Posted by alexandra_k on January 2, 2015, at 15:33:19
In reply to Re: psychiatry is an ougrowth of society, posted by alexandra_k on January 2, 2015, at 14:45:14
and of course bad philosophy is just awful, too. i'm sure there is some good work out there in economics...
the health system here...
You can pay a bunch of money to make an appointment with whichever GP has an appointment slot available.
Or... You can enroll with a particular clinic as your Primary Health Organization and then if you make an appointment there it is significantly cheaper.
Because the government contributes a certain amount of funding to clinics on the basis of the demographics of the people they have enrolled there.
The clinics get bonuses for things like having high need demographic people enrolled there. Bonuses for the number of Maaori and Pacific Island people enrolled there. Elderly people. Low income. Etc.
The clinics get bonuses for other things. Targets that the government sets. The government might have an objective like 'we want to increase the number of Maaori and Pacific Island kids who are immunised against the following diseases...' Then the clinic gets a bonus for the number of immunisations they give to the target kids. Lots of stuff like that. Cervical smears. Prostate exams. Etc.
When I went to the student clinic here they started out by making me fill out a form that involved them asking me about all kinds of things like that. So they knew which of their current targets they should target me for. Because it meant more money for them.
I then had to meet with a nurse. Since the government contributes a certain amount toward all PHO enrolled GP visits the government will save a significant amount of money if it can persuade me to prefer to see a nurse rather than a doctor wherever possible. So... That first meeting... The clinic made me meet with a nurse so as to build rapport etc etc etc to coax me nurse-wards in future. The clinic got a bonus for that. A bunch of research is starting to come out now on how people prefer to see nurses, they relate to them better etc etc etc. To help justify shunting people to nurses wherever possible. It isn't because the government said so / because it is cheaper for the government. It is because that is what patients prefer!
Just like what happened for me at community mental health where the nurse simply would not let me see a doctor...
_____
Lets suppose that I want the health care that is best for me. I don't want a GP pressuring me to get this or that mammogram or injection or whatever because it is in the PUBLIC's interests (according to some way of doing the math).
Lets suppose that I want my health care to be about ME instead of THE MAJORITY. The best thing I can do is to NOT enroll with a PHO. That way... The doctor is working for ME and not for the government.
Of course this doesn't have to be all or none. GP's are allowed to ask patients to contribute whatever they like over and above the amount the government contributes (unless the want a special bonus for agreeing not to go over and above a cap to help promote low income patients who they will also get a bonus for). So... You can contribute more towards your visit for less government interference. You can contribute more towards your visit for less homeless people in the waiting room, prettier secretaries, a little bit of art... more plants.
But but really what it is about is: A doctor who listens to YOU. Rather than the government.
That is what those assessment forms are about... The government / the health insurance company. It isn't about YOU it is about the healthcare industry. Which is about health about as much as the personal training industry is about training...
But the surest way to have the doctor work for me, rather than the government, is to ensure that the doctor doesn't get any bonuses for anything that does or doesn't happen with me. That way they are looking out for ME rather than the government / populations.
Then all I have to worry about is...
Pharma.
ahaha.
poster:alexandra_k
thread:1074584
URL: http://www.dr-bob.org/babble/social/20141123/msgs/1074733.html