cognitive model for instance) is more effective in achieving sustainable behavior change.
Also, many health insurers that would have no issues paying for a PSA test or screening colonoscopy in a 90 year-old would balk at reimbursing home renovations, even though the latter is much more likely to prevent (rather than cause) a hospitalization.
The redefinition of the output of the health sector as the treatment of disease implies a different allocation of consumer spending for health care services (across diseases rather than goods and services) and also different price indexes than those published in the NIPAs.