We are Ready

     The issue of primary care is a very interesting one in both the public and the private sector of health care systems. In the private U.S system we have companies which provide immediate specialty care to patients, companies such as Blue Cross and Aetna. When paying their higher premiums, some plans allow you to access specialty care immediately or spend minutes with a general practitioner in order to get a referral. Other companies such as Keiser allow you to pay a lower general premium than the other companies; however they put a higher emphasis on the use of GP’s and a full consultation with a primary care physician or “gate keeper” is always required, and specialty referrals are difficult to come by.
     To understand whether the American people are interested in seeing a “gate keeper,” we can turn to the customer satisfaction statistics available through JD power [http://www.jdpower.com/healthcare/ratings/health-plan-ratings/california]. Here one can actually see that Americans (in California at least) were most satisfied with a system in which GP’s were employed to reduce costs. I am not sure what the customer satisfaction was due to, but low costs would be my immediate guess. Now that we have established that Americans are ready for a primary care system, let’s analyze further.
     It is my personal belief that we should adopt a nationalized health care system or at least a system in which the government guarantees that every citizen has a basic level of health care provided for him or her. In terms of primary care, there are two countries with polar opposite philosophies in terms of primary care - Japan and the U.K.
     Japan has a system that has eliminated primary care for the most part. The population is extremely satisfied with the level of care, the longevity of the Japanese are at record highs, but the finances of this Japanese system are in the red. In the U.K, gate keepers are used to keep costs low and satisfaction and longevity are still quite high. With this information in mind, I think it would make both practical and cultural sense for the U.S to adopt a higher level of primary care in order to bring costs down. For ethical reasons, I think we need to make health care the government’s responsibility. 

     On another note, Massachusetts (arguably the state with the most progressive health care system) has just passed legislation to strengthen its own primary care system [http://www.aafp.org/online/en/home/publications/news/news-now/government-medicine/20080813masslegislation.html].