Wednesday, June 24, 2009

Healthcare Discussion

Updated 3/2017-- photos and all links (except to my own posts) removed as many no longer active. and it was easier than checking each one. 

I was in the “audience” of the phone conference today organized by Dr. Bob Goldberg, President, Center for Medicine in the Public Interest Advance (CMPIA).  In addition to him, Dr. Val Jones (Founder and CEO Better Health Network) and Dr Gary Puckrein (President, National Minority Quality Forum) were on the panel of speakers.  The focus was to be on the risks of government-run healthcare.
It seemed to me that many good points were made, but the main one was that the focus of the healthcare discussion needs to be refocused on the patient and the care given rather than simply on the high cost of care/insurance and any cost savings to be gained short-term.  As Dr Wes pointed out in his recent post (The $400 Billion Dollar Question), patients aren’t at the “table” of many of the discussions of healthcare reform that are taking place.
Should America understand precisely what is being cut when we see $400 billion suddenly disappear from the health care reform budget?
I would argue we must know.
After all, it's we the patients who are not at the policy table, and you can bet that it's the patients who will ultimately be paying the tab, be it directly through health care premiums, or indirectly by taxation or deficit spending.

There were two links given by the CMPIA as sources for factual information on the healthcare discussion: and
I went to both, but in an effort to keep this post at a reasonable length will highlight only a few from the first link.  First this one --
  • Public plan proponents are advocating a $1.25 per hour per employee tax to pay for the public plan. The Commonwealth Fund, “The Path to a High Performance U.S. Health System”, p. 29, February 2009.
I won’t comment on that one, but will this next one:
  • Under the public plan, doctors and hospitals would see their reimbursements for providing medical care cut by as much as 30%. The Commonwealth Fund , “The Path to a High Performance U.S. Health System”, p.33, February 2009.
This decrease in reimbursement troubles me as I have watched the struggles many hospitals have experienced over the past several years with the current reimbursements.  I think this trend will only get worse.  Check out Barbara Duck’s series at Medical Quack on desperate hospitals.  Here’s an excerpt from the May 24, 2009 post:
In Chicago, Illinois
The Loyola University Health System in west suburban Maywood on Tuesday said it will eliminate more than 440 jobs, or about 8 percent of its workforce, amid the recession and an economic downturn causing an influx of patients who cannot pay their bills.
The cost of patients who cannot pay has increased 73 percent, to $31.3 million from $18.1 million, from a year earlier for the nine months ended March 31.
"We have been hit by a number of things," Dr. Paul Whelton, chief executive of Loyola University Health System, said in an interview. "We are having more trouble with charity care, and the money we are getting [from patients] is more slow to come in. But we have a mission to provide care in our communities and we are going to stick to it."

In all this talk on healthcare reform, it seems to me and others at the phone conference that the quality of patient care rather than simply cost containment needs to be put back at the front of the discussion.   Healthcare should provide care without being hampered by more and more rules and regulations in an effort to contain costs.  We don’t need more rules like the Medicare’s 75% rule.
Saving money by providing an inferior “product” isn’t what any of us want.  Is it?


shadowfax said...

Super late, and I'm going to bed, so I'll be brief. You cited two "facts" from the linked site:

* Public plan proponents are advocating a $1.25 per hour per employee tax to pay for the public plan.

* Under the public plan, doctors and hospitals would see their reimbursements for providing medical care cut by as much as 30%.

Since you picked these bullet points to publicize, it might be beneficial to the discussion whether you found them or their source credible. I understand that this was the designated "con" side of the debate, so I don't expect a "friendly" set of evidence. But it should be subject to critical review. For example, do these two assertions correlate with the plans congress has thus far put forth? Or are they speculative warnings designed to gin up concern and opposition to the as-yet unspecified plan?

I'm OK with spin: it's part of the game. I'm just saying that it's most helpful when you're being spun to critique the spin as credible or just propaganda.

rlbates said...

You are so very right. Thanks.