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I recently received the following e-mail from a relative who was diagnosed with diabetes in the past year:

"I went to the diabetes doctor today and he was giddy. My A1C went from 8.8 to 6.2. I was down from 200 pounds on Super Bowl Sunday to 180 in the doctor's office - with shoes on. He thanked me for being the first patient he saw today that weighed less than 280. He did not give me a lollypop."

This relative tends to hail from the left, so I could not pass up the opportunity to inject a civics lesson:

Great job!  Congratulations on YOUR good work.

Who should get the credit? You-- or your doctor? I personally think you did the work, but your doctor's giddiness proves that your obedience is the exception rather than the rule.

Those who wrote ObamaCare want to set up a system of "Pay Per Performance." They want to reward physicians who have patients with good results like yours and dock those physicians who have patients whose numbers always seem to come out bad.

With "Pay Per Performance" the "worst" patients, the sickest or most non-compliant, would be handed off to a specialist. The special list would be happy to keep any "good, compliant patient" who listens to his doctor and realizes that following good advice is in his own best interest.  But before long the specialist might pass the toughest patients off to the University Medical School-- where the patient would then be taken care of by ....... an intern!  How ironic!  And how dumb.

This is what happens when the central planners try to dictate "best practices" and measure "success."  Under ObamaCare, Accountable Care Organizations will be formed where "providers are held more accountable for the total cost of the care for the patients, thus encouraging holistic care that addresses conditions and frequency of illness and injury."  The problem lies with the fact that outcomes often reflect patient behavior far beyond the ability of the physician to control.

http://www.horizonhealthcareinnovations.com/our-commitment-accountable-care-organizations.html

Our state is planning to give "merit pay" to teachers.  How can the bureaucrats measure success?  Your nephew received a perfect score on his SAT's, graduated summa cum laude from undergrad and has aced all his classes for the first two and a half years of medical school. His mother could only wish she had home-schooled him, as she would have enjoyed the "merit pay." These bright kids barely need teachers at all, but seem to soak up the information like sponges.  So are scores the best way to assign "merit pay" for the teachers?

In contrast, the most difficult kids, those who grow up in the inner city, who are constantly enticed by drug dealers, or who do not know who their fathers, will not have the same good scores. These distracted at-risk kids actually require the more skillful teachers, those who can captivate their minds and help them to understand why an education can be a ticket out of poverty and misery. But how would bureaucrats measure the "performance" of these dedicated teachers? I submit that they cannot.

Parents or guardians ought to be able to choose the best teachers by sending their children to the best public or private schools. If every child received a "scholarship" that could be applied at any school, the students would be more likely to wind up in a school that meets their needs best. Good schools would emerge all over-- with motivated administrators hiring motivated teachers and competing for the parents and students to choose them.

Likewise, patients need to choose their physicians, not by looking at a list of "preferred providers," but by evaluating their training, and listening to testimonials of friends and nurses who know them.  Then they should be able to access their own health savings accounts to pay the doctor that provides the greatest value-- kind, accessible, compassionate, and skilled medical care. High deductible insurance, purchased from the company of his choice, would be affordable and needed only when a major medical event occurred.  Note the expensive bureaucracy that would be avoided.

Things are not going well in this country. Health care and education are too expensive and the lack of consumer choice is the biggest reason. Let's hope things change on November 2nd and we have a chance to make a real difference.

Just thinking....

But keep up the good work-- would you like to be my patient?

I might need you to keep my numbers up!

Dr. Alieta Eck, MD graduated from the Rutgers College of Pharmacy in NJ and the St. Louis School of Medicine in St. Louis, MO. She studied Internal Medicine at Robert Wood Johnson University Hospital in New Brunswick, NJ and has been in private practice with her husband, Dr. John Eck, MD in Piscataway, NJ since 1988. She has been involved in health care reform since residency and is convinced that the government is a poor provider of medical care. She testified before the Joint Economic Committee of the US Congress in 2004 about better ways to deliver health care in the United States. In 2003, she and her husband founded the Zarephath Health Center, a free clinic for the poor and uninsured that currently cares for 300-400 patients per month utilizing the donated services of volunteer physicians and nurses.  Dr. Eck is a long time member of the Christian Medical Dental Association and in 2009 joined the board of the Association of American Physicians and Surgeons. In addition, she serves on the advisory board of Christian Care Medi-Share, a faith based medical cost sharing Ministry. She is a member of Zarephath Christian Church and she and her husband have five children, one in medical school in NJ.