Tuesday, August 28, 2007

Affordable Health Care Attacked

The Detroit News of August 27th has a news article titled "In-Store health clinics take off." It's about the growth of small convenience clinics sprouting up in chains such as Meijer and CVS in the Detroit area. I think these clinics are a great idea. Their low-cost helps the poorer part of the population as well as being open at night when doctors' offices are closed. This may even help alleviate some after hours visits to hospital ERs for non-emergency treatments. The article by News writer Jonnelle Marte list the pros and cons of the clinics:

Advantages

Prices for services are usually listed openly and range between $30 and $100.

Most health insurance companies are accepted.

Retail clinics are usually open seven days a week and in the evenings. No appointment is necessary.

Clinics have little or no wait time and visits are usually over in 15-20 minutes.

If you don't have a primary care physician, most clinics will refer you to a doctor in your area.
Disadvantages

Medical treatment is provided by nurse practitioners and physician assistants, not doctors.

Most clinics treat only a limited scope of illnesses, like colds, allergies and infections.

Retail clinics are not for people with serious health conditions or long-term illnesses.

Retail clinics are not for infants. Many clinics require patients to be at least 18 months old.
Services offered
The types of services offered at retail health clinics varies per clinic, but most offer vaccinations and treatment of common minor illnesses including:

Allergies

Bladder infections

Bronchitis

Eye, ear and throat infections

Sinus infections

Strep throat

Stomach flu

Minor sprains

Skin conditions such as cold sores, sunburns, poison ivy and ringworm

Vaccinations: Flu, Hepatitis A and B, polio, meningitis, pneumonia
But, as the main headline reveals "Quick, low-cost outlets prompt medical turf war", this is about political control.
But the growth has prompted the American Medical Association to issue a nationwide advisory calling for states to regulate the clinics -- which operate in places like CVS, Wal-Mart, Target and Meijer -- out of concern that there may be a conflict of interest between the clinics and the pharmacy chains that host them, as well as gaps in holistic care of patients.
Needless to say, more regulations will add time and cost to these clinics and defeat their purpose. But the real issue here is one of individual rights. Do corporations have the right to provide such services? Yes they do. Do individual citizens have the right to seek the kind of health care they want? Our constitution says yes. The state and apparently the AMA, say no.

It's been said that government must do something about the uninsured. Well:
Some clinic officials say they're providing affordable care for people who'd otherwise go without.

Juliet A. Santos, president of Early Solutions Clinic, said that about 40 percent of her patients are uninsured. "We are seeing a majority of people who don't have insurance and they're looking for access and affordability."
The free market would provide all the health care needed if the government would just get out of the way. After all it's common knowledge that the high cost of health care is due to Medicare, Medicaid, government creation of HMOs, the FDA and regulations.

Sadly, the article adds that regulations are in the works:
In response to doctors' concerns, the Michigan State Medical Society is working with Michigan's Department of Community Health to establish statewide regulations for in-store clinics by the end of the year.

Among the guidelines they'd like to establish are a limit to the scope of illnesses that can be treated and a patient referral system to local doctors. They also want care providers -- typically nurse practitioners or physician assistants -- at retail clinics to be clear about their qualifications at the outset of a visit. And they want the clinics to maintain electronic records and communicate with patients' primary doctors, said David Fox, medical society spokesman.

Many clinics are developing networks of local doctors for referral when patients require care beyond what they can provide.

"We are an adjunct to the medical providers in the regions," said Kent Lillemoe, chief financial officer of MinuteClinic, the largest U.S. provider of retail-based health care, which expanded to the Detroit area less than a year ago. "We are not trying to be a medical home for everyone."
I don't know how these regulations will affect the clinics, but I think they have an inalienable right to offer those services without government interference.
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