Well, it’s that time again — time to shepherd some tidbits from my weekly web wanderings:
- Clueless healthcare solution: This WSJ letter to the editor shows the typical cluelessness (a favorite of libertarians) to the solution of high medical costs, to wit: lets just increase the supply of doctors. Sorry, no workee: 1) If you pay physicians less than their cost to provide services, increasing the number of physicians will not solve the problem — it will worsen it; 2) the usual rules of supply and demand do not apply in medicine, where prices are fixed by third parties (the government and insurance companies), transparency is impossible (due to litigation risk and rules limiting openness in pricing and services); 3) where the consumer is largely sheltered from the costs of the services purchased; 4) Oh, and by the way: the government and the AMA don’t regulate the number of physicians trained.
In short, free market principles don’t work when the market isn’t free: Regulation Leaves U.S. Doctor Supply in Demand.
- Canadian health care system: Problems galore in the Canadian health care system — which is often seen as a model for the U.S. Here’s a bevy of links detailing them:
Top court strikes down Quebec private health-care ban
A new ‘Day’ for the CMA
Alberta fuels Canada healthcare debate
The family physician shortage
Canada’s doctor shortage to worsen without changes: Fraser report
Canadians begin waiting for surgery before getting on the â€œwait listâ€
This is Boomtown, Ont.
Public, private health should co-exist, CMA says
- 35W Bridge collapse photos: Amazing slide show here.
- Why aren’t doctors paid by the hour?: I’ve spoken about this before as one solution to exiting our health care maze: One part of the answer: the payors (government & insurance industry) hate the idea: Why aren’t doctors paid by the hour?
- Faith & meaning: We’ve been batting around the tension between faith and reason here recently (with more to come). Here’s an older post of mine touching on some of the same issues, from a little different perspective: Collision of Worlds.
That’s all for now — have a great week, and God bless.
3 thoughts on “Sunday Suggestions”
Every learned analysis of our healthcare problem continues to show total lack of concern for the inappropriate utilization of healthcare services: unnecessary admissions to the hospital, lack of medical necessity for diagnostics , imaging, and surgical procedures, and self-referral by physicians to their owned laboratories, imaging centers, and day surgery centers.
McKesson, in its Interqual Criteria Manual, has developed sophisticated criteria for the management of just about every medical condition you can name and, for the most part, it is ignored by the medical profession. Get with it, doc. The problem is a lack of accountability by the medical profession. For your information I have been involved in medical management for over 25 years. I have seen every infraction of acceptable integrity by physicians that you can imagine.
When you believe all physicians are greedy, corrupt, and incompetent — as you do — I have no doubt you will find such corruption everywhere you look.
So if I want to “get with it”, to whom should I turn? Why, to medical managers, of course. Those esteemed experts who will be more than happy to micromanage every medical decision, of course based only on the highest ethical and professional standards. Those same medical managers who never, ever make healthcare decisions based on profit or greed.
The same medical managers I see at our local hospitals — hiring dangerously incompetent physicians on their staff then marketing them and as highly competent; the same managers who buy expensive equipment for surgical procedures for which no one on their medical staff has been trained, then market themselves as “centers of excellence” simply because they have written a large check to buy the equipment. The same medical managers who have drastically cut nurse-to-patient ratios to pad their bottom lines; who regularly purchase poor-quality supplies and equipment which are medically dangerous to save a few dollars; who substitute paper forms and administrative hassle for good health care, and call it “quality.”
Ah yes, the McKesson algorithms: I know them well. It’s a little difficult for physicians to follow them, of course, because they are secret: These computer algorithms are used by the insurance industry for the primary purpose of denying valid healthcare claims — a practice for which the insurance industry was slapped down hard in a massive class-action suit several years ago. They paid out millions of dollars in damages when they settled that particular suit — but of course never released the secret algorithms which were used to make them multiple billions. In spite of the suit, their return on investment was huge — and continue to use these algorithms today to deny healthcare to patients in order to increase their profits. Just another cost of business, I suppose.
Healthcare in this country is micromanaged to an absolutely extraordinary extent by the government and the insurance industry — no other industry even comes close. No one asks the insurance industry for “accountability” as they pursue corrupt and unethical business practices on a massive scale. No one demands the government demonstrate that its intrusive policies adversely affect patient care.
But fools like you will just go on believing that what is needed is more physician “accountability.”
It’s hard to believe that any “fool” would object to physician accountability
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