Archive for the 'ObamaCare' Category

Why We Still Kill Patients: Invisibility, Inertia, and Income

25 Dec/AHRP – Between 1978 and 1999, 2.5 million American men, women and children died preventable deaths in US hospitals and 17 million suffered preventable injuries.  Two recent reports confirm that American hospitals continue to cause serious preventable harm to patients. Continue reading ‘Why We Still Kill Patients: Invisibility, Inertia, and Income’

ObamaCare: Bad Medicine

One hundred days after the new federal health care law was passed, Americans remain anxious about how it will impact them and their families. In fact, many Americans still want to know what is in the nearly 3,000 pages of legislation that might represent real health reform for them.

Unfortunately, when measured against the Administration‘s own stated goals, the new health law fails to address the top health care concerns of the American people. According to a March 2009 report released by Health and Human Services, a majority of Americans identified cost as their top concern with American health care.

Independent experts have found that the new health law will increase the cost of health insurance and health care services. According to the nonpartisan Congressional Budget Office (CBO), premiums for millions of American families in 2016 will be 10-13 percent higher than they otherwise would be.  This represents a $2100 increase per family, compared with the status quo.

And, according to a recent memo from the Actuary of the Centers for Medicare and Medicaid Services, the medical device and pharmaceutical drugs fees and the health insurance excise tax will ―generally be passed through to health consumers in the form of higher drugs and device prices and higher insurance premiums, with an associated increase in overall national health expenditures….

This is not the only bad news. According to the same memo, the new health care law bends the cost curve upward and increases national health spending. In other words, health care will cost more because of this new law.

Contrary to the promise that Americans who like their current health plan can keep it, the Administration published a regulation regarding ―grandfathered health plans – plans that are exempt from the changes under the law.  According to the published regulation, as many as seven out of every 10 businesses across the country will lose their ―grandfathered health plan. This means that about half of the more than 150 million Americans enrolled in employer plans will lose their current plan and either remain without employer coverage, or see the cost of that employer-provided coverage increase due to government mandates and regulation.  (Full report posted here.)

This report was written and published by United States Senators Tom Coburn, M.D. and John Barrasso, M.D.

AAPS Reports 93% of Doctors Oppose ObamaCare

The headline says it all… Obama invited physicians to discuss reform and then used their presence to give credibility to his plan. (video)  More information is posted at AAPS.

A View from the Exam Room

I learned a lot about the cost of health care when I had a hybrid general surgery practice in California ‘s rural San Joaquin Valley.  My practice consisted of uninsured women with breast cancer combined with a smaller percentage of cosmetic patients whose cash payments for “vanity care” subsidized the treatment of women unable to pay for needed medical treatment.
Although patients seeking cosmetic services tend to be healthy, I evaluated them like any other patient.  I asked about medical history, allergies, medications and genetic disorders.
Upon questioning Sherry S., a pretty 46-year-old seeking wrinkle relief, I learned that four of her immediate family members had been diagnosed with breast or colon cancer before the age of 50.  Alarmed, I asked why she had not had the recommended screening mammogram for more than four years.
She said that she knew already that her risk for developing breast cancer was likely higher than that of most women.
“But I don’t have insurance,” she replied.
A screening mammogram could be obtained for about $90 and was discounted or free at local facilities every October for “Breast Cancer Awareness Month.”
She smiled when I proposed a deal: if she were to get a screening mammogram within sixty days of her treatment, I would offer a discount on what she paid me for cosmetic services.
“I’ll think about it,” she said, then shelled out over $400 for BotoxTM injections that took me ten minutes to administer.
Five months later, when she returned for her next wrinkle treatment, she reported that she still had not obtained a mammogram.
I encountered patients who gladly paid upwards of $1000 in cash for laser hair removal treatments.  The paperwork filled out during their initial consultation asked them to indicate whether or not they had health insurance.
 
Several hair removal patients reported being covered by Medi-Cal, the government funded health coverage for California ‘s low-income population.
 
A friend of mine sells private health insurance plans.  He told me of the 39-year-old father of two whose family was quoted a monthly insurance premium of $250.
“Are you kidding?” he said, refusing the coverage. “That’s almost as much as my boat payment!”
When serving in the Rural Health Center in my community, my colleagues and I offered free or discounted care for a large number of patients.  Many were covered by Medi-Cal or one of dozens of state programs paid for by the taxpayers of California.
The following items were commonly seen on patients or carried by their dependent children, who were also covered by subsidized programs:
• Cell phones and “BlackBerry” PDAs, including just-released models with a price tag of $400, plus an ongoing monthly service fee of $65-$150
• iPods and portable DVD players
• GameBoys and handheld electronic games
• Artificial fingernails requiring maintenance every two weeks at a cost of $40-$60 per salon visit
• Elaborate braided hair weaves, $300 per session plus frequent maintenance
• Custom-designed body art, including tattoos covering the entire torso, neck and arms, as well as body jewelry piercing every skin surface imaginable-and a few unimaginable ones.  Custom tattoo work, particularly the “portrait-type” and “half sleeve” art popular in this area, runs from $100-$300 per hour and can require up to 20 hours of work, depending on the complexity of the design. 
[Author's note: in three years, I performed over a dozen operations as the result of complications related to infected or abnormally healed body piercings.  Breast abscesses were the most common pathology, followed by cauliflower-shaped keloid scars that interfered with function.  Blood-borne diseases can be contracted during amateur and prison tattoos and piercings, and patients self-reported Hepatitis B, Hepatitis C and HIV infections.  Treatment of the complications of body art among my patients was largely covered by Medi-Cal or left unpaid.]
 
From the office I shared with another doctor at the clinic, I had a clear view of the patient parking lot.  It was not unusual for me to see clinic patients drive away in late model SUVs or cars customized in the style popular in my area.   I was given an education about the after-market accessories I saw daily, including “mag” wheels, chrome trim, spinning hubcaps and fancy custom paint jobs.  Gasoline prices were particularly high in central California at that time.
I overheard patients and their children chatting as I wrote in their charts.  Many had an excellent command of the plotlines of cable television shows aired only on premium channels.  Basic cable in my area cost over $50 per month, with premium channels extra.
I also overheard the front desk clinic staff members explain politely to angry patients that they did, in fact, have to make $5 co-pays for an office visit or meet their $20 “Share of Cost” on a $600 bill as required by Medi-Cal.
Like many of my colleagues in rural communities with few resources, I did care for patients who actually lived in poverty.  For them, luxury meant keeping the utilities on and having clean clothes for a rare visit to the doctor.  In California ‘s Central Valley , “dirt poor” is not just a phrase.  But these patients, who rewarded me in ways that don’t fit in the lines on any tax return, were outnumbered by others who considered health care a lower budget priority than decorated skin and expensive toys.
Individuals in this country have a right to decide how — and how not — to spend their money.
But that right does not include accepting entitlements without sharing responsibility.  Doing so contributes to the high cost of care that burdens every unsubsidized patient.
If individuals prefer to buy luxury items rather than pay for their healthcare needs, that preference should not be rewarded while taxpayers struggle to foot their own bills.
Dr. Linda Halderman was a Breast Cancer Surgeon in rural central California until unsustainable Medicaid payment practices contributed to her practice’s closure. She now serves as the healthcare policy advisor for California’s Senator Sam Aanestad while continuing to provide trauma and emergency services in rural communitieswww.americanthinker.com