Tuesday, March 25, 2014

Altman part 1

Altman began the book by telling about his personal dilemma of deciding on whether or not to put his 96 year old mother through triple bypass heart surgery.  He did this to introduce the problems with American healthcare. He personally faced a decision on whether to put his fragile mother through a possibly life threatening procedure or to let her die naturally.  He said cost was not a central issue in his problem despite the fact that it is among the most prominent problems in the American system.  The rest of the section was devoted to thoroughly describing the attempts of the Nixon and the Clinton administration to improve the american healthcare system.  In Altman's description of the Nixon attempts he mentions the emergence of the HMO idea.  I found his description of HMO's interesting because before reading I had only heard of the name.  I feel the HMO model is a good concept for governmental cost control in its set salaries for doctors; however i also feel that this practice could harm the quality of care that doctors give by decreasing the incentive for quality care and also decreasing the incentive for student to become doctors.  
Altman also described the attempts of the Clinton administration and I was surprised at how fiscally centered many of his plans were. Due to party stereotypes, I would have assumed the Clinton administration would have been less fiscally responsible. At the end of this section Altman described earlier attempts at universal health care by the bolsheviks, and by FDR (which we read about in the last book).  I found it interesting to see how the issue evolved both inside and outside the US.  


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