Comments on: THE TRAGEDY OF GOVT-RUN HEALTH CARE http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/ Cleaning the Augean Stables of the Health Care Debate Thu, 09 Feb 2012 20:22:13 +0000 http://wordpress.org/?v=2.3.3 By: Marc Brown http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9584 Marc Brown Thu, 01 Nov 2007 19:54:09 +0000 http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9584 Indeed. Thanks to David - he's drawn attention to the latest Commonwealth Fund study: 'A new Commonwealth Fund survey finds that, compared with adults in six other countries, U.S. adults are most likely to go without health care because of the cost and more likely to say that the health care system needs to be rebuilt completely. In addition to cost concerns, the survey analysis, by Fund Senior Vice President Cathy Schoen and colleagues, finds the U.S. has multiple symptoms of less-efficient care.' More at http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=568237 Indeed. Thanks to David - he’s drawn attention to the latest Commonwealth Fund study:

‘A new Commonwealth Fund survey finds that, compared with adults in six other countries, U.S. adults are most likely to go without health care because of the cost and more likely to say that the health care system needs to be rebuilt completely. In addition to cost concerns, the survey analysis, by Fund Senior Vice President Cathy Schoen and colleagues, finds the U.S. has multiple symptoms of less-efficient care.’

More at http://www.commonwealthfund.org/publications/publications_show.htm?doc_id=568237

]]> By: drmatt http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9561 drmatt Thu, 01 Nov 2007 13:53:14 +0000 http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9561 I actually worked in the NHS for six months or so, I understand, Catron trashes anything he doesnt understand. "Sarcasm is the protest of the weak". There is no such thing as a system without problems, no perfect system. The question, to me, is one to be put to the population, "what do you want from the health care system?" we can't have it all, nobody can, but we must first answer that question before we can begin to outline a system that suits us. All this banter, though interesting and educational, is pointless if we (as a society) have not come to some agreement on what we want from the system. I actually worked in the NHS for six months or so, I understand, Catron trashes anything he doesnt understand. “Sarcasm is the protest of the weak”. There is no such thing as a system without problems, no perfect system. The question, to me, is one to be put to the population, “what do you want from the health care system?” we can’t have it all, nobody can, but we must first answer that question before we can begin to outline a system that suits us. All this banter, though interesting and educational, is pointless if we (as a society) have not come to some agreement on what we want from the system.

]]> By: Marc Brown http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9554 Marc Brown Thu, 01 Nov 2007 12:28:59 +0000 http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9554 'Furthermore a system designed to outline, evaluate, and use/pay for (proportionally) medical techniques, tests, treatments and interventions that are actually proven to benifit while causing minimal harm would benefit all of us.' We have such a system in the UK, run by the National Institute for Health and Clinical Excellence (http://www.nice.org.uk). Catron likes to trash the NHS, but it has: - Local primary care purchasing of acute and other services (eg physiotherapy) - Funding by national insurance and direct taxation via both employees and employers - A major new hospital programme - Universal access - Improving access times - now 48 hours max to see a primary physician, two weeks max to be referred to a cancer specialist. - Integrated targets with social care providers. Yes, there are problems in areas such as dentistry. And we share issues with you such as MSRA. But no one here would swap it for your 'system'. ‘Furthermore a system designed to outline, evaluate, and use/pay for (proportionally) medical techniques, tests, treatments and interventions that are actually proven to benifit while causing minimal harm would benefit all of us.’

We have such a system in the UK, run by the National Institute for Health and Clinical Excellence (http://www.nice.org.uk).

Catron likes to trash the NHS, but it has:

- Local primary care purchasing of acute and other services (eg physiotherapy)
- Funding by national insurance and direct taxation via both employees and employers
- A major new hospital programme
- Universal access
- Improving access times - now 48 hours max to see a primary physician, two weeks max to be referred to a cancer specialist.
- Integrated targets with social care providers.

Yes, there are problems in areas such as dentistry. And we share issues with you such as MSRA. But no one here would swap it for your ’system’.

