Posted in Access to healthcare, Accountable Care Organizations, American Presidents, big government, Doctor-Patient Relationship, Economic Issues, Electronic Health Records, Health Insurance, Medical Costs, medical inflation, Medicare, Patient Safety, Policy Issues, Uncategorized

How Medicare Ruined American Healthcare | Medpage Today

Regarding the King-Anderson bill, the forerunner of Medicare, touted by JFK which eventually was defeated in the Senate…

“Edward Annis, MD, spoke eloquently to an empty Garden and to one of the biggest TV audiences of the times.

He explained directly to viewers: “This is not health care insurance … It will put government smack into your hospitals … deciding who gets in, who gets out, what they get, and what they don’t get. … This King-Anderson Bill is a cruel hoax and a delusion. … It will stand between the patient and his doctor. And it will serve as a forerunner of a different system of medicine for all Americans.”

In the late 1990s I asked Dr. Annis what was in the King-Anderson Bill that enabled him to predict in 1962 the insolvency of Medicare and the coming government takeover of healthcare. He replied with a smile, “Cost-plus financing. It was a license to steal.”

Indeed, Medicare ushered in unbridled spending for two decades before approaching insolvency.

But, as predicted by Dr. Annis, the system became insolvent by the early nineties… Hospitals and many providers became addicted to the easy money and abused the system. Why not? Cost-plus meant guaranteed profit.

Faced with Medicare insolvency, the insurance lobby persuaded Hillary Clinton to have secret meetings, without physician input.

Though Hillarycare never became law, the effort brought a sea change. Patients could no longer choose their doctor. Insurance companies now owned the patients. Participation in HMOs rose from 10% to 50%. Your doctor could no longer refer you to the best hospital or consultants if they were “out of network.” The doctor-patient bond had been successfully severed.

Medicare does not mandate who gets into hospitals, but it forces patients to get out by paying for only a limited number of days.

For the past two decades, hospitals have aggressively been buying up medical practices. The goal is to establish accountable care organizations (ACOs). Private practitioners are being elbowed out slowly but surely. General practitioners (GPs) cannot admit a patient to the hospital without “hospitalists” taking over. Hospital surgeons cannot refer to private surgeons, etc. Even the concierge model will be wiped out.

The Medicare approach to ACOs requires three things: 1) electronic medical records, 2) a “Quality Care Protocol,” and 3) a “Protocol for the Elimination of Non-Compliant Physicians.”

This is the ideal rationing system.

The computer will eventually dictate all allowed testing and treatments according to a “quality,” or more likely “cheapest way to do it,” protocol. Providers will ration according to the computer or they will fall into the “protocol for elimination of non-compliant physicians.”

In the new system, no one has a doctor. Doctors have a shift. The doctor you see on the morning shift has absolutely no responsibility for you when his/her shift is over or on a day off. A nurse practitioner takes the patient history and physical, further fractionating care. A system like this requires that all doctors are created equal. They are not.

Politicians and bean counters have never understood healthcare delivery. It was used and abused as a political tool.

No one listened to the warning of Dr. Annis. The AMA is often demonized by historians for opposition to Medicare, but it understood healthcare delivery and the destructive nature of cost-plus financing. I blossomed in the Golden Age of Medicine and bear witness to the fall.

Source: How Medicare Ruined American Healthcare | Medpage Today

Posted in Doctor-Patient Relations, Electronic Health Records, emotional intelligence, Philosophy, Uncategorized

FDA Approves First Drug to Treat Medical Burnout | Medpage Today

“Idongivafumab’s unique ability to target and inhibit C-suite peptides, as well the entire electronic health record (EHR) cascade, represents a quantum leap in burnout science,” Palmer explained in a statement.

“Clinical test subjects also noted a marked decrease in symptoms of Entitled Patient Pruritus (EPP) during the course of treatment. Some 87% of those treated stated they felt ready to type at a keyboard with their back to the patient; feeling a need to apply to law school, write a novel, or sell crafts on Etsy fell by a whopping 98%. This drug may truly revolutionize health care.”

Posted in Access to healthcare, advance-pricing, Economic Issues, Electronic Health Records, Government Regulations, Health Insurance, Healthcare financing, Medical Costs, medical inflation, Organizational structure, out-of-pocket costs, outcomes, Patient Choice, Patient Safety, Patient-centered Care, Policy Issues, Portable Insurance, Price Tansparency, Quality, Technology, Uncategorized, Uninsured

Health Care: You Are Not the Customer (David Goldhill) – YouTube

David Goldhill

Health “insurance” is NOT…INSURANCE. When everyone’s house is on fire at the same time we’re not talking about managing risk, we’re talking about a perpetually increasing spend.

