January 13, 2013

A better way for medical care

The United States provides some of the best medical care in the world.

Yet, we lag behind some other nations in the use of technology in medical records. Our system imposes upon its residents one of the world’s highest costs, as a share of gross domestic product. We have one of the highest rates of residents unable to receive medical care. And, without major innovation and reform, we will be unable to produce prosperity for our children and health for our elderly.

These seemingly contradictory facts are not surprising, once one understands how medical care is delivered in this country. The system was designed three quarters of a century ago so large companies could attract new workers but without offering higher wages. Employers provide health care by paying insurers, and insurers pay providers to care for workers. It has produced a patchwork system that discourages worker mobility just as corporations are unable to commit long term to their employees. Our system has also evolved to treat the disease rather than the customer, and ties workers with pre-existing conditions to employers rather than to a better skills match.

The good news, though, is that there are some excellent examples of innovation, especially right here in Clinton County.

The strength and weakness of health care American style is that it rewards greatness. A renowned surgeon or specialist, a highly reputable teaching hospital, or an innovative clinic attracts those who demand the best and can afford it. Excellence is rewarded, and prima-donna professors at medical-research centers encourage it. Often, the general practitioner becomes a mere middleman between patient and specialist. There is a distinctive hierarchy, with medical salaries keeping score.

Our system directs more and more of our medical-school graduates to the more scarce and rarified specialties that garner the greatest salaries to pay off their exorbitant student loans. This bias toward the best encourages excellence, but at a price.

Text Only | Photo Reprints
  • ken_wibecan.jpg Another day in the life

    Each morning I rise from bed, slowly, as is my habit, and sit quietly on the bed contemplating the day that looms before me, writes columnist Ken Wibecan.

    August 19, 2014 1 Photo

  • PPR small talk mug 081714 Corner store is no more

    Columnist Gordie Little offers a reminder of the little grocery stores of days gone by.

    August 17, 2014 1 Photo

  • PPR skin deep mug 081714 High-end products worth the splurge

    Regardless of the price, writes columnist Felicia Krieg, she would buy the core group of her makeup products over and over again.

    August 17, 2014 2 Photos

  • paul_grasso.jpg Tax code needs overhaul

    Corporations may be criticized for exploiting loopholes, but it is the complex tax system that is at fault, according to columnist Paul Grasso.

    August 17, 2014 1 Photo

  • Hagar_mug1.jpg Ideas about soil health changing

    New techniques like no-til and cover crops can make soil healthier than conventional tillage, according to columnist Peter Hagar.

    August 17, 2014 1 Photo

  • colin_read.jpg Economy may have changed forever

    The Great Recession has reordered the workforce in a way that makes it unlikely it will ever be the same, according to columnist Colin Read.

    August 17, 2014 1 Photo

  • Terry_Mattingly.jpg The dark side of fun funerals

    Something strange happened in American culture in the past decade or two: People started planning fun funerals, writes religion columnist Terry Mattingly.

    August 15, 2014 1 Photo

  • PPR fit bits mug Developing power key to success

    While strength is important, the ability to generate power is required for many basic activities in life, writes columnist Ted Santaniello.

    August 12, 2014 1 Photo

  • PPR you had to ask mug 081014 Time to reel in youth sports parents

    Do not scream at a child that he's a loser, at least not in a language he understands, columnist Steve Ouellette writes.

    August 10, 2014 1 Photo

  • colin_read.jpg Treating corporations like people

    Problems arise in many areas when businesses take on the attributes of individuals as mandated by the court, according to columnist Colin Read.

    August 10, 2014 1 Photo

Peter Black: Canadian Dispatch

Lois Clermont, Editor

Cornell Cooperative Extension

Richard Gast: Cornell Ag Extension

Bob Grady

Guest Columns

Peter Hagar: Cornell Ag Connection

Health Advice
Ray Johnson: Climate Science
Gordie Little: Small Talk
Terry Mattingly: On Religion

Steve Ouellette: You Had To Ask

Colin Read: Everybody's Business

Pinch of Time