]]> By: drmatt http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9552 drmatt Thu, 01 Nov 2007 11:38:55 +0000 http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9552 Racquetballer, Coburn's plan is pretty much terrible, first he is giving 2k to purchase health insurance? the avg price for a decent plan in this state is about 5K a year for one person and 12k for a family, not taxing income that is used to pay for health insurance only makes a difference if you change tax brackets by buying health insurance. Furthermore his implication that the insurance companies will then "compete" for patients, oh yes, they will compete for healthy patients, the rest of you, with any sign of risk will find yourself constantly shopping for health insurance, choice will not increase, it will decrease. Finally, his implication that you have no choice is also bull, only those on medicare have limited choices, you can see any doc you want, there are no laws forcing you to go to anyone in particular, you just have to decide whether it is worth paying out of pocket for, the lack of choice has been put on us by the very insurance companies he seems to want to subsidize with tax credits, they place financial barriers between you and medical care to decrease thier expenditures. Good luck with that plan, certainly isnt even close to a plan that would inspire me back to clinical medicine!! Racquetballer, Coburn’s plan is pretty much terrible, first he is giving 2k to purchase health insurance? the avg price for a decent plan in this state is about 5K a year for one person and 12k for a family, not taxing income that is used to pay for health insurance only makes a difference if you change tax brackets by buying health insurance. Furthermore his implication that the insurance companies will then “compete” for patients, oh yes, they will compete for healthy patients, the rest of you, with any sign of risk will find yourself constantly shopping for health insurance, choice will not increase, it will decrease. Finally, his implication that you have no choice is also bull, only those on medicare have limited choices, you can see any doc you want, there are no laws forcing you to go to anyone in particular, you just have to decide whether it is worth paying out of pocket for, the lack of choice has been put on us by the very insurance companies he seems to want to subsidize with tax credits, they place financial barriers between you and medical care to decrease thier expenditures. Good luck with that plan, certainly isnt even close to a plan that would inspire me back to clinical medicine!!

]]> By: spike http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9521 spike Thu, 01 Nov 2007 00:25:50 +0000 http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9521 Not to mention that even the most efficient payers will drive up your administrative costs when you have 23 plans that all interpret HIPAA and other regulations slightly differently. the Free market and the proliferation of payers that comes with it is a huge drain on provider groups. Not to mention that even the most efficient payers will drive up your administrative costs when you have 23 plans that all interpret HIPAA and other regulations slightly differently. the Free market and the proliferation of payers that comes with it is a huge drain on provider groups.

]]> By: racquetballer101 http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9514 racquetballer101 Wed, 31 Oct 2007 23:27:24 +0000 http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9514 Why do "we" look to the government to solve our health care issues/problems when they government has proven they can't run a government program like a business to begin with?! I.E. U.S. Postal Service, Social Security, Medicare, Veterans Administration. Has anyone looked at Dr. Tom Coburn's (U.S. Senator) proposed solution to the health care problem? http://coburn.senate.gov/public/index.cfm?FuseAction=HealthCareReform.Home I would be intersted in anyone's opinion about his solution. Thanks. Why do “we” look to the government to solve our health care issues/problems when they government has proven they can’t run a government program like a business to begin with?! I.E. U.S. Postal Service, Social Security, Medicare, Veterans Administration. Has anyone looked at Dr. Tom Coburn’s (U.S. Senator) proposed solution to the health care problem? http://coburn.senate.gov/public/index.cfm?FuseAction=HealthCareReform.Home

I would be intersted in anyone’s opinion about his solution. Thanks.

]]> By: Scott http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9508 Scott Wed, 31 Oct 2007 21:14:35 +0000 http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9508 I would agree with most comments here. Private practices are getting hit quite hard (especially PCP's) from both sides of the fence in terms of reimbursement. As this study shows: http://www.physicianspractice.com/index/fuseaction/articles.details/articleID/933.htm Quote: "According to our sixth annual national survey of fee schedules, average physician reimbursement from commercial payers and Medicare collapsed in 2006, with payment levels averaging 17 percent below that of 2002 and a staggering 36 percent below that of 2004." With that being said; at one point in my life I was consulting a physician that was losing an awful amount of money in his practice. Well it didn't take me long to figure out that his top five payers (by encounter) reimbursement was dreadful; the allowable’s were way below Medicare. After contacting these payers / networks, I come to find out; due to some obtuse contractual language the doctor was getting reimbursed from the fee schedule available at the time of the contract agreement. These fee schedules were not updated unless the doctor requested a review (which never happens). In other words, these fee schedules were not being updated to reflect fair market value as the years went by. No real recourse there but to cancel the contracts and start over; you have to be aware at all times in this business or prepare for a bumpy ride. I would agree with most comments here. Private practices are getting hit quite hard (especially PCP’s) from both sides of the fence in terms of reimbursement. As this study shows:

http://www.physicianspractice.com/index/fuseaction/articles.details/articleID/933.htm

Quote: “According to our sixth annual national survey of fee schedules, average physician reimbursement from commercial payers and Medicare collapsed in 2006, with payment levels averaging 17 percent below that of 2002 and a staggering 36 percent below that of 2004.”

