Monday, December 10, 2012
Why does health care reform have to mean spending more on health care? We spend much more per person than any other country. We d-emphasize the trusting relationship between patient and physician while over-using drugs and devices. Instead of addressing relevant issues Congress has passed an expensive insurance bill. This blog discusses how a physician-patient based system versus a government price control system would provide universal coverage while decreasing costs and providing better care. Every American should have a Health Savings Account, From Birth, with High Deductible Insurance, a reasonable plan is publisher here. http://www.washingtontimes.com/news/2012/may/3/prudence-of-a-patient-centered-approach/
Tuesday, August 14, 2012
As industry moves from mass production to mass customization, our soviet style PPACA attempts mass production, ignoring individuality. Using price controls and central planning the Soviet Union imploded under the weight of its own bureaucracy. Instead of promoting individuality and rational pricing using health savings accounts and high deductible insurance the PPACA uses Soviet like price fixing, central planning and rationing in a failed attempt to control costs. In no other field is individuality and judgment more important than in medicine. A centralized bureaucratic system will not work.
Friday, July 27, 2012
The reality is that no one knows in our price fixed health care system the real value for any activity good, bad or indifferent. With price transparency, health saving accounts and high deductible insurance we could provide excellent care for all in America at far less cost. One only has to look at the state of Indiana to see the success of this model of health care.
Thursday, July 19, 2012
By the Supreme Court not striking down the PPACA our nation will possibly be saddled with an intrusive unworkable health bureaucracy, the inability for physicians to care for their patients appropriately and huge deficits we cannot afford. Many millions will remain uninsured with many millions in Medicaid which borders on having no insurance at all. The irony is that Health Savings Accounts along with High Deductible Insurance was beginning to spread throughout the country lowering health care costs. With creative tax policy we could provide excellent care for all in America with these patient centered insurance policies.
Wednesday, July 18, 2012
Posted in part on Sermo 7/10/2012 Hypocrisy abounds, the AMA, ACP and others support the bill because they think they will receive more money. Ironic, from a government that has to mortgage the future of our children and grandchildren to do so. There are of course better alternatives that using proven methods would insure all Americans at far less cost and promote a closer relationship between the patient and their doctor. As an example see our article in the Washington times, http://www.washingtontimes.com/news/2012/may/3/prudence-of-a-patient-centered-approach/
Tuesday, May 15, 2012
Published in the Washington Times FISHER AND GROSS: Prudence of a patient-centered approach Allowing patients to choose level of care would result in savings By Dr. Kenneth A. Fisher and Dr. Lee S. Gross Thursday, May 3, 2012 Everyone wants affordable, high-quality health care. The Affordable Care Act (ACA), also known as Obamacare, is proving to be a less-than-viable approach to accomplishing that goal. Physicians, politicians and patients are beginning to realize that the ACA neglects to address problems with cost, quality and access. Obamacare fundamentally changes the doctor-patient relationship. For patients, it neglects individuality and forces a Washington-based, administratively imposed, one-size-fits-all expensive approach to the practice of medicine. It expands the failed government policies that have plagued Medicare and Medicaid for decades. The government’s own actuaries predict that future health care costs will exceed 20 percent of gross domestic product, greater than our present economy-choking 18 percent. Additionally, the projected 10-year cost of the law already has increased from $800 billion to an astonishing $1.76 trillion. Although intended to provide universal coverage, Obamacare still leaves approximately 20 million people uninsured. Sixteen million people are to be covered by expanding Medicaid, a failed system that does not provide adequate care. Just 30 percent of physicians currently see Medicaid patients because the reimbursement they receive for those patients doesn’t even cover their overhead. Practicing physicians know there is a better way, a patient-centered approach. A simple way to restore responsibility to health care spending is to put people in charge of how they spend their own health care dollars. All Americans should have individual health savings accounts (HSAs) coupled with high-deductible health plans (HDHP) for unexpected catastrophic conditions. HSA funds could grow, accumulating tax-free over a lifetime, thereby eliminating the need for succeeding generations to subsidize holders’ care. For the approximately 17 percent of our population who are truly indigent, their HSAs and HDHPs would be funded from Treasury assets. For the 30 percent of families receiving the earned-income tax credit, those funds would be deposited into their HSAs. For the remainder of Americans, HSA contributions would have tax incentives. Employers, instead of providing traditional health insurance, could provide funding for HDHPs, which, because of their lower cost, would increase employees’ take-home income. Individuals and businesses would use pretax dollars for purchasing all health insurances. Historically, the model of HDHPs was criticized because it was thought many people would avoid getting preventive and chronic-disease care because of possible large expenditures out of pocket or from their HSAs. That was a legitimate concern before direct primary care programs, which today remove the obstacles to patients seeking preventive care and management of chronic conditions. Routine expenses should not be the responsibility of an insurance company, anyway. Homeowner’s insurance doesn’t pay for weeds in your lawn, nor should health insurance pay for your cold or sprained ankle. In a direct primary care model, patients meet most of their basic health care needs for less than the cost of their cellphone bills. HDHP is then restored as true catastrophic insurance. This enables health care decisions to remain between the patient and doctor. Free-market principles do work in medicine. Lasik surgery is not covered by third parties, yet over time, the cost of the procedure has decreased markedly while quality has increased significantly. Patients have to determine value, and surgeons must compete on price and quality. HSAs, along with direct primary care plans and high-deductible catastrophic insurance, can provide outstanding individualized care for all Americans. This could enable each generation to fund its own care while decreasing our national health care costs and greatly improving our economy. When compared to the government-centered approach, patient-focused solutions win every time. Dr. Kenneth A. Fisher, a nephrologist, and Dr. Lee S. Gross, a family physician and co-founder of Epiphany Health, are the presidents of the Michigan and Florida chapters of Docs4PatientCare.
Sunday, April 22, 2012
I Posted this on Sermo, a physician discussion web site, Nov. 29, 2010, still pertinent today. In my opinion, both political parties have it wrong, we need a health care reform bill not an insurance reform bill. Isn't it time for physicians to tell the Congress and the American public that given the right tools, we can provide excellent care for all Americans costing about 15% of gross domestic product versus today's 18%. This would require a retro-fit of our medical culture, good histories, good physicals, less reliance on technology, adequate payment for a 30 minute visit and significant changes at the Congressional level. I believe we must offer the nation a viable alternative for our message to be heard.