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WHO SPEAKS FOR YOUR DOCTOR
We hear a lot from the media about the proposed great health care reform. Yet, who speaks for your doctor? Despite playing a critical role in this health reform, his thoughts are not considered.
Why are not the doctors at the negotiation table? They can offer practical constructive solutions for the health care reform and certainly have insight into why our health care system is so non-functioning.
Certainly, doctors are as concerned with increased government intervention as you are. They also are aware of what a greater expanded role of the federal government will mean for our healthcare: they certainly know firsthand how broken our medical system is.
DOES THE AMA SPEAKS FOR YOUR DOCTOR?
Certainly not! The American Medical Association has only 15 % of all doctors as members. Most of the membership consists of hospital-based doctors from large medical centers. They join so they can dictate policy for their hospitals.
The AMA has pledged to work with the white house committees and leadership to build support for the white house health plan. They seek funding the new coverage for the uninsured by cutting payments to doctors and hospitals in Medicare and Medicaid. All of this is certainly not the view of your doctor.
Over 17 state medical associations and three specialty organizations recently broke away from the AMA. Many state hospital associations balk at the $155 billion across-the-board Medicare cuts planned. None of this will change the delivery of healthcare services. Over half of the American hospitals will be operating at a deficit or close to it when these cuts are implemented.
Mayo Clinic, upheld by Pres. Obama as a model for reform, also had unkind words to say about the House bill. “It misses the opportunity to help create higher-quality, more affordable health care for patients. In fact the opposite will be true, since the proposals are not patient focused or results orientated. The losers will be the citizens of the United States”.
SGR
Doctors seek repeal of the sustainable growth rate, or SGR, (a formula that Congress created mandating automatic cuts in physician payments if entitlement spending rises to steeply.) Because of this, next year the cuts to doctor payments will increase 22%.
Doctors despise the SGR, since Medicare prices are already 30% lower than those of private insurers. Congress threatens to pay even less for the medical goods and services it wants to buy.
The SGR is a political attempt to control health spending. Certainly is a. preview of expansion under Ocala’s care package.
WHAT BIG MEDICARE CUTS MEAN TO YOU
As deeper cuts in Medicare occur, many doctors may stop treating Medicare patients. Some doctors will compensate by shifting their costs onto their other private patients or they must make up in volume what they lose on margin and Medicare.
CUTS ELIMINATE SPECIALISTS
Congress must wring out new savings by underpaying doctors and hospitals, and it will be easy because Congress controls the bulk of US health dollars.
Especially hard hit will be the specialists who provide expensive treatment that the White House decided is wasteful and not necessary. Gradually our specialists will be converted into civil servants, as they are in Britain and Canada. All of medicine will function like Medicare does today, but far worse.
HEALTHCARE DEFICITS
The Medicare and Social Security trustees reported recently that healthcare costs are driving out long-term entitlements. With many families taking less pay these days, household budgets are being strained, and health insurance is not affordable.
State and local governments are also feeling the pinch. Money that was earmarked for investment in areas as education and overall economic growth now must go for health care.
Healthcare costs can be reduced over time without impairing the quality of care or outcome. In some areas the volume of healthcare services are skyrocketing.
This higher spending does not appear to have better health outcomes then in areas with less spending. More intensive tests and procedures and additional days in the hospital, and procedures do not promote health.
Some academic medical centers are receiving twice as much Medicare money in the last six months of patients’ lives, with no better medical outcomes.
SAVE 30% WITH NO COMPROMISE IN QUALITY
Pres. Obama feels that health care costs could be reduced 30% or about $700 billion a year without compromising the quality of care. Certainly major efficiency improvements in healthcare are possible, but they don’t add up to one-third of all money spent.
The government wants to obtain more health information technology and measure effects. They push for more research on what works and what doesn't work, eliminating recommended treatments that don't improve health.
Lets provide people with prevention and wellness information so they can stay healthy. Change the financial incentives for doctors so that they are not penalized for delivering high quality care at lower costs. Steps have been taken to provide resources for electronic medical records, patient centered health research, and some prevention and wellness interventions.
