WELCOME TO THE MEDICAL TUESDAY NETWORK
Physicians, Business, Professional and Info-Tech Communities
Networking to Restore Accountability in HealthCare & Medical Practice
Fifth Tuesday, October 29, 2002, HealthPlanUSA
Fifth MedicalTuesday for October
This is the six-month anniversary of MedicalTuesday which
currently networks, in most cases, on the second and fourth Tuesday of every
month via electronic mail - known as e-letter in the USA or e-zine in Europe and
web-zine in Canada for electronic magazine. With an extra Tuesday this month, it
is appropriate to take inventory of the current status of health care in the
United States - what is happening and where we are going.
HealthPlan Overview - USA
The United States currently has a number of private and
public health plans. The working classes generally obtain their health care
insurance through an employer-sponsored plan, which may be a Health Maintenance
Organization (HMO) policy, a Preferred Provider Organization (PPO), or a fully
covered indemnity plan with various fixed or percentage co-pays. Because of
continued increases in health insurance premiums, these defined benefit plans
may be replaced by a defined contribution plan, in which an employer contributes
a certain set amount to the employee’s choice of health insurance with
the balance paid by the employee. Having been shielded from any conception of
costs, most patients’ lack of understanding of health care financing may be
further confused by the defined contribution plan. Their impetus will likely be
“somebody, like the government, please help us.” Should that happened, it
would be only a short term phenomenon as even more exorbitant costs would exceed
any possible tax increases.
Socialized Medicine - USA
The USA has a single-payer system or socialized medicine
for the elderly, the disabled and the poor. According to Goodman, this
combination has probably given the United States the best social net with the
least bureaucratic interference and the highest quality and access of care found
any place in the world. Ann Coulter states that the United States is not a third
world country and people buy what they wish to purchase, whether homes, cars or
vacations, which vary in expense depending on their income and tastes. However,
many of the thirty million people that wish to purchase health care without
having to purchase health insurance are considered to be under served. The
statist left estimates it is more like 40 million while the proponents of
individual freedom on the right believe it is more like 20 million. This
variation is consistent with the scientific accuracy of many health care
estimates.
Oregon’s Human Guinea Pigs
Socialized health care has been a failure in every country
in which it has been tried and has now been repackaged as “Single-Payer
Medicine” in the United States. Oregon leads the pack. Dr Harvey
Frey, an out-of-state activist promoting Oregon’s single-payer initiative on
the ballot next week, states “It’s important to know whether such a system
will work and the Oregonians are offering themselves up as guinea pigs.” The
WSJ editorializes why Dr Frey fails to explain why he thinks Oregonians
should fare better than the laboratory human guinea pigs on medical-care waiting
lists in single-payer countries such as Canadian Medicare or UK’s NHS. The
estimated cost in Oregon will exceed taxes by $3.5 billion in the first year
alone with new taxes averaging approximately $5,000 per resident. That is more
than gold–plated private health care coverage would cost per person.
Cross Purposes in HealthCare
Unfortunately there currently isn’t a major health plan
in the United States that returns health care to the competition and cost
savings of the Medical MarketPlace. In all cases, there are many counter
productive influences which cause great excesses in the cost of care without
improvement in the quality of care. Government involvement has generally
revolved around reduced care for cost containment reasons unrelated to the
individual patient needs or welfare, which in turn has reduced the quality of
care. The HMOs have simply replaced a government bureaucracy with their own
bureaucracy. The government and HMOs have instituted measures to restore quality,
but they are window dressings for public relations purposes and do not restore the
quality which was present prior to their intrusion. Returning health care to the
Medical MarketPlace will introduce real competition which reduces costs
and increases efficiency, innovation, and quality, along with making care more affordable.
It further personalizes the health care to each individual's medical needs,
whether real or desired, without imposing on others the huge variation in health
care appetites.
Competition Is Always Good News
HealthCare is primarily a personal relationship of
patients with their physicians. Patients tell us things about themselves they
wouldn’t think of telling their Priest, Minister, Rabbi, or attorney. But as
health care became more expensive because of technology and hospital expansion, not
controlled by physicians, costs went out of sight. When I was a
medical student doing my preceptorship in rural Kansas in 1961, the three local
doctors owned their own hospital. I stayed that month in their private room, one
for which they charged patients $10 a day, generally paid in cash, which
was also covered by Blue Cross/Blue Shield. The semiprivate rooms were $8 for
each patient, and the one 5-bed ward was $6. The doctors checked the hospital
prices in the neighboring towns and frequently found that the costs were higher.
