Abstract
“It is only because of multiple payer system that we in the United States have been able to defer these tough economic choices on funding.”
This week I have the honor of visiting colleagues Dr Pal Ramesh and Dr Andy Goldberg in London, England. We will share ideas about foot and ankle care, innovation and publishing in the global economy.
Although excited by the travel, the “opportunity cost” of leaving my practice is arguable the biggest financial consideration. One irrefutable reality of private practice is that overhead allocations remain more or less the same whether you are in session or not. In other words, there is a value to your time at home and away.
Just as I value my time I also value the time of my patients. The value of time is what I feel is the major distinguishing feature that separates the Canadian health care system, which I trained in, from the US health care system where I practice. To be clear I am referring to the subset of the US health care system where patients have insurance coverage and freedom of choice to pick their provider. The economic equation of disease or injury includes the cost of medical care but also the value of the patients’ time when waiting for care and the negative drain on the economic system secondary to decreased productivity as they wait to return to full employement.
In a single payer financial model, system goals are paramount. Health care is administered to the best of the ability of the providers while meeting obligatory financial budgets. This is not wrong but instead an economic reality. It is only because of multiple payer system that we in the United States have been able to defer these tough economic choices on funding. This does, however, mean that care, although individualized, is based on treatment algorithms without as much consideration of the individual social or economic needs.
The United Kingdom has a hybrid system of public and private working to provide the same goals of other nations: different health care systems with respect to funding, yet the same orthopaedic care delivered to our patients.
So this week I will not only learn some new orthopaedic techniques and discuss innovative products but also perhaps gain an understanding of a different perspective on funding. It is clear to me that in t he next few years we will see innovation in all health care arenas including funding models.