The High Cost Of American Health Care: You Asked For It

2014

The perverse incentives in our health care system are well-known, not talked about much by politicians as it is easier to take on the insurance companies than the AMA or AHA, but well-known never the less. I use the term well-known loosely because I doubt patients think about the system all that much.

Patients don’t think about physicians investing in emergency rooms, or walk-in centers or in high-tech equipment all of which much generate revenue to be successful. Patients don’t think about treatment alternatives; some of which generate more revenue than others. And who questions a system where the provider of services also generates demand and sets prices? Would we tolerate an oil company that determines the mileage your car gets, how many miles you drive each year and the price per gallon of gasoline? I think not.

This is a complex problem indeed and changing the system means a major change in perceptions with powerful forces seeking to keep the status quo. Until the cost of health care really hurts, patients will not support change because they will accept the opposing argument that change means lower quality health care … even while there is no logical reason for that to be true.

Unfortunately, Obamacare is taking us in the wrong direction in this regard. The Affordable Care Act in name only is misleading. Is care “affordable” simply because someone else pays the bill or the government subsidizes premiums and in some cases out-of-pocket costs as well? Should the government ever be using the word “free?”

Why can’t we have a system under which physicians are salaried plus quality bonuses, work forty hours a week and only practice medicine; no paperwork, no administration, no running a business? Of course, there will be problems just as there are with any salaried person, but it has to be a darn sight better than what we have now. Let’s set up regional pay scales. Family and general practitioners, $200,000 a year, orthopedic surgeons $300,000, etc.  plus bonus opportunities based on pre-set quality measures that will help to avoid under or over utilization.

Following is an excerpt from a very interesting article, you might want to take a look at the full article.

From the perspective of the patient, it is easy to assume that (a) more care is better care, or (b) that any added expense is essentially free. But in practice, neither assumption is true.

via The High Cost Of American Health Care: You Asked For It – Forbes.