As they considered their cost, they agreed that they were making adequate return
on their investment and never raised their rates for ten years. They also bought
the latest equipment they felt necessary to provide the care they felt optimal.
They told me that some of the nearby hospitals were about 300 percent higher. But
competition kept their hospital full at all times, especially as patients from
neighboring towns sought them out. Their office calls were $2, and the patients
all seemed pleased to be seen. The free market kept health care affordable for
all concerned, providing high quality in a very pleasant environment.
Reverse Competition is Always Bad For Patients
Two developments changed the personal relationship patients had with their doctors. The government took over
health care of
the elderly and, in order for payment, the
diagnosis had to be reported to Medicare and Medicaid - an intrusion of the confidential doctor/patient relationship and patient
privacy. Hospital Physicians-in-Chief were being replaced by facility
administrators. Money was coming in from the taxpayers faster than doctors,
administrators and hospitals could spend. There was reverse competition, with
hospitals trying to be
the most expensive. Departments in one hospital conferred with their
counterparts in adjacent hospitals, and the one charging the lowest fees
would raise them to the highest, rather than the reverse. This reversal
of competition resulted in obtaining the highest possible revenue not balanced
by competition, because there wasn’t any.
MedicalTuesday’s Mission
When I was Director of Respiratory Therapy in one
hospital, I controlled the costs, or so I thought. My department was always the
lowest in the city but still received the highest revenue over cost of any
department. One day my Technical Director informed me that he had discovered
that the price of oxygen had risen from 25 cents an hour to three dollars an
hour. The administrator could make this change because my therapists only
recorded the hours per day each patient received oxygen. The business office
made the calculation of charges. When we determined that the actual hospital cost of
oxygen was 25 cents an hour, we went to the administrator in charge of our
department for an explanation. He could not understand our concern. He looked at
me very sternly and said, “Isn’t getting the money in the name of the game?
We still have not found the maximum that Medicare, Medicaid, Blue Cross &
Blue Shield will pay. In fact, I have already authorized the next increase to
$3.50 an hour since they are paying the current rate.” He did not see this as
price gouging or as unethical. This sort of practice primarily occurred because
patients were removed from the financing and thus the hospital did not have to
account to them for any fees. Bringing back accountability in health care is
our primary goal.
MedicalTuesday’s Growth
The response to MedicalTuesday has been rather phenomenal.
From an initial address book of a few dozen, now including thousands, it reaches into 25
states and 18 countries on 5 continents. We have an unknown quantity of
secondary mailings. A number of physicians have stated that they have forwarded
the messages to their entire physician list. The secondary lists are the most
important for our growth in changing the face of health care, not only in the
United States but also globally, currently reaching Canada, UK, Europe, Asia,
Australia and South Africa. This week we have focused only on the United
States. But from the email I receive from over a dozen countries, the world is
watching us as we solve our health care dilemma. Many have vocalized their
support in the hope that they can use our success to restore the Medical
MarketPlace in their countries. If you agree with the message, you are
encouraged to forward it to your business friends and professional colleagues.
Feel free to send a copy to Info@MedicalTuesday.net to facilitate adding
them to our list and to keep record of our growth.
Stay Tuned to the MedicalTuesday.Network
This week we welcome the Mercatus Center at George
Mason University which hosted an evening in Sacramento last Thursday. The
speaker, the Hon Maurice McTigue, QSO, discussed how he restored
accountability in New Zealand by reducing the cost of Government from nearly
half the GDP to about one-fourth the GDP. The Mercatus Center’s goal is to
similarly restore accountability in the United States. We heard of the
significant inroads they are making (www.mercatus.org). Each
individual on our mailing list is either personally known, has requested to be placed on
our mailing list, or was recommended as someone interested in our cause of
making HealthCare affordable and accountable. If this is the case with you,
please consider opening a folder in your inbox labeled MedicalTuesday or placing
the e-letters in your template folder so that they are available to be reformatted as new and
forwarded when the occasion arises. If this is not the case, or you are not
interested in or sympathetic to a Private Personal Accountable HealthCare
System, email me DelMeyer@MedicalTuesday.net, and your name will be
sorrowfully removed.
Del Meyer, MD, CEO & Founder
Del Meyer, MD, CEO & Founder
DelMeyer@MedicalTuesday.net
HealthPlanUSA.Network
www.MedicalTuesday.net
www.HealthPlanUSA.net