Dr. Winn is the founder of e-MDs ambulatory electronic medical records systems located in Austin, Texas. After seeing the post on my blog and 
watching the video, he offers his response. By the way, this is the last evening you can watch the documentary for free and for a reasonable fee you can purchase the DVD as well. It is suggested material for use at hospitals and other healthcare institutions. I happen to know Dr. Winn and his sentiments are real and authentic. I have had a few others email to say thanks for including this information at the blog from hospital CEOs and a few others.
I do have to also mention that he shares the same sentiments I often mention with healthcare reform, and that is the lack of confidence with our current Congress to fully understand what is happening and in my opinion, it lags from most members probably not being an active participant in their own healthcare. In other words with the prescription being talked about for everyone for managing healthcare, you have to participate to see value and without that experience, you just can’t get what everyone else is doing and talking about. It sadly appears we have no participating role models today, just a lot of “its for those guys over there” and items in the news that seem to indicate mixed or little progress with true reform of US healthcare. BD
“Money drives everything in a free market, capitalistic system and that, in theory, improves competition and quality. Due to the complexity of illness and the difficulty for consumers to comparative shop and due to a perverse payment system by the insurance industry (Wall street rewards insurance companies with higher stock prices for cutting costs – ie. withholding/denying payments), U.S Healthcare does not operate efficiently in such a free enterprise model (and certainly not in the best interest of patients) when constrained by such factors. Intermountain has an interesting model of employed physicians who are expected to apply quality metrics to the treatment of certain conditions.
Aided by an EMR, they track physician performance along best practices and meet regularly with physicians to show them how they are doing. Actual performance data compared to peers helps outlier physicians to understand where they are deviating from best practices and modify their performance accordingly. Without good data, personal bias and anecdotal experience tend to blind physicians to where they might have deficiencies. As a self insured, not for profit entity, Intermountain is able to wield the EMR to show higher quality and do so at a lower price than traditional hospital/physician groups.
Many healthcare providers are happy with the status quo. They know how to ‘game the system’ by cranking up ‘visit’ volume, invasive procedures or gimmicks like chelation therapy – and get quite rich doing so, but this is not in the best interest of their patients or society in general. I believe the U.S. will continue to lag behind the world health community (W.H.O.) in quality scores and morbidity/mortality until something drastic is done.
By drastic, I believe the entire health insurance industry needs to be disbanded in favor of not for profit physician/hospital owned communities like Intermountain. I believe the savings from eliminating the insurance middleman would more than pay for a universal healthcare system. EMR technology and the expansion of chronic disease management and prevention as envisioned by such models as Intermountain and the primary care driven Medical Home will make this possible. Whether or not Congress has enough courage and moral conviction to stand down the insurance industry is the rate limiting step IMO.”
In addition, here’s a letter Dr. Winn furnished that he has written and sent to President Obama. You can double click or follow this link to read the enlarged version. BD
Dr. Mr. Obama - Dr. David Winn
Money Driven Medicine The Documentary – Streaming During the Month of November So You Can Watch for Free
I should have been on to this sooner, but thank goodness for Twitter as I received a message about it today and say thanks for letting me know. There are a few days left in November so you can watch the 85 minute documentary. I have written about it and watched myself so here’s a few notes below from my prior posts. Part of the entire theme here is to practice medicine wisely and not just do more to get paid more, and, involve and care for the patient, make healthcare revolve around the patient and care, not paperwork and administration.
Money Driven Medicine – Taking Back Healthcare from the Bill Moyer Show
Related Reading:
E-mds solutions software released to include continuity of care ...
e-MDs and QuadraMed Join Forces to Integrate and provide solutions for ambulatory EHRS and Hospitals
If we're going to have to have single-payer insurance, then we need this kind of input to keep it from being too disastrous. But I'm not giving up in my fight to stop it. Dr. Winn may have the best single-payer health care plan, but the odds are against him that it would be implemented exactly in this way. Even if it was, all it takes is the next batch of politicians who don't have Dr. Winn's understanding to mess it all up for everybody. That's what's wrong with centralizing anything. If insurance companies are so lousy, then we have to ask ourselves, why are people purchasing it? Well they're not in most cases. Their employers are. It's not so much that the insurance companies are the middle man. Employers have become the middle man to acquiring insurance. Employers just provide insurance required by the government, not giving much thought as to the quality and whether insurance companies follow through. Employees accept passing on the responsibility to employers instead of taking it upon themselves to be sure they are going to get what they pay for. Again, it's regulation, not the free market that's keeping consumers from making the right decisions. It's so much simpler, efficient and effective to remove regulation to solve our problems. Not to add more.
ReplyDeleteI do have to agree on one item, employers should not have the stronghold that they do today, it messes everything up. When you run the numbers volume gets discounted pricing and the single person can't keep up.
ReplyDeleteWe should take the profit out and return to non profit as insurance was originally designed to spread the cost out over the largest group possible.