[kitchencabinetforum] EMPOWERING PATIENTS AS KEY DECISION MAKERS

Empowering patients as key decision makers must be the foundation of any health system. Karen McKeown points out the current trend of rapidly rising health care costs is unsustainable. Many proposed reforms to curb spending rely on some type of rationing imposed by an unaccountable government body.

A better alternative would be to allow individual consumers to make their own decisions about care, including the self-rationing of medical services, based on cost and their own desires. Such a policy is compatible with libertarian values of limited government and individual liberty and responsibility. State and federal policymakers should adopt measures to facilitate personal control of health care decisions.

This sensitive issue cannot be fully explained in a post, but only in a speech, in that magic eyeball to eyeball contact, baring my soul, and declaring truths that cause shock and awe. That's why I look forward to the invitation of your organization to speak at your conference. Basil Venitis, venitis@gmail.com

McKeown notes health care costs are consuming ever larger portions of the gross domestic product (GDP). There is broad bipartisan agreement on the need to control these rising costs and to control federal entitlement spending in general, including spending on the giant health care entitlements Medicare and Medicaid. http://venitism.blogspot.com

However, the standard approach to limiting federal health care spending is to limit federal payments for medical goods and services. This limitation, in itself, is a form of health care rationing. In fact, rationing of one form or another is already a routine feature of public and private health insurance arrangements, although it is often covert, opaque, or subtle in its implementation.

For policymakers and the public, the basic question is not whether there should be rationing in health care: It already exists. Economics itself is an exercise in rationing among goods and services because limited resources cannot purchase unlimited goods. The crucial question is: Who should make the rationing decisions?

McKeown says citizens value personal liberty and self-rule, libertarian values at the heart of political culture. Given these values, Americans have consistently resisted any health care proposals that threaten to undermine these principles as they understand them. Although they acknowledge the problem of health care spending, including rising government spending, Americans are unlikely to accept rationing decisions made by a European-style pseudoindependent body or an unaccountable government agency. Instead, policymakers should seek a libertarian solution that enables individual patients to make the key decisions about their care in accordance with their own preferences, beliefs, and values. This is especially important in decisions relating to end-of-life care.

McKeown asserts that to achieve this level of patient engagement, policymakers must reduce or eliminate barriers to patient decision making, including patient ignorance of and insulation from the true costs of care, the lack of information on medical prices and options, and medical malpractice and inadequate skills among doctors and nurses and other medical professionals in dealing with an engaged patient.

Smart words are more effective than smart bombs! Mighty words of a charismatic keynote speaker can transform your people to a new dimension of organizational climate, efficiency, self-actualization, enthusiasm, belonging, and motivation. I would like very much to speak at your conference in order to explain this issue much further. Basil Venitis, venitis@gmail.com

Policymakers need to make the health care sector far more transparent. They can do this by promoting a free market for health insurance coverage in which prices and the content of insurance are clear and transparent; creating an information-driven system of choice to enable patients to better understand the range of available benefits and services; enacting medical malpractice reform in the states where it is sorely needed; and encouraging better education of medical professionals to prepare them to communicate more effectively and clearly with all patients, including those facing a long illness or the end of life itself.