According to data from the Center for Medicare & Medicaid Services (CMS), hospital care in Kitsap County is 40% more expensive than in the surrounding communities. In documents filed as part of the lawsuit, a former physician president at TDC summed up the affiliation with CHI best: “You can now get your outpatient care in a complex, relatively unsafe, and vastly more expensive location.”
First, the Balanced Budget Act of 1997 capped the number of residency slots in teaching hospitals which were eligible for Medicare payments. This mistake has facilitated a shortage of primary care physicians across the country. A larger supply of primary care physicians is associated with a lower mortality rate. In fact, adding 10 primary care physicians per 100 000 population increases life expectancy by nearly two months, whereas the same increase in specialty physicians only improves life expectancy by 19 days.
The viability of rural hospitals, fighting to remain financially solvent despite implementation of additional mandates, must be balanced with the need for nurses working 12-hour shifts to have protected time for meals or breaks. Both are important and a viable resolution exists somewhere in between. Sacrificing meals and breaks for nursing staff already dangerously spread thin is not the solution to keep rural hospitals afloat. And indeed, Senate Bill 1155 passed with bipartisan support and will now head to the Governor’s desk for signing.
The country bearing the closest resemblance to the U.S. proposal, where decision-making is centralized, is France, where the government is responsible for 77% of total health expenditures. There is an out-of-pocket cost share for patients though it is relatively low, at 7% annually. The Netherlands, Singapore, and Taiwan are also highly centralized; however, they are smaller in scale–with populations similar to that of individual U.S. states – and their relative affluence allows them to sidestep long wait times.
There are 800,000 physicians in America and more than 65% believe the Maintenance of Certification process, known as MOC, has no clinical value for patients. For the first time in the history of our profession, physicians have a fighting chance to topple a Goliath-esque organization, the American Board of Medical Specialties.
Research shows that physician-owned practices provide better quality of care. For example, in comparison to organizations employing more than 100 physicians, practices with 3 to 9 physicians had 27% fewer preventable hospital admissions and those comprised of one or two physicians had 33% fewer preventable hospital admissions. Fewer days spent in the hospital leads to fewer bills for consumers to pay.
In a socialist construct, one central power controls the means of production and the goods produced, goods which may someday include U.S. physicians. The Cuban government generates $11 billion annually by “leasing” their physicians out to foreign countries, in order to fund the Cuban national health system, which is “free.”
In a world where opinion is shaped through social media, a public health strategy based on trying to “educate people” by shoving “facts” in their face when the facts are in dispute is not going to work very well. In reality, it may backfire and produce exactly the opposite result from the one you intended. And that is exactly what is happening here.
In the United States, 400 physicians commit suicide annually – an average of one per day. Physicians have the highest rate of suicide of any profession; almost double that of the general population. While physician suicide has reached epidemic proportions, the general public is relatively unaware of this tragic phenomenon. Robyn Simon has produced a documentary film, Do No Harm, to shed light on this taboo topic.
A physician should be called a “physician.” A nurse practitioner should be identified as “nurse practitioner.” Please call a physician assistant, “physician assistant.” These are accurate titles, reflective of their specialized education, training, and expertise. They are all venerated professions which share a mutual goal of improving patient’s lives, yet the vocations are fundamentally different.