tag:blogger.com,1999:blog-7323692122514281455.post4648115025211149487..comments2024-03-22T17:05:55.267-04:00Comments on MD Whistleblower: Medical Insurance Companies: Heroes or Villains?Michael Kirsch, M.D.http://www.blogger.com/profile/07555280388086931097noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-7323692122514281455.post-9380685920745695382016-05-16T07:10:39.266-04:002016-05-16T07:10:39.266-04:00Appreciate comments above. @anonymous quickly dri...Appreciate comments above. @anonymous quickly drifted away from my primary point - the primacy of personal responsibility. @MC, uncertain I grasp your point that personal responsibility should be morphed into a 'partnership' between patients and professionals. I think in medical care and in life we need to accept the consequences and enjoy the benefits of our decisions. If a physicians advised a screening colonoscopy to an informed pt, and the procedure is declined, then future (or present) unwanted growths in the colon are solely the patient's responsibility. If a financial advisor recommends an investment, and I decline to invest, is it both our responsiblities of the investment's return soars and I have missed out? I think across society there are ongoing attempts to blame others for adverse events.Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-26115014441567823022016-05-15T13:09:19.429-04:002016-05-15T13:09:19.429-04:00I think an earlier blog I wrote this year is relev...I think an earlier blog I wrote this year is relevant to this discussion (http://georgiacontrarian.blogspot.com/2016/01/coproduction-in-health-care.html). It highlights the concept that health care is not delivered by physicians of health systems alone, it is co-produced by "providers" and patient together. It may be best to view this not as a personal responsibility issue but as a co-producer competency issue. Without a competent and engaged patient (and perhaps family) partner in creation of health care outcomes, the outcomes will always be suboptimal. Whether specific investments in optimizing this (?patient education) or changes in incentive structures can improve engagement is an open question. There may be specific individuals where no amount of investment will help. The Medical Contrarianhttps://www.blogger.com/profile/09240492315542223258noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-39830802464842443502016-05-15T08:59:22.193-04:002016-05-15T08:59:22.193-04:00While I agree with personal responsibility your sc...While I agree with personal responsibility your scenarios imply that medical science can foresee or forestall all medical conditions. Treatments and screenings are not perfect and can often do harm themselves (who should pay for that?). Insurance can and should pay for major medical expenses but those expenses should be priced at affordable levels, not at the high levels seen today. Let's face it, today's pricing includes costs that have nothing to do with medical care (administrative costs, bigger fancier hospitals, and yes, profits).Anonymousnoreply@blogger.com