Obama em defesa da reforma
O Presidente Obama proferiu um importante discurso link no encontro anual da American Medical Association (AMA) link
"Se não corrigirmos o nosso sistema de cuidados, a América seguirá o caminho da GM - pagar mais, receber menos, até à falência."
O que representa a maior parte dos nossos custos resulta da natureza do nosso próprio sistema de prestação de cuidados de saúde - um sistema em que se gasta grandes quantidades de dinheiro em coisas que não são necessariamente indispensáveis para tornar o nosso povo mais saudável, um sistema em que os cuidados mais caros não equivalem a melhores cuidados.
"Se não corrigirmos o nosso sistema de cuidados, a América seguirá o caminho da GM - pagar mais, receber menos, até à falência."
O que representa a maior parte dos nossos custos resulta da natureza do nosso próprio sistema de prestação de cuidados de saúde - um sistema em que se gasta grandes quantidades de dinheiro em coisas que não são necessariamente indispensáveis para tornar o nosso povo mais saudável, um sistema em que os cuidados mais caros não equivalem a melhores cuidados.
Etiquetas: USA health 2
3 Comments:
As impertinências do Dr. Who...
A defesa da reforma passa, indiscutivelmente, por melhores cuidados, reduzir as más práticas médicas e organizar melhor os serviços de Sáude...
Na realidade, os EUA, vivem uma posição insustentável na relação custos/benefícios. E são um grave problema social os fenómenos de exclusão que esses "erros" ajudam a criar (mais graves nestes tempos de crise).
Isto é o "be-a-bá" da gestão (clínica, administrativa, financeira e social), mas não podemos continuar a bater no ceguinho...
Os americanos têm de mudar de conceptualidade política e económica e começar a questionar a compatibilidade do neo-liberalismo com as mudanças. Pensar como moderar os lucros das grandes companhias farmacêuticas (de marca e de genéricos), das grandes cadeias de farmácias e das companhias de seguros, como no referido artigo, comenta, com alguma oportunidade, um tal "Dr. Who", ao que julgo um incógnito comentador (...médico?).
Aliás, as questões que se levantam, nos EUA, sobre a reforma da Saúde, à primeira vista, são uma espécie de "matéria dada", há muito tempo, por cá (refiro-me à UE).
Claro que há Organizações e Instituições de Saúde modelares nos States, onde muitos portugueses fizeram ou fazem formação médica com um alto nível de especialização.
Mas, não podemos confundir "alhos com bogalhos".
Nos serviços e, portanto, nos cuidados dependentes das empresas de seguros (do ramo saúde), onde incidirá o cerne do actual e complexo processo de reforma quando à sua universalidade, há de tudo um pouco.
Do bom ao péssimo...
Basta ir aos Congressos e amenamente conversar...
Nancy Nielsen, the AMA’s outgoing president, and J. James Rohack, who will become the group’s president tomorrow, are holding a press conference to respond to the speech. Here’s what they’re saying.
1:43 Nielsen speaks. She says the AMA was delighted that the president came to address the group. “Like the president, the American Medical Association is committed to covering all Americans.” Everybody deserves affordable, high-quality coverage. The AMA has been working on this issue.
1:45 “The president was very warmly received,” she adds, and starts to take questions. (The audio is difficult to hear, but we’ll do the best we can.)
1:46 The group was “thrilled” that this was the first Democratic president to talk about liability reform.
1:47 Over the next days, the AMA will figure out the way it can best help the president reach the goals they share, which is affordable health insurance for all Americans.
1:48 Rohack speaks. Both the president and the AMA share the goal of all Americans having affordable health coverage and to not have the emergency room be the access point for health care. The AMA is also excited about the president’s emphasis on prevention.
1:49 Nielsen speaks. On malpractice-liability reform, the AMA knew Obama was opposed to a cap on damages. “But what we were very pleased about was that he is open to considering options that would lower the cost of defensive medicine.” He acknowledged the issue, which pleased the AMA.
