Bill, I think I hear what you are saying. If I may be so bold as to add a few thoughts. First, I do think healthcare should be viewed as a business. However, I think we look at it as a national commodity when in fact it is a service...a vital service, none the less a service. To further complicate matters we have taken this "commodity" and made it a "right" to "have access" in our conversations around how to regulate. So, strictly speaking from a business model, or more specifically an economic model we do not have true "free market" economic principals in play. Namely, supply and demand. Here is another way to look at it. If you or I had to take what we do as therapist and "package" it in a way that the consumer would buy it, I fear that most consumers would not buy. When I say consumer I do mean the end user not the "fiscal intermediator" or any other entity that holds the purse strings. So what is the answer? I think in part is lies (at least in the US) with "cleaning up" the insurance industry. This includes Medicare and all private insurances. It would involve new innovative ways of thinking that are actually not new. Give the consumer control. One of the "products" that I think could be useful in changing the paradigm is HSA's (healthcare savings accounts). You can find plenty of info on-line (try HSA.com) that speak to particulars. In a nutshell, these are insurance products that are a high deductible policy matched with a savings account that is interesting bearing and is yours. It is not dependant upon your employer. Something like this would have to be phased in gradually starting with 18 year olds. The power in a product like this is the same as any interest bearing accounts--compounded interest over time and it rolls over from year to year. This is so unlike any of the so called FSA's that do not encourage saving but spending. Anyway, at the end of the day we would be "selling" our services to the consumer and not to congress. I do see a place for congress to be involved, but on a limited basis and simply to provide oversight and safeguards where necessary (like making sure it is portable from state to state). Hope this makes sense.
Neal C. Luther,OTR/L Rehab Program Coordinator Advanced Home Care 1-336-878-8824 xt 3205 [EMAIL PROTECTED] Home Care is our Business...Caring is our Specialty The information contained in this electronic document from Advanced Home Care is privileged and confidential information intended for the sole use of [EMAIL PROTECTED] If the reader of this communication is not the intended recipient, or the employee or agent responsible for delivering it to the intended recipient, you are hereby notified that any dissemination, distribution or copying of this communication is strictly prohibited. If you have received this communication in error, please immediately notify the person listed above and discard the original.-----Original Message----- From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] On Behalf Of Bill Maloney Sent: Saturday, November 08, 2008 12:28 PM To: OTlist Subject: Re: [OTlist] doubling patient in acute rehab On the subject of DB/DT: ethics, rules, varying standards of individual clinical practices, etc. notwithstanding, the bottom line is PROFIT. If you look very closely at ALL clinical settings, the bottom line has to be "healthy" (seemingly at whatever cost) or the business fails. With the US economy faltering, business owners, board members and trustees are more than likely interested in the path of least resistance when it comes to ethics, i.e. as long as you're not doing anything harmful enough to hurt business, rock on. I am absolutely and certainly not implying, in any way, that the "suits" don't hold themselves to high standards of ethical business behavior (perhaps some do, perhaps some don't). I am just jaded, I guess, by all the improprieties that are regularly surfacing from behind the scenes in the corporate world. Healthcare is no different, it is a business. The questions I would have are two: 1. The cart before the horse: does the business side of healthcare exist and do what it does to keep the wheels spinning in order for us to provide excellent care to our recipients; or do we provide our service to the recipients as a means of generating revenue for the business (is the dog wagging the tail, or vice-versa)? and 2. When you've applied ethical framework guidelines to how you're practicing, and asked all the appropriate questions, and answered them to the best of your interpretation, do you stay put or move on to something that better aligns with your personal practice philosophy? Thanks, Ron and others for allowing freedom of expression on this site. Bill Maloney, OTR -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
-- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
