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Healthcare regulation: past, present, and future
1Ohio University College of Osteopathic Medicine, Athens 45701-2979.
The Journal of the American Osteopathic Association
|January 1, 1994
Summary
Excessive healthcare regulation hinders patient care by introducing barriers and intermediaries. Reforms should prioritize the patient-physician relationship over process controls.
Area of Science:
- Healthcare Policy
- Medical Regulation
- Physician-Patient Relationship
Background:
- The historical evolution of healthcare policy has led to a highly regulated system focused on cost containment.
- Government and private regulatory agencies increasingly intrude upon the patient-physician relationship.
Purpose of the Study:
- To examine the history of healthcare policy and the rise of regulatory controls.
- To detail the impact of specific regulations on the patient-physician dynamic.
- To advocate for reforms that respect the patient-physician relationship.
Main Methods:
- Historical analysis of healthcare policy from 1900 to the present.
- Examination of the effects of Diagnosis-Related Groups (DRGs).
- Analysis of Utilization Review (UR) firms' role.
- Assessment of the Clinical Laboratory Improvement Amendments of 1988 (CLIA).
Main Results:
- Diagnosis-Related Groups empower hospital administration to monitor patient care.
- Utilization Review firms act as gatekeepers, questioning the appropriateness of care.
- The Clinical Laboratory Improvement Amendments have led to laboratory closures, limiting patient access to care.
Conclusions:
- Excessive regulation creates significant barriers for physicians treating patients.
- Proposed reforms aim to remove undue regulatory control from the patient-physician interaction.
- Future regulation should focus on outcomes rather than dictating healthcare delivery processes.