Are the hospital systems about to be Trumped? Our president warns our hospitals that their costs are on his radar.

Anyone who has had a test in the hospital, or in a hospital-related system is aware of how dysfunctional and overpriced these services can be. The system of high prices, billing services sending us bills from people we may not know and in and out of network scams is a huge part of what drives the cost of care. If small medical practices ran their offices like that, they would likely be out of business.

President Trump’s new healthcare secretary Alex Azar is putting hospital systems on notice while speaking at the Federation of American Hospitals convention in D.C..

As reported in “The Hill”, “The administration will make it easier for patients to access their health records, encourage health providers to be more transparent about costs of procedures and services and remove regulations that “impede” innovation. HHS will also “experiment” with payment models in Medicare and Medicaid to “drive value and quality,” he said.”

The problem thus far has been due to entrenched special interests, and money.   While this sounds great, the problems are so entrenched and integrated between hospital monopolistic mega systems that were developed as insurance companies tried to pick off the smaller hospitals with underpricing, tiers and other mechanisms, the response from private hospitals was to get big or go home.  In NJ, the Barnabas system is a prime example.

The funky system of rebates and middlemen that sell medical supplies and drugs have raised costs.

The incentives for doctors to do more tests than to spend the time to evaluate, treat and refer appropriately is also a huge part of the problem as well. Most of these tests come back negative and often, the problems are of a musculoskeletal nature however, most medical doctors do not know how to rule this out in their examinations.   Testing and procedures are far more profitable and as a rule, doctors will do what is more profitable, as reimbursements for what is more appropriate and cost-effective are reduced.

Primary care doctors have often developed poor referral patterns because of a lack of time with their patients, as they see more patients to make up for declining reimbursements.  It is easier and less risky for them to refer out than to spend the time since their reimbursements have gone down, while their record-keeping and administrative duties have increased.  Most doctors dislike their electronic record systems that are time-consuming to use and the systems themselves do not talk to each other. Many doctors blindly refer to physical therapy even though chiropractors are much more successful at managing many musculoskeletal complaints. Many pediatricians just refuse to use chiropractors or refer to them, even if they are the more appropriate referral for a musculoskeletal complaint.

Medicare’s new system of rating doctors based on how they refer may or may not work due to entrenched referral patterns and just plain bad habits on how and who they refer to and why.

Often, we are referred for tests to hospitals, instead of to smaller clinics who are less expensive because doctors must refer to the hospitals they have privileges with and refer there, instead of to less expensive clinics.  Large hospital systems have purchased physician practices who see patients and refer back to the system which is anti-competitive, while they use loopholes to charge higher fees even for their primary care visits.

While it is time to look at what is really wrong; the problem in healthcare is capitalism, where the search for profit from the large institutions of hospitals, drug manufacturers, middlemen, and insurers has developed a system of money care, regardless of the outcomes.

This has to change, but can it change while insurers and large hospital systems are in charge of the systems, while they are also a huge part of the problem?   Time will tell but I wish Mr. Azar good luck in trying to unwind it while large insurers are using an unstable Obamacare marketplace to keep us insured.

Check out the article here

Trump’s health chief warns hospital execs about health care costs: ‘Change is coming’

BY JESSIE HELLMANN – 03/05/18 01:27 PM EST

President Trump’s new health secretary issued a warning Monday to a room of hospital executives about soaring health care costs: change is coming, whether you like it or not.

Speaking at the Federation of American Hospitals convention in D.C., Health and Human Services (HHS) Secretary Alex Azar laid out a series of actions the administration will take that are aimed at lowering health care costs and warned that it wouldn’t be deterred by powerful special interests.

“Today is an opportunity to let everyone know that we take these shifts seriously, and they’re going to happen — one way or another,” Azar said. “The administration and this president are not interested in incremental steps. We are unafraid of disrupting existing arrangements simply because they’re backed by powerful special interests.”

The administration will make it easier for patients to access their health records, encourage health providers to be more transparent about costs of procedures and services, and remove regulations that “impede” innovation. HHS will also “experiment” with payment models in Medicare and Medicaid to “drive value and quality,” he said.

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