Medicare changes are paying hospitals less when they don't get patient treatment right the first time. This can reduce the number of patients who need to endure readmission to hospitals.
RATIONING MEDICAL SERVICES
We all talk about how rationing of medical services will be alarming, but rationing of services already exists today. The insurance industry has contributed to this health care crisis by cherry picking only healthy people to insure.
A single-payer program will ultimately lead to health care rationing of services, especially for the elderly, who are the sickest and most vulnerable. Rationing for patients, will result in fewer treatment options for them, and increased difficulty for them to see a doctor.
HEALTH CARE INSURANCE COMPANIES
Today there are only a couple of healthcare insurance providers. Insurance, by having multiple insurance providers, results in free enterprise and maximum efficiency.
Insurance companies are responsible for the high cost of healthcare. They set the premiums, they do the reimbursements, and they squeeze everyone by their schemes. All of this is the name of profit, not health care.
When you have a different premium price for people with pre-existing illnesses you deny insurance to those who need it the most. Instead of making people wait, elective procedures would just be denied altogether to people who don't have insurance. That's the American way of rationing.
GOVERNMENT AND INSURERS BOTH WIN
Make the insurance companies accountable to insure all patients who have a pre-existing illness. Have one premium level for all insurance participants. Cover the cost of insurance for those who can't afford it through a fund. (It could be funded by taxing activities that increase the risk of illnesses as tobacco and alcohol.)
Many doctors today already are not accepting Medicaid because of dwindling payments, tremendous paperwork, and delays in payment, long waits, and impersonal attention. It will be nice for everyone to have insurance; the problem will be that many will not have doctors.
Medicare already out sources to private health insurers, and this will be a big boon for them. Volume will go up, profit margins will rise, as government-sponsored cost-effectiveness research demonstrates that expensive medical treatments are not proven effective.
This will be another win-win game for the government and health insurers. It's all about numbers. Shipped to preventive health care, and a healthy will be happy and is sick will be shoved aside.
A PUBLIC ONE PAYER SYSTEM
The proposal by Congress that participation in a public plan be mandatory has caused a revolt among all physicians who accept Medicare. Insurance options must coexist with any reform agenda, offering a range of proposals on how to make the health care system efficient and more equitable.
As many options as possible should keep open. Primary care societies and large hospital centers favor a one-payer system. They say if a person wants CONCIERGE care he should buy it.
What really is wrong with a two-tiered system? Provide a basic coverage for those who can't contribute, and get a premium plan for those who can pay. We can all get Water, but if you want bottled water, you have to pay out of your own pocket. Or better yet, give us the Premier health coverage Senators Kennedy and Byrd and the rest of congress are getting. (They certainly are not visited by end of life panels.)
Cover treatments for everything clinically significant, and if you want anything else, feel free to buy it.
PREVENTATIVE MEDICINE
Give patients incentives to seek preventative medicine especially in the management of their health lifestyles such as diabetes and hypertension. Initiate a torrid campaign to prevent fitness nutrition and disease prevention
Stop the massive legal defense testing and redundant tests. Eliminate the need for malpractice insurance that causes massive defensive medical testing.
Have a national licensure for nurses and doctors to decrease the cost of multi-state practices. Eliminate the variations in insurance laws that occur state-by-state and unify the method of determining eligibility for health care insurance.
COMMENTARY
If doctors are not included in the discussion of health care, you will find great resistance. Our bright innovative students will no longer want to spend 14 years for medical education after college-- if they are to be treated as civil servants, told what to prescribe, how long they can talk with a patient, and be forced to use cookbook medicine.
Our medical care will greatly suffer with this 1100 page health plan. Ask your doctor what he thinks, and he will give you an earful. A bad plan can’t be packaged beautifully and sold as a great plan.
Lets go back to the drawing board, reset our thinking, take some time and come up with a plan that makes sense and we can all agree on.
And lets hear from our doctors on what they think is needed. Do you want your health plan run as our postal service is run? They are 10 billion in the red and lost over 2.5 billion this quarter. Let people who know health care give us the answers, not our congressional lawyers.
What do you think? Visit www.drneedles.com for more commentary on controversial medical issues.
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