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Feedback

Recently I asked for feedback on how people viewed their healthcare. I appreciated the large input. I noticed most comments were negative and the big winners were high deductibles, loss of or no coverage, and abundance of red tape. I will have some thoughts on solutions next. Read More 
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Healthcare solutions

The healthcare consumer must have some role as payer. Deductibles are flawed because they severely dissuade patients from initiating care. Sometimes this is something serious which will become much more expensive as time goes on. Co-pays are a great idea when somewhat tied to ability to pay. It makes you think about decisions like going to the doctor, or worse, the ER for a very minor problem. It also makes you consider whether an inexpensive proven treatment is as good as the outrageously costly new, less tried alternative. Read More 
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Too complicated

In summary, the healthcare system has become cumbersome to the point of being dysfunctional. Our proposed new system, which I originally endorsed, will clearly not solve things. As it is now it is also overly complicated with too many moving parts. There is clearly no perfect solution, but we can do better. More next time. Read More 
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The pot grows bigger

When Medicare and Medicaid arrived, the pot became much larger, and possibilities to increase income improved. Read my three books THE CORRIDOR, THE PAIN DOC, AND THE LABYRINTH for great examples. At the same time, the insurers and now the government began to fight back with deductibles, co-pays, and piles of bureaucracy and paper work. When I first entered practice the three-man group had all the billing done by one part time employee armed with a pencil and a pad of bills. Now such a practice might have four or more full time people with computers to do the same work. This type of inefficiency has invaded every corner of medicine. Read More 
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"Gaming" the system

Insurance companies were very clever, but in general physicians are a very intelligent group. They would not be where they are today if this was not so. New ideas to “game” the system arrived, creative billing, always doing the most expensive procedure, streamlining systems to see more patients. I do not claim this included all physicians, but it’s very easy to rationalize using the newer, more costly, but not necessarily superior diagnostics or treatments. Read More 
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Reimbursement drops

It did not take long for employers and insurers to take notice rising fees, after all, they were the payers. Insurance companies began to ask doctors and hospitals to “participate in their plan.” In return they would send patients their way and, at first, even pay the participating provider more. Once the “hook” was set, the fees began to drop, and if unhappy providers “dropped out” they would not be paid at all. Read More 
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Price Escalation

Unfortunately over the ensuing years two predictable things occurred. With more secure payment, technology soared and with it price. Secondly, people came to expect the best and wanted the newest and most expensive care and drugs even when their physician told them they were more costly and not any better—or even inferior. In addition, patients and providers wanted coverage for office visits, drugs and other things. Of course, doctors, hospitals, drug companies, etc. had no qualms about raising price. Since the patient wasn’t paying, he didn’t care. Read More 
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