A NY Times article exposes a huge problem with medical specialist profiteering that is part of why we pay so much for healthcare in the USA
Healthcare is a game of chess. The insurance company makes a move, the healthcare providers, the people who make the equipment, the drug companies, the hospitals make another move. The game is financial with big winners and of course big losers.
The game continues to go on, without benefit to those who are served by the system; the patients. Unfortunately, huge mistakes have been made by insurance carriers as they are penny wise but pound foolish, manipulating the healthcare system to supposedly keep costs in check. Providers, being some of the brightest (they did go to medical school) often respond in ways that keep their personal situation viable.
According to the NY Times, a number of specialties have managed to take simple procedures, and turn them into cash cows, charging ridiculous fees we all pay for through the nose with our ever increasing healthcare premiums. They charge more, we wonder why premiums keep going up, and the average physician who may not have had a raise but has had significantly decreased reimbursements from insurers for years is struggling to pay their bills in their busy practices. Something is clearly wrong with this picture.
The insurers have been tinkering with our model for many years and have promised us through HMO and other plans that limit what we receive that we are taken care of and healthcare costs were to be kept in check. Of course, that is a fairytale and yet another reason we may finally see a single payer system such as Medicare become what everyone has, since it has the most clout to reduce costs and healthcare inflation, rather than our current system of higher out of pocket costs, copayments and reduced time with your primary care doctors as they struggle to see more clients to pay the overhead.
The NY Times explores a huge growing problem in our healthcare system. Isn’t it time we break up the healthcare monopoly?
Patients’ Costs Skyrocket; Specialists’ Incomes Soar
CONWAY, Ark. — Kim Little had not thought much about the tiny white spot on the side of her cheek until a physician’s assistant at her dermatologist’s office warned that it might be cancerous. He took a biopsy, returning 15 minutes later to confirm the diagnosis and schedule her for an outpatient procedure at the Arkansas Skin Cancer Center in Little Rock, 30 miles away.
That was the prelude to a daylong medical odyssey several weeks later, through different private offices on the manicured campus at the Baptist Health Medical Center that involved a dermatologist, an anesthesiologist and an ophthalmologist who practices plastic surgery. It generated bills of more than $25,000.
“I felt like I was a hostage,” said Ms. Little, a professor of history at the University of Central Arkansas, who had been told beforehand that she would need just a couple of stitches. “I didn’t have any clue how much they were going to bill. I had no idea it would be so much.”
Ms. Little’s seemingly minor medical problem — she had the least dangerous form of skin cancer — racked up big bills because it involved three doctors from specialties that are among the highest compensated in medicine, and it was done on the grounds of a hospital. Many specialists have become particularly adept at the business of medicine by becoming more entrepreneurial, protecting their turf through aggressive lobbying by their medical societies, and most of all, increasing revenues by offering new procedures — or doing more of lucrative ones.
It does not matter if the procedure is big or small, learned in a decade of training or a weeklong course. In fact, minor procedures typically offer the best return on investment: A cardiac surgeon can perform only a couple of bypass operations a day, but other specialists can perform a dozen procedures in that time span.