A study of the commonwealth fund shows that there appears to be an international shift towards self directed care focusing mostly on the elderly. This is not surprising in the least if you really think about it. The government is oftentimes the one paying the bills through Medicare, so of course they are going to want to get the best service for the lowest price available. Doing this does not mean blindly trusting the physicians, but means getting educated and making smart decisions.
- 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.
Another major focus of the SDC (Self directed care) movement is people with chronic issues. This again should come as no surprise as these people have the most time to get educated about their disorder and the treatments. They also are the ones that will be spending the largest amount of money treating their diseases. By allowing the patients to make more of their own decisions, all costs across the board get lowered. Hospital costs, insurance costs, doctor fees, medical costs, and prescription costs, which saves both the patient and the governments money. Also, since the customer is not acting under any source of interest aside from getting the best care for themselves, they can insure the quality of what they receive. This is definitely a step in the right direction.