Sunday, June 19, 2016
The Downside (escalating costs) of Merging Doctors and Hospitals http://nyti.ms/1rldU17 . The problem is that there is now not one trusted doctor in charge! Because patients are not in control of their own healthcare funds and we have a price fixed system patients cannot fund having their own physician be in overall charge when hospitalized. All the computer programs and other bureaucratic attempts by our government to coordinate care are destined to fail.
Wednesday, June 8, 2016
Macra: The Quiet Health-Care Takeover - From the May 31, 2016 Wall Street Journal by James C. Capretta & Lanhee J. Chen http://www.wsj.com/articles/macra-the-quiet-health-care-takeover-1464734029 A Few quotes from the article: "Unfortunately, the law empowers the federal bureaucracy at the expense of the doctor-patient relationship, putting the quality of American health care at risk" Comment, The more we detract from the patient-doctor relationship, the worse the care & greater the cost "In April the administration presented a 962-page regulatory behemoth. This new set of rules uses the power of Medicare to put the federal government in charge of almost every aspect of physician care in the U.S." Comment,This is the same government that runs the VA, these rules result from a poorly written, misguided law and an administration that believes in the ultimate power & correctness of the state.
Saturday, June 4, 2016
Latest essay posted 6/4/2016 on MDalert about my e-book, Understanding Healthcare: A Historical Perspective. Gives a flavor of the story of the beginnings of modern medicine to today's massive confusion. http://www.mdalert.com/article/understanding-healthcare-a-historical-perspective
Tuesday, May 31, 2016
"Understanding Healthcare: A Historical Perspective", my new e-book was the topic of discussion with Gordon Evans on Kalamazoo, MI NPR WMUK. The discussion was far ranging and informative. Here is the link, http://wmuk.org/post/wsw-health-cares-history-and-present
Sunday, May 15, 2016
Mr. Andy Slavitt Acting Administrator Center for Medicare & Medicaid Services 7500 Security Boulevard Baltimore, MD 21244 Re: MACRA Regulations Dear Mr. Slavitt, While trying to control costs, Congress and CMS have over the years been in the process of destroying the patient-physician relationship, paradoxically increasing costs. MACRA only exacerbates this problem. This has happened as physicians take time from patients to enter data demanded by the bureaucracy. Additionally physicians have less time to think about and conceptualize their cases causing the need for greater testing. It is true that healing is better when patients feel a bond with their physician. This is becoming more difficult as the government tries to micro-manage the patient-physician interaction. Also the negative impact of this law on physician training will be massive. Residents now are spending more time with computers and less with their patients. Their history taking and physical diagnostic skills are rapidly decaying. Thus, in the future, we will have physicians with less skill needing to order more tests greatly increasing costs, while providing care of lower quality. The idea of providing bonuses and penalties around an arbitrary price-fixed amount devoid of market verification is economically unsound. The value of a physician visit should be determined by the individual patient and not by a distant bureaucracy. A way to accomplish this change would be a voluntary program for seniors. Those who wish to do so would have an actuarially determined yearly deposit into a special health account. This account would be used to pay for most outpatient care and fund a nationally available high deductible plan. In this light the only solution regarding regulations for MACRA is for your agency to return to the Congress and ask for re-addressing the “SGR FIX”, advising them to implement this voluntary Medicare plan addressing physician re-imbursement. Sincerely, Kenneth A. Fisher, M.D. Nephrologist – Author “Understanding Healthcare: A Historical Perspective” Cc. Congressman Fred Upton
Monday, April 25, 2016
Two recent articles In Forbes (in electronic form) discuss how this administration is doing its best to eliminate health savings accounts and what an enlightened policy would look like. In “HSAs Under Attack In Obama Exchanges” by Grace-Marie Turner, Forbes, 4/21/2016 http://www.forbes.com/sites/gracemarieturner/2016/04/21/health-savings-accounts-under-attack-in-obamacare-exchanges/#7bbe09fe1ceb In this article Ms. Turner writes that instead of giving Americans more choices, this administration is formulating rules that make purchasing the popular health savings account on the exchanges just about impossible. While Dr. John Goodman in Forbes, 4/19/2016, “Roth Health Savings Accounts: What The World Needs Now” http://www.forbes.com/sites/johngoodman/2016/04/19/roth-health-savings-accounts-what-the-world-needs-now/#18c15fae6d30 Writes that unencumbered by legal restrictions Roth Savings Accounts would via tax policy balance payments by the individual for routine healthcare with third party insurance that would for big-ticket items. This could be available to all Americans who choose to do so via a refundable tax credit.