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‘Equity’ Pursuits Don’t Provide Fairness in Our Healthcare System – Brospar Daily News

Daniel Johnson and Robert Moffett

Millions of dollars are spent pursuing “fairness” in our healthcare system while insisting that we have no “fairness” because our entire healthcare enterprise is systemically racist. To achieve this, some even suggest prioritizing care based on skin tone.

This approach is problematic. It creates racial divisions. It also conflicts with the overarching goal of medicine to provide the right care in the right setting at the right time when a patient develops disease or injury, with an emphasis on preventing disease or injury as much as possible.

At a time when we already have so much disagreement and resentment, here’s a thought: why not just agree to focus on delivering the highest level of care to every patient, regardless of race, ethnicity or background? other features?

The words equity, equality and equality mean different things to different people. However, all three share a common goal: fairness. Rather than advocating divisive and discriminatory demands, should we unite and focus on fairness? In health, simple fairness and color blindness are desirable and realistic.

Rather than exploiting racial divisions, a patient-centered approach is ambitious and seeks to achieve true equity by creating unity of purpose. There are many advantages and few disadvantages.

The relationships most critical to achieving equity in the health care system are the doctor-patient relationship, the collaborative relationship between doctors and other members of the health care team, and the relationship between patients and the system. health care.

A patient-centered approach avoids divisive ideologies. It is a positive and ambitious approach that aims to achieve real equity by building, not by reducing.

The three pillars of a patient-centered approach to providing high-quality care at sustainable costs are 1) expanding individual choice, 2) individual ownership of choice in health care arrangements and insurance policies. health insurance, and 3) equitable provision of any government commitment to health. Insurance subsidies and the federal tax treatment of health insurance.

A patient-centered approach assumes not that patients cannot make informed healthcare decisions themselves, but that they can. There are a variety of possible ways to fund and deliver high quality care. Why not pit them against each other and let patients choose what suits them best?

Giving individuals the ability and responsibility to choose and own their healthcare arrangements and insurance – with regular opportunities to change if they are unhappy with their choices – ensures personal control and portability. And, by definition, health plans and others in the health sector will be directly accountable to patients.

Almost all Americans receive some financial assistance when purchasing health insurance, whether it is tax-exempt workplace coverage, some level of government subsidies, or a charity. This help should be the same regardless of race, ethnicity or other characteristics. It’s fairness.

A variety of non-health factors, including housing and transportation, and especially education, can contribute to differences in access to health care. These factors are very real and specific remedies must be provided through sound social and economic policies.

For example, pulling students from all backgrounds out of failing schools through school choice should be a top priority for national and local policymakers interested in promoting equity.

A high-quality K-12 education is designed to provide graduates with the knowledge to find and obtain jobs or pursue higher education, which will allow students to prosper, rather than live in poverty, which will lower expectations. and social and economic outcomes.

In the practice of medicine, to achieve sustainable health systems, health professionals must focus on identifying health disparities and supporting research on how to eliminate them.

Medical education has reason to focus on excellence. No one wants their doctor to hold an MD or CDO as a “participation prize.” Your physician should continue to be motivated to obtain optimal training and lifelong continuing medical education for the type of practice chosen. The medical elite is not a myth.

Likewise, the care provided must be of the highest quality possible for the medical condition in question. Physicians have a moral duty to ensure that this happens. It is not a zero-sum game with winners and losers.

Education and health are closely linked. Promoting individual choice and defined contribution financing has the same benefits in education reform as in health system reform. When responsibility shifts to students and recipients, costs go down, quality improves, disparities narrow, and health care improves.

Equity: everyone benefits.

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Daniel Johnson, Jr, MD, is a diagnostic radiographer in Metairie, Louisiana and past president of the Louisiana Medical Association. Dr. Robert Moffit is a senior fellow at the Heritage Foundation Center for Health and Welfare Policy.

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