Thursday, November 15, 2007

Recently, I read an article by a Family Physician, of my vintage, in which he described the problems with American Medicine. He claimed that all our problems started with Medicare. He reflected about how he used to do most everything for the patient with a little help from a surgeon and an orthopedist. There weren’t many other specialists in his town, so he was it. If a patient was unable to pay, he simply didn’t charge them. In his world of healthcare, everyone was covered. What he didn’t mention was that the doctor couldn’t do much for the patient. If you got real sick you died. People didn’t go to the doctor very much, they just toughed it out.

I have a little different view. I would argue that Medicare has been a savior for the majority of America’s senior citizens. The problem started in the late 60s with the explosion in technology and the spiraling cost of providing healthcare. Patient’s expectations also changed in that they developed a gluttonous appetite for healthcare. Folks started going to the doctor for everything and expecting miracles. Miracles became possible because of the incredible advances in medicine. Medicine was the fountain of youth. The problem is all of these good things cost a lot.

Medicine became a big business and the goal of hospitals was profit not quality care. Reimbursement for the hospital by all payers further compounded the problem. The emphasis was to move patients in and out as quickly as possible to maximize reimbursement. Payment for doctors favored the procedures they performed. Self-referral gave physicians the ability to greatly profit from owning their own equipment and resulted in unrestrained utilization to reap more dollars. Doctors became unbridled thieves with a license to rob.

American medicine has become a business and is driven by greed. Altruism is dead. I know I am a traitor for writing such things, but it feels good to tell the truth.

So, in my view, the problem is not with Medicare. Physicians, themselves are a big part of the problem. Not all are bad. 99 percent of physicians can spoil the rest.

It’s sure good to be retired from practice and sitting here on the porch. I don’t have to worry about solving the problems anymore. The wonderful field of presidential hopefuls have the solutions. Hillary will likely become the next president and we already know of her success in solving the healthcare dilemma. My prediction is that we will have a single payer system, which is the federal government. It may only be 99 percent bad but that could spoil the rest.


Post a Comment

<< Home