Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Sunday, August 4, 2013

Just As Good

All the hype about healthcare reform and the Affordable Care Act and Obamacare reminds me of an article a friend sent me a couple years ago.

The basic idea is that you can't have more people covered and better quality of care for less money. So concessions need to be made somewhere.

The article, written by David Kent, entitled, Just-as-Good Medicine, and published in American Scientist,  March/April 2010 issue, is not only informative, it's extremely well-written and entertaining. Please read it.

And here's the first paragraph, to whet your appetite:

The rabbi’s eulogy for Sheldon Kravitz solved a minor mystery for my father: what was behind the odd shape of the juice cups he had been drinking from after morning services for the last few years? Adding a bit of levity while praising his thrift and resourcefulness, the rabbi told of how Sheldon purchased, for pennies on the dollar, hundreds of urine specimen cups from Job Lot, that legendary collection of pushcarts in lower Manhattan carrying surplus goods—leftovers, overproduced or discontinued products, unclaimed cargo. At the risk of perpetuating a pernicious cultural stereotype, for men of my father’s generation like Sheldon, raised during the Great Depression, bargain hunting was a contact sport and Job Lot was a beloved arena. My father, too, would respond to the extreme bargains there with ecstatic automatisms of purchasing behavior and come home with all manner of consumer refuse, including, and to my profound dismay, sneakers that bore (at best) a superficial resemblance to the suede Pumas worn and endorsed by my basketball idol, the incomparably smooth Walt “Clyde” Frazier. My father would insist that such items were “just as good” as the name brands. But we, of course, knew what “just as good” really meant.

1 comment:

  1. Very interesting article, which I just passed along to a couple of colleagues who are into health policy. In the course of discussing “decremental cost-effectiveness", Kent makes other crucial observations: that most consumers can’t comparison shop for emergency or esoteric procedures, that price rationing has its own drawbacks, and that implicit rationing already occurs in aggressively shortened hospital stays and added "hassle factors" that makes care harder to obtain. Thanks for the link.