Mad About Medicine - The Good and the Bad about American Medicine

Mad About Medicine - The Good and the Bad about American Medicine: "Nature abhors a vacuum. For years I never understood that line. I always thought that it meant that if you suck everything up there will be nothing left for anyone else and you will be hated. That, of course is not nature and a vacuum but the American insurance industry- sucking up all that is left of healthcare dollars. What I have learned over the years is that if an important thing is left unattended, then it will be attended to by default- usually by the least qualified. This leads us to the obvious- The Government and the press are waging a war they call healthcare reform with no clue as to the problems or the solutions. Our healthcare reform vacuum is being filled by the vacuous. Heaven help us."
If all you did was read the press recently this is what you would learn the "reason" why healthcare is in trouble in America:

1. An unacceptable number of people are uninsured
2. American medicine generates tens of thousands of fatal errors yearly
3. We have a shorter life expectancy that the British, French, German, Canadians, and Japanese
4. 16% of our resources go into healthcare
5. There is over 700 billion dollars of waste in American medicine

Source: Bush's Turn to Health Care, Sebastian Mallaby, NY Sun, January 17, 2006

I bring these up, not to point out the NY Sun's expertise in reporting healthcare (not) but only that these are common complaints and were so noted in this article. Unfortunately, solutions are rarely offered in these reports.

One of the big problems we are having is connecting problems with solutions. Here is what the Asylum inmates are saying now:

If you pay bonuses to hospitals and doctors that score well on quality and price measures this will work. Brain dead. The Harvard researchers who preached this should be ashamed of themselves. Maybe they should move to Yale instead. Here's a reality check for Ivy League researchers- insurers don't want to pay. They not only don't pay doctors and hospitals market value, they don't want to pay at all. Ever. They will delay payments and rachet down payments to squeeze out more stockholder value. They certainly will not pay "bonuses." In New York, Oxford Health Plans has not raised any of its reimbursement for 6 years. Not even covering inflation.

Paying market level is NOT A BONUS.

Also- who defines a quality measure? The National Council of Quality Assurance (NCQA) rates health plans on things like pediatric immunization and pap smears. This means that an HMO can hire Vin Diesel to blow up San Francisco but if he immunizes the 3 surviving children and does a pap smear on their mother The Vin Diesel HMO scores high in NCQA ratings. Nice job. Pin a medal on his chest and sign me up.

A small percentage of the gross profit of American insurance companies can pay for the healthcare of the uninsured for 17 consecutive decades. Anyone ever think of that as an idea? That is a little too complex for the current "Abramoff Congress"- Democrats and Republican who have their heads so far up the insurance company lobby's rear that the sun won't shine on the backdoor of healthcare for eons to come.

Certainly there are answers out there but in the end, everyone thinks it's the doctors, hospitals, and patients that are ruining health in America- it is actually the overregulation and the raping of the system by greedy insurers, pharmaceuticals and failure of the lobby-controlled government to act responsibly.

In a truly superb book, Healthy, Wealthy, and Wise, five points were noted by authors John F. Cogan, R. Glenn Hubbard, and Daniel P. Kessler:

1. The tax law needs to be changed to reduce the preference for medical-care purchases through employer-based insurance.
2. Health insurance regulation needs reforming.
3. Health information needs to flow more freely.
4. Hospitals, doctors, and insurers need to control anticompetitive behavior. (a corollary is that the government needs to free them in the free market)
5. Reform the malpractice system.

These are clear and concise suggestions. So what does the Government and the Press say about this? Nothing. They just heap blame on anyone EXCEPT insurance companies.

The uninsured will not magically awake to insurance one day. Doctors do not charge too much for services. Hospitals really do care about the health of patients. Hello.

Years ago, healthcare rooms were filled with caring doctors, nurses and hospitals. Someone thought that while this clinical room was full, the finance rooms and regulations rooms were a bit empty. We then filled them with criminally insane insurance executives, Senators, and Congressmen that control healthcare in America like Nurse Ratchet in One Flew Over the Cuckoo's Nest. Where is McMurphy when you need him?