Wednesday, June 17, 2009

Obama to the AMA

Time for a "doctory" post...maybe you heard this week that Obama spoke to the American Medical Association. You can read the full transcript here (and you should with some discernment.) Here are some of the "highlights" and my own personal opinions about them.

Our largest companies are suffering as well. A big part of what led General Motors and Chrysler into trouble in recent decades were the huge costs they racked up providing health care for their workers; costs that made them less profitable and less competitive with automakers around the world. If we do not fix our health care system, America may go the way of GM: paying more, getting less and going broke.

Hmmm. I'm no expert but don't the insurance companies charge the high rates? We have been fooled into thinking that "high medical costs" are the culprit (i.e.unnecessary tests, treatment, etc.) Raise your hand if you think that the insurance companies are barely making it. Anyone? If medical costs were sooo high, then insurance companies would be struggling to make it. They would be paying out their profit to take care of their customers. NOT HAPPENING. I'm sure that insurance rates are high...they are for everyone.

However, let's think about how much Unions are costing GM....GM is paying workers even when they are not working. Who else gets that. If I'm a small business owner and shut down my store for weeks and don't sell anything, I don't make any money. NO WORK=NO PAY. I understand taking care of one's employees, I do, that is noble but the favor is not returned by the workers who could have taken pay cuts to save their company but we get used to our cushy paycheck and spend, spend, spend and have no cushion for the meager times. Let's think about where the finger is being pointed.

First, we need to upgrade our medical records by switching from a paper to an electronic system of record keeping. And we have already begun to do this with an investment we made as part of our Recovery Act.

I agree wholeheartedly. There are not many things more frustrating than having to take care of a patient that has spotty or no medical history!

The second step that we can all agree on is to invest more in preventive care so that we can avoid illness and disease in the first place. That starts with each of us taking more responsibility for our health and the health of our children. It means quitting smoking, going in for that mammogram or colon cancer screening. It means going for a run or hitting the gym, and raising our children to step away from the video games and spend more time playing outside.

Again...agreed.

Building a health care system that promotes prevention rather than just managing diseases will require all of us to do our part. It will take doctors telling us what risk factors we should avoid and what preventive measures we should pursue. And it will take employers following the example of places like Safeway that is rewarding workers for taking better care of their health while reducing health care costs in the process. If you're one of the three-quarters of Safeway workers enrolled in their "Healthy Measures" program, you can get screened for problems like high cholesterol or high blood pressure. And if you score well, you can pay lower premiums. It's a program that has helped Safeway cut health care spending by 13% and workers save over 20% on their premiums. And we are open to doing more to help employers adopt and expand programs like this one.

Yes...again, yes.

Here is where it starts to get dicey...

We need to bundle payments so you aren't paid for every single treatment you offer a patient with a chronic condition like diabetes, but instead are paid for how you treat the overall disease. We need to create incentives for physicians to team up--because we know that when that happens, it results in a healthier patient. We need to give doctors bonuses for good health outcomes--so that we are not promoting just more treatment, but better care.

With reform, we will ensure that you are being reimbursed in a thoughtful way tied to patient outcomes instead of relying on yearly negotiations about the Sustainable Growth Rate formula that's based on politics and the state of the federal budget in any given year. The alternative is a world where health care costs grow at an unsustainable rate, threatening your reimbursements and the stability of our health care system.

Folks...that means that your doctor will be paid based on how well you take care of yourself. Have out of control diabetes? Overweight? When those lifestyle managed risks result in hospitalization, your doctor takes it in the nose because apparently doctors are supposed to be able to babysit you and your lifestyle choices. Not very fair. Do you think that doctors are going to want to assume the care of unhealthy patients to begin with?

We need to use Medicare reimbursements to reduce preventable hospital readmissions. Right now, almost 20% of Medicare patients discharged from hospitals are readmitted within a month, often because they are not getting the comprehensive care they need. This puts people at risk and drives up costs. By changing how Medicare reimburses hospitals, we can discourage them from acting in a way that boosts profits, but drives up costs for everyone else. That will save us $25 billion over the next decade.

Let me state for the record...I know for a fact that Doc and every other doctor I know would never withhold comprehensive care that an elderly person needs so that they could readmit them later on to make money. Obama, come on...really? You think that is what doctors are all about?

In regards to insurance...

If you don't like your health coverage or don't have any insurance, you will have a chance to take part in what we're calling a Health Insurance Exchange. This Exchange will allow you to one-stop shop for a health care plan, compare benefits and prices and choose a plan that's best for you and your family--just as federal employees can do, from a postal worker to a member of Congress. You will have your choice of a number of plans that offer a few different packages, but every plan would offer an affordable, basic package. And one of these options needs to be a public option that will give people a broader range of choices and inject competition into the health care market so that force waste out of the system and keep the insurance companies honest.

I believe he's talking about a government sponsored health insurance company option as the "public option". Here's what currently happens...the government says to doctors "you have medicaid patients and here's what we're going to pay you" then the other insurance companies say, "you take x amount in payment from medicaid...we're going to pay you the same." So essentially, you will have no competition. You will have the government insurance setting the standard payment (most likely low) and the other insurance options following suit. Then you'll have the government option being cheaper than all other insurance options and the majority of the nation going with the government option because it is more affordable, essentially creating a monopoly. Who would pay more than they have to? That leaves us with socialized medicine. Sneaky.

Everyone getting healthcare is a great and noble idea but we MUST factor in our own responsibility for taking care of our health and also the fact that we live in a capitalistic society. I want options, choices...not to be slowly funneled into a government run insurance because it is the only affordable option. Sorry, but our government doesn't run much of anything well.

3 comments:

Mandy said...

I don't support Nationalized Healthcare.

However, I do think that the insurance companies need an overhaul. Let me give you an example as to why:

In Chicago, when taking off my son's snowsuit, it pulled his arm. After about an hour, he would still not move his arm at all. I took him to the hospital. We waited for hours, then got in to see a doctor. The doctor jingled some keys and my son reached for them and he was fine. Quite some time later, I received a bill for my portion of the co-pay and the details of what had been sent to the insurance company. It was incredible! There were 3 days worth of charges including everything from heart medication to latex gloves. I fought it for so long. Years, literally, but it did no good. In the end, my insurance company did not care that it was paying for stuff that didn't happen and the hospital ultimately never got anyone to look into any of it.

The exact same thing happened when my daughter fell and scraped her chin badly on a Saturday afternoon. Same outcome.

Here in Wichita, the hospital and doctor bill for the birth of my son went smoothly without a single hiccup. So, I'm not saying that it's all hospitals, but I believe that some of them tack on extra things so that insurance companies will pay more. It brings more profit.

Is that the fault of the hospital, doctor or the insurance company? Personally, I feel like it's both the hospital and the insurance company. It's no wonder our insurance rates are so high.

In my view, a complete overhaul is needed, but nationalizing is not the answer. I have friends in Canada...I don't want that mess!

Sondre Lyn said...

Can I just say that I have typed in about 4 responses, and they just ramble on and on. So I will just make it short and sweet... I agree! :D

I do appreciate the way you present this subject and put a human face on the great and mighty -- and severely daunting -- healthcare system.

Charity said...

I'm going to be even shorter.

I really REALLY agree!

I too want an overhaul, but NOT NOT NOT government medicine.