With that being said; at one point in my life I was consulting a physician that was losing an awful amount of money in his practice. Well it didn’t take me long to figure out that his top five payers (by encounter) reimbursement was dreadful; the allowable’s were way below Medicare. After contacting these payers / networks, I come to find out; due to some obtuse contractual language the doctor was getting reimbursed from the fee schedule available at the time of the contract agreement. These fee schedules were not updated unless the doctor requested a review (which never happens). In other words, these fee schedules were not being updated to reflect fair market value as the years went by. No real recourse there but to cancel the contracts and start over; you have to be aware at all times in this business or prepare for a bumpy ride.

]]> By: drmatt http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9500 drmatt Wed, 31 Oct 2007 18:35:06 +0000 http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9500 In regards to the title "The Tragedy of Gvovernment-Run Health Care". Terribly inaccurate, the health care in this tragedy is not run by the government, it was run by the doctor, who chose to accept a govt insurance plan. She closed her practice for the same reason I closed mine, she moved into a community where the proportion of people on sub standard insurance was greater than those on reasonable insurance. With good conscious and integrity she accepted the members of her community, unfortunately the math was against her. If you are under the impression that the government insurances are the only ones that will put you out of business you are sadly mistaken. In my community I accepted 23 different types of health insurance, out of those, three were government run (govt run insurance, not health care) and there were four that paid a reasonable reimbursement rate. The remaining 16 paid as poorly and in many cases worse than the "govt plans" and often had more beaurcracy and overall inefficiency. In regards to the title “The Tragedy of Gvovernment-Run Health Care”. Terribly inaccurate, the health care in this tragedy is not run by the government, it was run by the doctor, who chose to accept a govt insurance plan. She closed her practice for the same reason I closed mine, she moved into a community where the proportion of people on sub standard insurance was greater than those on reasonable insurance. With good conscious and integrity she accepted the members of her community, unfortunately the math was against her. If you are under the impression that the government insurances are the only ones that will put you out of business you are sadly mistaken. In my community I accepted 23 different types of health insurance, out of those, three were government run (govt run insurance, not health care) and there were four that paid a reasonable reimbursement rate. The remaining 16 paid as poorly and in many cases worse than the “govt plans” and often had more beaurcracy and overall inefficiency.

]]> By: drmatt http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9496 drmatt Wed, 31 Oct 2007 17:58:47 +0000 http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9496 I personally agree with you Marc, I also think that a national health plan will have the bargaining power (without the loyalty to stolk holders) to place much needed restraints on the pharmacuetical industry and the medical liabilty thieves. Furthermore a system designed to outline, evaluate, and use/pay for (proportionally) medical techniques, tests, treatments and interventions that are actually proven to benifit while causing minimal harm would benefit all of us. The corporate insurance companies (by law) have a primary responsibility to stolk holders, not policy holders. I personally agree with you Marc, I also think that a national health plan will have the bargaining power (without the loyalty to stolk holders) to place much needed restraints on the pharmacuetical industry and the medical liabilty thieves. Furthermore a system designed to outline, evaluate, and use/pay for (proportionally) medical techniques, tests, treatments and interventions that are actually proven to benifit while causing minimal harm would benefit all of us. The corporate insurance companies (by law) have a primary responsibility to stolk holders, not policy holders.

]]> By: Marc Brown http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9493 Marc Brown Wed, 31 Oct 2007 16:07:18 +0000 http://www.healthcarebs.com/2007/10/30/the-tragedy-of-government-run-health-care/#comment-9493 'Point being, there will be no fix to our ailing health care system from the government or the private sector unless we discuss and change all the negatively effecting factors.' Nothing will change until you introduce decent national or state insurance systems and commission services to meet local need. ‘Point being, there will be no fix to our ailing health care system from the government or the private sector unless we discuss and change all the negatively effecting factors.’

Nothing will change until you introduce decent national or state insurance systems and commission services to meet local need.

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