Sean Khozin, MD, MPH

Respect for individual liberty is the basis of an ethical society and should be the prominent feature of the ideal healthcare system. The main problem with our healthcare system today is that both doctors and patients have lost their freedom of choice. Third party control of healthcare financing with their cartel-like price fixing behavior and tight grip on the allocation of resources is anti-competitive and dictatorial. The freest nation on earth can and should do a lot better.

The game studio Virtual Heroes and the Department of Homeland Security have come together in making a new video game called Zero Hour: America’s Medic, which allows players to respond to terrorist attacks and diagnose and treat patients. Zero hour can be used for training first responders or just for fun.

More info: Virtual Heroes, WIRED

If your dog gets sick and need a bronchoscopy, you would have to shell out about $2500 for the procedure, according a couple of veterinary price lists that I found online. The same procedure done in a human is reimbursed by Medicare $156.29 to $377.45 (for a CPT code of 31622 in New York City).

Human doctors are cheap.

Yesterday, the U.S. House of Representatives passed legislation, on a 355 to 59 vote, to postpone a July 1st 10.6% cut in payments to physicians treating Medicare patients. They instead recommended trimming the government’s funding of the wasteful Medicare Advantage programs, a proposition that the White House has threatened to veto.

The Medicare cuts can seriously threaten the viability of many medical practices and may force doctors to stop seeing Medicare patients. The current postponement under the House legislation is only for 18 months and the ball has moved to the Senate’s court. Powerful health insurance companies are aggressively opposing the House’s decision since it recommends reducing the scope of Medicare Advantage programs. Humana has the most to loose since Medicare Advantage accounts for 48% of its revenues. Patients and doctors, on the other hand, have a lot to gain if the government eliminates these programs.

Forbes

Here’s an update on where our healthcare dollars are going (placed next to the profits of the “mischievous” Halliburton types).

There is nothing wrong with making money unless it’s at the expense of retarding innovation, competition, and delivery of apporpriate services, as it’s the case with our health insurance system which is operating according to principles set forth by the mafia and third world dictatorships (I’ll write more about this befitting analogy later).

So here’s the latest news from California: “HMOs spent $6 billion on administrative costs, which include hefty CEO salaries, according to a report by the California Medical Association, which said the money could have gone toward driving down premiums or better protecting the insured.”

It seems like people are going bankrupt because of “rising insurance premiums and having their benefits gutted simultaneously.” Insurance companies are even going as far as “taking steps to persuade physicians and patients to switch from effective medicines to different medicines based primarily on cost to the insurer, without appropriate regard for each patient’s best treatment option,” according to an op-ed piece by Marcy Zwelling-Aamot, an internist and critical care physician in Los Alamitos.

I wonder when all this nonsense and criminal-like behavior on part of some insurance comapnies is going to stop.

I’m in Canada again for a business meeting and this was on the front page of Yahoo: “Canadians continue to suffer from a doctor shortage, according to a new report that found 1 in 5 people have not been able to find a physician to treat them regularly.”

There is a serious problem with access to care in Canada, proving that universal coverage does not equal universal access to care. It seems like no one in the country wants to go to medical school anymore, despite the fact that it’s almost free. The draconian healthcare system in Canada is turning a lot of smart people away from pursuing a career in medicine, a trend that is also happening in the U.S., although for different reasons.

1 in 5 Canadians can’t find doctor

More info: MSN

The Open Letter Campaign is entering a new phase with top health policy experts and notable figures expressing their support for the movement. One of the latest supporters of the Open Letter is the world-renowned surgeon Dr. Edward R. Annis whose impressive accomplishments include serving concurrently as President of the American Medical Association and the World Medical Association from 1963-1964.

The following is Dr. Annis’s statement about the Open Letter:

I started medical practice in 1938 and for the first twenty years after that patients were free to choose their doctors, to agree with their doctors on what was best indicated to take care of any medical problems that required treatment, and to agree to fair and sensible payment for services rendered. For those with low income or no income, realistic adjustments were common practices so that proper treatment could always be provided.

I consider the Open Letter to be a superb document containing easily substantiated facts as to why people have been separated from their doctors and why todays medical costs are so abusive and unjustified.

The answers are in the first paragraph of the Open Letter which summarizes how patients have been separated from their doctors by politics, profits and special interests.

I consider the Open Letter to be an excellent document containing clear and understandable messages that need no additions and I hope that it gets Nationwide distribution to alert the American people.

Ed

Click here to read the Open Letter from America’s Physicians.

The current healthcare system is burdened by needless administrative costs that consume over 30% of our healthcare dollars. This is no small change and amounts to billions of dollars of wasted money and resources. Advocates of a single payer healthcare system claim that consolidating the fragmentation of third party requirements into a single payer system is the only way to recapture this wasted money. These people remind me of corporate managers who believe that the only way to improve their prospects is through mergers and acquisitions. Unfortunately, evidence and history have shown us that most mergers and acquisitions fail and, as James Surowiecki in a recent New Yorker article puts it, “corporate marriages only rarely end in bliss.”

Most corporate takeovers are motivated by maximization of efficiency and management utility reasons, rather than by the maximization of shareholders wealth (Mallikarjunappa). I’m afraid that even if we achieved better efficiency in a single payer system (highly unlikely), we won’t be able to maximize our shareholders wealth, i.e. the health of our patients. The health of the public can best be served by new innovations and value creation driven by competition among providers. We need to shift the balance of power from insurers to providers, whose objectives are best aligned with patients’ needs. Single payer systems, just like corporate mergers, are anti-competition. They are more concerned with size and control than value and quality. As Surowiecki observes “while acquisitions, almost by definition, boost a company’s growth rate, they too often make it bigger without making it better.” In reconfiguring our fragmented healthcare system we have to try our best to make it better, not bigger.

More info: The New Yorker

I’m in Canada right now for a business trip and just saw a very funny comedy show on TV called This Hour has 22 Minutes. One of the clips was a parody of the FOX TV series House. It seems like Canadians are very aware of the deficits of their healthcare system. Luckily I was able to find the clip on YouTube. Watch it to see what I mean.