Physician Rip-Offs and A Quick Solution to the Health Care Crisis
You will hear a great deal about health care in the current Congress and during the next presidential campaign. Some of the proposals, such as President Bush's tax deductions to subsidize payments for individual insurance, have promise, but most of what you hear will be the same old government control nonsense.
As I've suggested, there are some good signs, especially in the area of prescription drugs. People with "good insurance" (for now) tend to think of prescription medications as free, or nearly so. That's because they pay either nothing or a small amount for life-saving drugs.
In this life, nothing is really free. Someone always pays for it, and much more often than not, that "someone" is you. For example, if your employer is paying $10,000 or so each year to provide health insurance for you and your family, I assure you that $10,000 will never show up in your paycheck. Also, if the employer finds they can't afford such costs, one of two things eventually will disappear: either the health insurance or your job.
For the government, the combined yearly costs of Medicare (for the old, like me, and the disabled, like my wife) and Medicaid (for the poor, like my brother) have passed three-quarters-of-a-trillion dollars. At current rates, those costs will pass the trillion-dollar-mark midway through the first term of President Hillary Clinton.
To keep health care from bankrupting the country, two related things are necessary: (1) more information, what now gets called "transparency," about what health care really costs; (2) true competition in medicine, where doctors and hospitals and hospitals reveal exactly what kind of treatment they supply and how much it costs, at which point customers will make choices, and prices generally will go down.
Gee, if such things happened, could the nation stop the usual double-digit annual increases in health care costs? Yep. Could it even begin driving down the costs -- adjusted for inflation -- as we see in many other industries? Yep. I'd guess the savings soon would be in the hundreds of billions yearly.
If you doubt that, read some of my previous columns about pharmaceutical savings. Our nation is spending tens of billions on drugs that have much cheaper, and equally effective, alternatives. That's more than a dirty little secret. It's a dirty BIG secret.
In the critical area of information, I've mentioned Consumer Reports "Best Buys" in drugs and how the information provided can produce major savings. In terms of hospital costs, there's an early-stage web site called "Health Grades" that compares costs at hospitals for various procedures.
In one hospital uterine surgery cost $4800.00. In another facility, it cost $3200.00. Which surgical unit is better? Actually, hospitals work hard to keep such things secret, but we shouldn't assume that it's the more expensive facility.
At some point, I intend to work with others to start a Web Site that will provide information about doctors -- information that will be critical to your medical and financial health. Such information is NOT available now, except by word-of-mouth.
For example, my family and I had a physician just outside the city of Pittsburgh. He provided prescriptions but would only give two or three refills. That meant the three of us -- four, when my brother was with us -- had to return quarterly, at a cost of at least $75 per visit per person, to get our scripts refilled.
When we switched to a two-physician group in Bridgeville in Pittsburgh's South Hills, the refills were for five months. The same is true of our wonderful physician in Ambridge. (Our doctors in Bridgeville were Don McFarland and Nicollette Chiesa, both superb; the doctor in Ambridge is Kathleen Osten, maybe the best physician we've ever encountered. Her top-notch partners in Ambridge are Donna Craig and Michael Karp.)
For almost all medications, the two- or three-refill approach is a red flag that a scam is underway. It forces people to come into the doctor's office more often than they need. It raises the significantly of the patients' (and/or their insurers') costs.
It's unnecessary and even immoral. When doctors manipulate something like the number of refills, they can dramatically increase their revenue, making them richer and the patients poorer. Doctors who see themselves as human cash registers don't excel at providing care.
With hospitals, some of the smaller ones provide outstanding service -- at relatively reasonable prices. One of them is the Springfield Hospital in Springfield, Vermont. It's tiny, but the care is superb, as my wife learned when she had a stroke and went originally to that facility.
The health situation I'm describing in these columns should outrage you, as a consumer and taxpayer. Are my "allegations" true? You can check them out quickly by asking a few good questions of your pharmacy and physician. .
In the Pittsburgh area, your congressman (all men, currently) will be one of the following: Jason Altmire, Mike Doyle, Tim Murphy, or John Murtha. I encourage you to send these columns to your representative and ask him when he's going to carry out the proposals I make.
Alas, prepare for a very long pause before you get a response. Keep their feet to the fire.