Comments on: OBAMA, HOT AIR & ACTUAL REFORM

By: Matt Horn

Matt Horn — Mon, 23 Jun 2008 14:24:11 +0000

James, I think the increasing costs of delivering care are across the board. It includes new technology, compliance with new government regulations, cost shifting due to lower Medicare reimbursements and new courses of treatment. I would like to see a way to place higher cost sharing requirements on individuals that do not take care of themselves. I think a wellness aproach is vital, as we do not want to go to an abyssmal system like the NHS.

By: Marc Brown

Marc Brown — Sun, 22 Jun 2008 22:39:41 +0000

‘You have no stake, other than the premium you pay, into how this system works.’

Single payer/universal care would introduce more accountability by making healthcare a collective political issue. It’s also a myth that US citizens use health services more because the costs are hidden - in fact they visit less on everage than most other major western countries.

‘You have no incentive to lose weight, excercise, and stop smoking (the only prevention you can practice).’

Well, diet is a big factor. But health promotion is a complex society wide issue - it’s not just about acute heath care costs.

‘I can tell you, MD’s in the 80’s got about $5k for doing radical cancer surgery. Today I get about $1900-2300 for the case and 90days of perioperative/postoperative care.’

The main difference between US healthcare and the other OECD countries is the sheer direct cost of your hospitals and doctors. Paying yourselves a decent but not huge salary and not charging for piece work would be a good start, as would wondering why some of your top administrators get salaries in the millions of dollars compared with say a maximum of about $300,000 in the UK and France.

By: James

James — Sat, 21 Jun 2008 03:00:46 +0000

You are getting close to the mark.
I’m a cancer surgeon.
The problem is basically this: we have a collection of systems (Medicare, Medicaid, private insurance, SCHIP) which has somebody else paying your tab for healthcare.
You have no stake, other than the premium you pay, into how this system works. You have no incentive to lose weight, excercise, and stop smoking (the only prevention you can practice).
Furthermore, these “third parties” have grown into multi-billion dollar industries that have all driven up the cost of that premium artificially, claiming that “costs are rising” for delivering care. I can tell you, MD’s in the 80’s got about $5k for doing radical cancer surgery. Today I get about $1900-2300 for the case and 90days of perioperative/postoperative care. This has all come about through denials/downcoding of my “claim” (not bill) for reimbursement for my services. I, in essence, and forced to take whatever they pay me and I can’t bill you for the rising cost of my overhead. My paycheck has decreased yearly since 2000.
Yet they tell you that I and my colleagues are pumping up the cost of medicine.
Here’s what nobody is saying: smart guys are currently NOT choosing this profession.
You are all screwed. It’s over.
In exchange, you are getting technicians more interested in time off than breaking their backs being good at medicine.
Mark my words. All this BS about “quality assurance” only works for manufacturing– not for professional excellence.

By: Rich

Rich — Wed, 11 Jun 2008 21:18:26 +0000

“Will everyone have health care at a cost they can afford?”

Herein lies the rub:

Define “health care.”

By: Matt Horn

Matt Horn — Wed, 11 Jun 2008 20:55:07 +0000

No. The fix is taking responsibility for your health. This will lower the overall utilization and open up more resources for those that have conditions that are unrelated to lifestyle.

By: groetzinger

groetzinger — Wed, 11 Jun 2008 17:17:51 +0000

If you believe it is fixable what is the fix?Will everyone have health care at a cost they can afford?