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A Matter Of Opinion

The Health Care thread

Since the health care debate is approaching the importance of Obama’s birth certificate, thought I’d give it its own thread, so we can keep the debate in one place.

I’ll kick it off with this:

People scoff at the possible savings with Medicare. Too hard! Have to get between the patient and the doctor! We’ll need Health Nannies!

Actually, we just need the high-cost regions to act like lower-cost regions. The result. No diminuntion in quality and big, big savings. Once Medicare did it, the insurance companies would want to follow suit. They’d certainly have the financial incentive to do so. Can’t keep passng the costs of unneeded care on to patients forever, right?

Now, I know about defensive medicine, but that’s practiced everywhere. It doesn’t explain the wide disparities. In fact, Texas enacted tort reform with hard caps ($250k max for noneconomic damages). Lawsuits plunged. But HC policies and malpractice insurance continue to climb. McAllen is the second spendiest place in the country. Guess tort reform didn’t solve that defensive medicine issue.

Check this out::

According to the study, doctors in the high spending areas were much more likely to recommend expensive and discretionary services, such as non-critical hospital admissions, referrals to sub-specialists, and more diagnostic tests. But the study also concluded that all this extra medical care did NOT result in any greater survival rate.  It just cost more money.  To find out what the Medicare reimbursement rates are in your area,   click here for an interactive map of the United States.

Atual Gawande of the New Yorker interviewed doctors in McAllen.  They even admitted the problem was over-utilization.  That’s a fancy word for ordering unneeded tests.  Gawande came to the conclusion that about 15 years ago, a few McAllen leaders took profit growth to be perfectly acceptable in the practice of medicine.  He writes “a medical community came to treat patients the way subprime-mortgage lenders treated home buyers: as profit centers”

Here’s the real kicker!  According to the Dartmouth study, at current spending rates the Medicare balance sheet will be $660 billion dollars in the red by 2023.  But if we just contained costs like Hawaii and San Francisco (yes San Francisco!) in the year 2023 Medicare would be in the black $758 billion.




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