Physicians care deeply about our patients and our communities. Physicians must ensure they have input on the next healthcare go-around. Meaningful healthcare reform will require pragmatism, diligence, compromise, and patience. Working across the aisle is vital to developing better health care legislation for the American people.
The CEO of the Mayo Clinic, Dr. Noseworthy, was last heard recommending patients fire their physicians suffering from burnout. While he does not have truckloads of compassion or empathy for colleagues; he is, at least, honest. Dr. Noseworthy recently confessed “We’re asking…if the patient has commercial insurance, or they’re Medicaid or Medicare patients and they’re equal that we prioritize the commercial insured patients enough so… We can be financially strong at the end of the year to continue to advance our mission.” The ‘ailing’ nonprofit generated a paltry $475 million last year.
Legislators in more than 30 states have proposed legislation to promote price transparency, with most efforts focused around publishing average or median prices for hospital services. Some states already have price transparency policies in place. California requires hospitals to give patients cost estimates for the 25 most common outpatient procedures. Texas requires providers to disclose price information to patients upon request. Ohio passed price transparency legislation last year; however a lawsuit filed by the Ohio Hospital Association has delayed implementation. The cost of a knee replacement is $15,500 at the Surgery Center of Oklahoma, whereas the national average is $49,500.
There is a growing body of evidence that hospital mergers lead to higher prices for consumers, employers, insurance, and government overall. It is imperative to educate patients and lawmakers as to how the consolidation of hospitals and medical practices raise costs, decrease access, eliminate jobs, and ultimately reduce care quality as a result. Lawmakers should focus on this “first pillar” of cost control as they go back to the drawing board.
U.S. Healthcare needs a revolution; ‘the shot heard round the world’ frequently refers to the opening shots of the American Revolution in 1775. The Big Pharma lobby is holding the American people hostage with their exorbitant ransom demands. Last summer, Mylan Pharmaceuticals, led by CEO Heather Bresch, overplayed their hand. Mylan came under fire for a 400% price increase in the EpiPen two-pack. This device is considered life-saving for children and adults with anaphylactic reactions to various food, insect, or environmental insults. Ms. Bresch insisted the significant price increase ($600-$700 for a medication which costs pennies) was justified due to the more ergonomic appearance of the delivery device and improved safety profile.
Should patients fire their doctors if they suspect burnout? In a recent PBS interview, Dr. Noseworthy suggested patients should “change physicians” when faced with non-empathetic doctors suffering from burnout. His cavalier resolution (continue reading →)
Over the last century, health care has morphed from a system valuing individual responsibility to one grounded in physician dependency. Patients are viewed as clients who ravenously consume scarce resources, while physicians dispense answers and guidance for a price deemed too high by bureaucrats to be sustainable. Knowing how invested patients are in understanding their conditions and their willingness to take responsibility for their good or bad choices are metrics worth tracking. It is important to remember physicians make recommendations, educate their patients, and would do best by engaging in shared decision making with those patients. That entire process saves money and improves how patients view their quality of care.
I am not convinced time and money spent implementing new technology does anything to improve patient care; I am fairly certain, however, conversations with my patients provide considerable value.
A man called our office this week and asked what WE charge for co-pays. What the what? Copays and deductibles are what YOUR insurance requires you to pay according to your contract. They consider it “your investment” in your health care. We were asked the other day whether the copay really makes a difference in our bottom line. You bet it does! It makes up a significant portion of total income for our business and keeps us afloat.
