Sunday, June 14, 2009

Public Health Insurance - Beam Me Up

Star Trek fans will recognize this line. "No signs of intelligent life here. Beam me up, Scotty."

The same could be said for a government run, public health insurance plan.

At least, if it is run like Medicare.
If the government is going to help subsidize coverage for the millions of uninsured, it will need to find significant savings in Medicare spending, at least some of which should come from reducing over-treatment. In the long run, if doctors can’t be induced to rein themselves in, there is little hope of lasting reform.
Isn't this what Obama-man promises? To rein in costs?
Dr. Gawande, a Harvard-affiliated surgeon and author, traveled to McAllen, Texas, to find out why Medicare spends more per beneficiary there than in any other city except Miami.

None of the usual rationalizations put forth by doctors held up. The population, though poor, is not sicker than average; the quality of care people get is not superior. Malpractice suits have practically disappeared due to a tough state malpractice law, leaving no rationale for defensive medicine.
Then what is the explanation?
The reason for McAllen’s soaring costs, some doctors finally admitted, is over-treatment. Doctors perform extra tests, surgeries and other procedures to increase their incomes.
Say it ain't so!

Once the pay czar get's finished with them, they will be singing a different tune.
After adjusting for differences in health, income, medical price and other factors, the Dartmouth researchers’ overall conclusion is that the more costly areas and institutions provide a lot more tests, services and intensive hospital-based care than the lower cost centers. Yet their patients fare no better and often fare worse because they suffer from the over-treatment.
Suffering from over-treatment.

Not to mention endless hours in the waiting room and only last summers big print Readers Digest to bide your time.
When President Obama speaks at the annual meeting of the American Medical Association on Monday he will need all of his persuasive powers to bring doctors into the campaign for health care reform. Doctors have been complicit in driving up health care costs. They need to become part of the solution.
I can hear Barry now:

"OK, guys, listen up. Either you agree to take a pay cut or we will do it for you."

"The American people are tired of those big salaries and expensive junket's. You are going to have to learn to live on $400,000 per year plus free housing and an unlimited travel budget just like I do."

"If you don't agree, we will have to nationalize health care, put you into bankruptcy, then sell you to the Italians. They were stupid enough to buy Chrysler. Seems only fitting we give them something else in return."
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