Access to Medical Care: Common Sense for Doctors, Patients, and the Public
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About this ebook
This book offers a common sense, many-sided approach to America's present medical delivery problems, and the more than forty-five million American citizens who have no medical insurance.
Dr. Dahlberg writes both to the family that is searching for better medical care, and to doctors who seek to improve it.
Sample chapters include: What Makes Medical Costs Rise The Costliest Medical Tool The Medicine She Never Took Payment Up Front: The Uninsured Electronic Records Medical Insurance
Keith Dahlberg MD
Keith Dahlberg, MD is a graduate of Syracuse University and SUNY Upstate Medical University. He took his residency at Denver's Presbyterian Hospital combining a year each of general medicine, OB/GYN, and general surgery. Under the American Baptist Churches International Ministries, he served in Burma (now Myanmar) for five years as physician and surgeon at their hospital in Kengtung. When Burma closed to foreigners in 1963, he and his family transferred to Thailand to open a new hospital for hill tribe people at Maesariang. He has worked a total of ten years in Thailand, at Maesariang and at Kwai River Christian Hospital at Sangklaburi. In 1967 he entered family practice in Shoshone County, Idaho, at first in a six-member partnership, later in solo practice. He returned to Thailand for another four year term from 1977 - 8l. He retired from office practice in 1994 at age 65, and continued part-time practice for another ten years as a "locum tenens" supplying doctor's offices, emergency rooms, and hospitals needing a temporary doctor, across nine states plus further work in Thailand, Myanmar, and Papua New Guinea. He has focused his fifty-year career on family practice for those who have financial or geographic difficulty finding adequate medical care. He and his wife Lois reside in Kellogg, Idaho. They have four adult children and nine grandchildren. This is his fourth published book.
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Access to Medical Care - Keith Dahlberg MD
ACCESS TO
MEDICAL CARE
COMMON SENSE FOR
DOCTORS, PATIENTS, and the
PUBLIC
KEITH DAHLBERG, MD
iUniverse, Inc.
New York Bloomington
ACCESS TO MEDICAL CARE
COMMON SENSE FOR DOCTORS,
PATIENTS, and the PUBLIC
Copyright © 2009 Keith Dahlberg, MD
All rights reserved. No part of this book may be used or reproduced by any means, graphic, electronic, or mechanical, including photocopying, recording, taping or by any information storage retrieval system without the written permission of the publisher except in the case of brief quotations embodied in critical articles and reviews.
iUniverse books may be ordered through booksellers or by contacting:
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Because of the dynamic nature of the Internet, any Web addresses or links contained in this book may have changed since publication and may no longer be valid. The views expressed in this work are solely those of the author and do not necessarily reflect the views of the publisher, and the publisher hereby disclaims any responsibility for them.
ISBN: 978-1-4401-7452-0 (pbk)
ISBN: 978-1-4401-7451-3 (ebook)
Printed in the United States of America
iUniverse rev. date: 9/28/09
Contents
Preface
Chapter One:
Dealing With Our Fear of the Future
Chapter Two:
What Makes Medical Costs Rise So Fast?
Chapter Three:
The Costliest Medical Tool
Chapter Four:
The Medicine She Never Took
Chapter Five:
Some Other Medical Costs under Doctors’ Control have less acceptable reasons to exist.
Chapter Six:
Making access to a doctor easier
Chapter Seven:
Payment up front, and the uninsured
Chapter Eight:
Communicating With Your Doctor
Chapter Nine:
More on Communication
Chapter Ten:
Electronic Records
Chapter Eleven:
Population Growth
Chapter Twelve:
Lowering the Cost of Care: Medical Insurance
Chapter Thirteen:
The Patient’s Role
Chapter Fourteen:
Watchdogs and Government Interference
Chapter Fifteen:
Other Important Players in Reducing Medical Costs
Chapter Sixteen:
Where Do We Go from here?
Chapter Seventeen:
Working Together
Notes
Preface
Most Americans agree that the cost of medical care is growing out of control, but we disagree on a solution. Some say, Keep government out of it. Let private enterprise fix the problem, like it has always done.
Others reply, Everyone needs access to medical care, but it is being priced beyond our ability to pay for it.
Private enterprise has not fixed it, so far, and the cost is still rising. It’s not going to get better by itself.
The President and Congress are trying to respond to the need, with some progress, but no consensus yet at the time of this writing.
President Obama has (in my opinion) chosen some practical goals:
1) Affordable medical insurance for all Americans
2) Emphasize preventive care
3) Electronic records
4) Lowering over-all cost while maintaining quality of care, by addressing cost overruns, fraud, education methods that don’t work, and getting the waste out of entitlement programs (Medicare, Medicaid, VA, etc.)
Some people object to the cost, some others doubt that government bureaucrats can keep anything simple; still others object because their beliefs oppose drastic change to the status quo. But the continuing growth of the present medical delivery system will very soon make that status quo unreachable even for a nation as rich as the United States.
The purpose should not be to construct a large new expensive system. The goal is to lower the overall cost while improving the care. That turns out to be a complicated job.
Personal Disclaimer and Credentials: The purpose of this small book is not to promote a political viewpoint, but to suggest some practical ways to help reach the goal of access to medical care for all.
My suggestions are based on a half century in medical practice, in America and abroad, plus opinions offered by neighbors, patients, and professional colleagues along the way. No one’s experience is complete, and I welcome any reasoned counter-arguments to what I have to say.
I entered the medical system in 1948, as a hospital orderly and ambulance rider. I completed college in 1950 (pre-med, BA in chemistry, at Syracuse University.) I earned my MD in 1954 from SUNY’s Upstate Medical University at Syracuse. My internship and residency training was at Denver’s Presbyterian Hospital (one year each in general internship, obstetrics, and surgery.)
I joined an American overseas organization and spent the next ten years practicing tropical medicine and general surgery, opening and managing a hospital, first in Burma and then another in Thailand. I was a doctor on salary, working amid a national socialized medicine environment.
Beginning in 1967, I entered private medical practice in an Idaho mining town, first in a group, later solo, plus another four-year term in Thailand.