stat counnnter

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.

7 comments:

softwareNerd said...

The AMA is one of the country's influential unions. They might yet be able to squeeze this good development.

Galileo Blogs said...

I concur with softwarenerd. The AMA's sole concern is with preventing competition.

I like the entire concept behind the clinics. Going to a doctor for a prescription for an antibiotic is an extremely inefficient waste of time and money. The doctor is over-qualified to provide that; years of medical school are not necessary to issue a drug that I can buy over-the-counter in Mexico. It is also a tremendous waste of time having to visit a doctor for something so minor.

The same argument applies to getting flu vaccines and all the rest.

The AMA will do their best to protect their turf, but this is an unprincipled losing battle. Since these regulations are enacted state-by-state, the walk-in clinics will simply open up where they are permitted and then pressure the other states banning them to open up.

I predict that these clinics will spread to nearly all states within 10 years. The AMA will lose this one.

Anyone have any good stock recommendations for this sector?

-GB

Mike N said...

SN and GB: I agree completely. The AMA is a union and doesn't like competition. These clinics are a good example of private enterprise filling an economic demand when free to do so.

I don't think it will help much but I'll write a few letters to my Reps and an LTE to the papers.

If anything, what these clinics offer to the public should be expanded, not limited.

Myrhaf said...

When I get a free moment, I will blog about this post and look at the ways government interferes with the free market in health care. Most people are unaware of how government has hampered health care, so when they look at the current crisis, like Michael Moore they want more government -- they want more of that which caused the crisis!

Mike N said...

Myrhaf:
I'll be looking forward to that post.

Mike N said...

This comment was moved from another post where it was accidentally placed.

Lori said...
You say a disadvantage to retail clinics is that they are staffed by nurse practitioners or physician's assistants. I realize you are quoting the article, but are you familiar with what it takes to become a nurse practitioner? I do--I am in a program now; we are tested at the same level as medical students and held to the same expectations. We even attend many of the same lectures and have the same clinical experiences. We can specialize just like doctors. When we graduate and pass our national certification exams, we are expected to perform as well as our doctor counterparts do--in whatever specialty we are in.
In other words, it is not a disadvantage that nurse practitioners staff these clinics!

Mike N said...

Lori:
Yes I was quoting the article. I should have made my own evaluation of the pros and cons clearer. I have high respect for nurse practioners and physician's assistants and I want to thank you for letting me and my readers know what kind of training such professionals undergo. I agree completely that such professions should not have been listed under "disadvantages."