1:50 Rohack speaks. Because of the advances of medical science, life expectancy is 10 years longer than when Medicare was first started. There’s improved technology, improved ways to take care of patients. But 50 million people don’t have affordable health insurance. We’re committed to trying to reform the system.
1:52 “We are at a watershed moment in our country,” Rohack says. He echoes the president’s emphasis on the importance of health care to the economy and again talks about preventive care.
1:55 Nielsen speaks. The AMA is committed to Americans having choice, and the president talked about that today as well. Choice of coverage, choice of doctors.
1:56 On the public plan, Nielsen says the group has tried to be “open to whatever possibilities are actually in play, being considered in Congress, rather than reacting to a label.”
1:58 On the idea of a health-insurance exchange, Rohack says the principle of “choice” is very important. Right now, Americans have a hard time finding different options. It is cumbersome to search for a plan. Rohack talks in a positive light about the choices that federal employees have. “It was clear that the president was also signaling his awareness that the patient-physician relationship is very important,” while at the same time having options for insurance is important. The exchange is a model.
2:00 Nielsen speaks. On comparative effectiveness, the president said that people think this means dictating what people have to do. He said that wouldn’t be the case. Getting good information that doctors and patients need — that’s what everybody agrees on.
2:03 Rohack says the president’s coming there today recognizes the important role that doctors play in health care. The AMA represents all doctors in the U.S. His coming recognizes that doctors are there for their patients, and if doctors don’t believe reform will be good for their patients, we’ll let our patients know.
2:05 Nielsen says the president indicated that putting a label on something before knowing what it is, is not the best way to handle this debate. Don’t look at labels, don’t let fear-mongering or rhetoric get in the way of plans we haven’t yet seen. We have to get to the goal of health care for all Americans. “It is the best chance and maybe the last chance in a decade.” We also want to get rid of the labels and wait until you hear what people are talking about.
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2:07 Asked what would make any plan unpalatable to the AMA, Nielsen says it would be taking away decisions from the patients and their doctors.
2:08 Rohack says the president signaled a recognition of a crisis and a need to solve it. He echoes the president’s point about the difficulty that patients with pre-existing conditions have getting health insurance. Doctors reacted enthusiastically to the president when he said that problem needed to be solved.
2:09 On primary care, Rohack says that systems that seem to control health-care costs the best, nationwide and internationally, they have a place where a patient has a “home” and can get coordinated care. Primary care is extremely important, but there are also specialties, such as general surgery, that are also in short supply. We have an opportunity to “deal with this burden of debt that the average student comes out with.” They’re choosing specialties based on their ability to pay off that debt. We want to work with the president to achieve a common goal of affordable health insurance and a work force that can provide them with care.
2:13 Nielsen says that the reality is that doctors make a good living, by and large. But they’ve also had difficulty keeping offices open. They have difficulty paying rent and paying their employees. Students come out of medical school and residency with $140,000 in debt. We have to get back to doing what we do best: caring for patients.
2:14 Rohack talks about the administrative burden of dealing with a lot of different insurance companies.
2:15 Rohack talks about Obama’s mention of hospital readmissions. Some of this has to do with a law that prevents doctors from providing IT services for hospitals. Patients go home and they don’t have their records. “The reality is we don’t talk to each other, still,” he says, referring to hospitals and doctors. Different organizations have electronic systems, but those systems don’t talk to each other, and that contributes to readmissions. The AMA is committed to working on this, and is doing so right now. Interoperability standards are key.
2:18 On malpractice reform, Rohack says the president showed he knows that part of the health-care cost problem is due to defensive medicine. We are willing to have best practices, but unless we have protection in a court room for not ordering a test, we are going to order the tests. Doctors need a “safe harbor.” That will help cut unnecessary costs, including defensive medicine.
2:19 The press conference is over.
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