I am/have been on staff at about 20 hospitals. I’ve served as a medical executive and currently work with surgeons, primary care, neurologists, OB/Gyns, family practice…
WE WHO ARE FREE OF THE INFLUENCE OF MEDICAL PAPER PUSHERS IN CHICAGO BOUND TO “PLAY FOR PAY”, WE WHO PRACTICE ON THE FRONT LINES OF HEALTH CARE, WE DO NOT SUPPORT THE CURRENT HOUSE BILL FOR HEALTH CARE REFORM. FURTHERMORE, WE CHASTISE THE AMA AND AARP FOR COMPROMIZING THEIR PRINCIPLES FOR THE SAKE OF POLITICS AND THEIR AFFILIATIONS WITH MACHINE GOVERNMENT WHICH IN FACT WILL JEAPORDIZE THE THE HEALTH CARE FOR MILLIONS MORE THAN THEY INTEND TO HELP.
GIVE US FOCUSED INSURANCE REFORM, TORT REFORM, MEDICARE REFORM !!!!!!!!!!!!!!
I recently listed some of the causes for the rapid rise in healthcare costs. As far as I can tell, the rise in healthcare costs can be attributed to the following defects in public policy:
• Taxes: My company—a C-corp—pays for healthcare insurance with pretax dollars; Individuals cannot. Cost adder to individuals 30% – 50%, depending on tax bracket and state.
• Insurance limitations & mandates: Large companies buy insurance across state lines under Federal EREISA guidelines; Small businesses and individuals must purchase health insurance from state-approved carriers. Thus, large companies choose from 1300 plans, while individuals & small businesses have a much smaller selection, made even more expensive by state mandates. In many states, 1 or 2 insurers control the 60% – 80% of the small business market. Cost adder to small businesses & individuals – 18% (national average).
• Medicare/Medicaid under-reimbursements – In most states, Medicare & Medicaid underpay doctors/hospitals for procedures, forcing healthcare providers to shift unpaid costs to the private sector in order to stay in business. In Wisconsin (which ranks near the bottom in this respect), this cost-shifting is adding 50% to healthcare premiums. Nationwide, this cost adder is 36%.
• Medical Malpractice costs – Many studies show that the threat of medical malpractice lawsuits encourages ‘defensive medical’ practices–unnecessary tests & procedures prescribed in fear of Malpractice lawsuits. Cost adder – 7% – 30%.
My company’s average health insurance costs $5,000/person; An individual must earn $7,000 to have enough left after taxes to buy the same: A large business who can purchase coverage across state lines pays only $4,300 for that coverage. Because Medicare & Medicaid underpay providers, shifting unpaid costs to the private sector, that healthcare should only cost $2,700.
To recap… My company’s health insurance costs $5,000/person. An individual must EARN $7,000 – $7,500 to have enough after taxes to buy the same. A large business can purchase coverage across state lines & pays only $4,300 for that coverage. Medicare & Medicaid underpay providers & shifts unpaid costs to the private sector, so that healthcare should only cost $2,700! $7,500 to pay for a $2,700 bill! How fair is that?
Other cost adders:
• Increase in use of advanced healthcare technology – More MRIs, CAT Scans, Ultra-sounds. In essence, we are paying for effective treatments for cancer, heart disease, etc., that were not available decades ago. In my view, these are not necessarily a bad thing. Often, you get what you pay for.
• Population lifestyle choices – I’ve seen a number of estimates that health-related side effects of lifestyle choices consume up to 75% of healthcare expenses. The largest is obesity, a lifestyle choice. Obesity is linked to diabetes, several cardiovascular diseases, cancer, erectile-dysfunction, brain-shrinkage, GERD, or gastroesophageal reflux disease, and many other diseases.
Just one example – Average healthcare costs for normal, healthy people are approximately $5,000/year. Average healthcare costs for COMPLIANT diabetics are over $11,000/year. Average healthcare costs for NON-COMPLIANT diabetics are over $20,000/year. Rising obesity rates are a PREDICTOR of rising diabetes rates and subsequent healthcare costs.
Given the aging population, the rising obesity rates, current public tax policy and regulation, tort and public program systems, we’re in for rough sledding.
By: Mike Conlin on November 6, 2009
at 2:16 am
Do doctors support the Medical Device Safety Act of 2009 so that patients can protect themselves from the politically influenced FDA? Rights that were taken away by the Supreme Court in Reigel v. Medtronic.
http://caselaw.lp.findlaw.com/scripts/getcase.pl?court=US&vol=000&invol=06-179
http://thomas.loc.gov/cgi-bin/bdquery/z?d111:SN00540:|/bss/111search.html|
By: Mark Baird on November 6, 2009
at 6:03 am
I don’t know of a single MD who would not stand up for a patient hurt by deceptive, criminal or grossly negligent actions of a fellow physician, hospital or medical equipment manufacturer. On the other hand, I also do not know of a physician who would support penalizing a manufacturer for an isolated, unanticipated/unexpectedly failed piece of equipment; some percentage of all machines fail and that is not a crime. True crimes should be punished–harshly, but unintentional mistakes and failures, regardless of the degree, should be seen as human. I have not read the Medical Device Safety Act but if it has the teeth necessary to discourage fraudulent merchandising and use of bad equipment, then I’m for it. If it is instead a tool legislating payoffs to injured parties regardless of criminal intent of gross negligence, then I would consider it an example of the true ills within our legal system and malignant nature of our entitlement geared society. Before I support penalizing a company such as Medtronic, who employees hundreds (thousands?), has advanced medical science and in doing so has saved countless lives, I would expect definative proof of wrong doing. If the Supreme Court turned their back on such proof I would consider that criminal as well, and I think most my peers would agree.
Thanks Mark
By: pissydoc on November 6, 2009
at 8:20 am