AN INTERNATIONAL TREND TOWARD SELF-DIRECTED CARE

[Guest guest]

AN INTERNATIONAL TREND TOWARD SELF-DIRECTED CARE

Critics of consumer-directed health care often argue that

patients are not knowledgeable enough and the market is not transparent enough

for consumerism to work in health care. But a study by The Commonwealth

Fund says there is an international trend toward self-directed care (SDC) and

it is focused on a most unlikely group of patients: the frail, the old, the

disabled and even the mentally ill, says John C. Goodman, President, CEO and

the Kellye Wright fellow of the National

Center for Policy

Analysis.

For example:

In the

United States,

Medicaid " Cash and Counseling " programs -- underway for over a decade

-- allow home bound, disabled patients to manage their own budgets and choose

services that meet their needs.

In Germany and Austria, a cash payment is made to

people eligible for long-term care -- with few strings attached and little

oversight on how the money is used.

In England and the Netherlands,

the disabled and the elderly manage budgets in a manner similar to Cash and

Counseling in the United

States.

Also

in this country, Florida and Texas have SDC programs for patients with

serious mental illness and the Veterans Administration has an SDC program

operating in 20 states for long-term care and mental illness.

Further, it appears that we have barely scratched the

surface in taking advantage of patient power opportunities. The greatest

potential in this area is in the treatment of chronic illness. Studies

show that chronic patients can often manage their own care with results as good

or better than under traditional care; and if patients are going to manage

their own care, it makes sense to allow them to manage the money that pays for

that care, says Goodman:

The

British National Health Service (NHS) is already contributing to SDC budgets

for muscu­lar dystrophy, severe epilepsy and chronic obstructive pulmonary disease.

 

The

NHS believes it is saving money in reduced hospital and nursing home costs.

The

NHS is also about to launch pilot programs that will include mental health,

long-term chronic conditions, maternity care, substance abuse, children with

complex health conditions and end-of-life care.

The advantage of empowering patients and families in this

way are straightforward: lower costs, higher quality care and higher patient

satisfaction, explains Goodman.

Source: John C. Goodman, " An International Trend Toward

Self-Directed Care, " Health Affairs, April 9, 2010.

For text:

http://healthaffairs.org/blog/2010/04/09/an-international-trend-toward-self-directed-care/

For Commonwealth Fund study:

http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2010/Feb/1370_Alakeson_intl_devel_selfdirected_care_ib_v2.pdf

For more on Health Issues:

http://www.ncpa.org/sub/dpd/index.php?Article_Category=16