> The demand for barefoot doctors (real doctors) is intense. But the
> longer time you spend on one patient interfers with the cash flow of
> seeing many patients all conveniently lined up in beds for morning
> rounds. Fifty dollars for one patient, or fifty each for ten.
That's a problem I can't see a solution to yet. A good health care system would have a lot of contact between caregivers and the patients, but as things are they would be paid on the level of nursing home employees, or home health care workers. My wife, whose first husband had MS, tells hair-raising stories about the exploits of the latter, not to mention the struggles she went through as a well spouse.
> Pretty soon you are spending half your week going in for tests.
Often, patients seem to work harder than the health care workers!
> Yeah but, diabeties usually shows up as an acute condition (I
> think). Then the treatment keeps it from becoming acute again.
The chronic nature of diabetes is that it is a malfunction of the blood sugar regulation systems (actually a family of a couple of dozen malfunctions or so). If it isn't caught by routine blood testing, it may show up as an acute condition, but by that time it is pretty far advanced.
> The kind of chronic conditions I had in mind are the slow progressive
> type
> things like arthritis.
Or MS, etc. Genetic therapies or stem-cell-derived therapies may eventually do something with them.
> Treatments like various kinds of herbal teas
> and heat and cold treatments and modest kinds of exercise which might
> be possible traditional approachs treat the symptoms of course and not
> the disease.
Well, I wouldn't knock symptomatic treatment, if the basic causes can't be attacked. Better less suffering than no treatment at all.
It seems to me, though, that when one is designing a better health care system, the questions of what conditions should be treated and what treatments should be considered eligible for coverage by the system, and especially the question of how answers to these questions should be obtained, are even more important than the "spiraling costs" subject, but are not discussed as much.
Jon Johanning // jjohanning at igc.org __________________________________ A gentleman haranguing on the perfection of our law, and that it was equally open to the poor and the rich, was answered by another, 'So is the London Tavern.' -- "Tom Paine's Jests..." (1794); also attr. to John Horne Tooke (1736-1812) by Hazlitt