Please listen to this insightful explanation by David Goldhill where he discusses this phenomenon and explains why Healthcare is not the economic Island that we made it out to be. Instead, much of what we believe and what we’ve done to healthcare, as far as economics and regulations, has made it an island unto itself. This is a huge part of the problem and one that has largely been self inflicted.

Posted in Access to healthcare, Affordable Care Act (ObamaCare), British National Health Service, Consumer-Driven Health Care, Deductibles, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relationship, Economic Issues, Education, Electronic Health Records, Employee Benefits, Employer-Sponsored Health Plans, Government Regulations, Health Insurance, Health Savings Accounts (HSA's), Healthcare financing, Individual Market, Medicaid, medical inflation, Medical Practice Models, Medicare, Organizational structure, out-of-pocket costs, outcomes, Patient Choice, Patient Compliance, Patient Safety, Patient-centered Care, Policy Issues, Prevention, primary care, Quality, Reforming Medicaid, Reforming Medicare, The Quadruple Aim, The Triple Aim, Uncategorized

David Goldhill on Cost Drivers and Price Distortions in Healthcare

Minus the introduction and Q&A, the 45 -50 minute presentation is well worth your time. Engaging delivery and compelling case to consider… the cost drivers and distortions come from HOW we access and bill, as opposed to WHAT services are actually exchanged or provided. The key to understanding healthcare costs and pricing is to acknowledge that the answer is contained within our insurance card…and the processes it dictates and the tax/regulatory environment that it operates in. It is kind of like hiding something right out in the open; we look for clues everywhere except for what’s right in front of us. We tend to point fingers at easily identifiable components but fail to see what links them.

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Crony Capitalism, DC & Related Shenanigans, Economic Issues, Electronic Health Records, Free-Market, Government Spending, Health Insurance, Hospital Uncompensated Care / Disproportionate Share Revenue, Independent Physicians, Influence peddling, Medical Costs, Organizational structure, Patient Choice, Patient Safety, Policy Issues, Price Tansparency, Quality

G. Keith Smith, M.D. – 10 Health Care Myths, and the Truth – 10 Health Care Myths, and the Truth

Dr. Keith Smith
Dr. Keith Smith

7). Free market principles don’t apply to health care.

Free market principles always apply, in spite of all attempts by the state to thwart them.  Acting in concert and consistent with free market principles allows for the most rational and fair and least wasteful and most moral allocation of resources.  Acting in concert with the free market and its characteristic open competition causes quality to soar and prices to plummet.  Every time, no exceptions.  Patients from all over the country are using our online pricing to leverage better deals in their local medical markets, as our facility and others embracing transparent pricing are only a short plane ride away!  As hard as many hospitals are trying to avoid it, they are in a competitive marketplace whether they like it or not.  Those in the medical industrial complex who say that free market principles don’t apply to their industry are typically those who benefit from avoiding competition at all costs.

Read the full article at: G. Keith Smith, M.D. – 10 Health Care Myths, and the Truth – 10 Health Care Myths, and the Truth.

Posted in Access to healthcare, Deductibles, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relations, Economic Issues, Electronic Health Records, Employer-Sponsored Health Plans, Health Insurance, Medical Costs, Medical Practice Models, Patient Choice, Policy Issues, Tax Policy, Third-Party Free Practices, Uninsured

Components of Optimal Health Insurance: #2 – Insurance Should Not Suppress Market Forces | Robert Nelson, MD | LinkedIn

Robert Nelson, MD

The way we buy and bill for healthcare via the third-party claims-based insurance model has resulted in near complete suppression cost-value signals that normally allow buyers and sellers to establish a meaningful trading point, called the clearing price.  This efficient market mechanism helps ensure that each participant reaches their best position without causing the deal to fall apart.  Absent these efficient market forces, it is no wonder healthcare costs have skyrocketed during the reign of the third-party billing cartel. 

The mandatory use of CPT/ICD billing codes in all medical insurance billing is at the heart of this economic dysfunction.  It has become a self-perpetuating system propped up by biased tax laws favoring employer-sponsored insurance and overly restrictive insurance regulations, both contributing to the “job-lock” dilemma.

Houston, we have a coding problem

via Components of Optimal Health Insurance: #2 – Insurance Should Not Suppress Market Forces | Robert Nelson, MD | LinkedIn.