Sunday, April 17, 2011

Hospital Advertising

Have you ever noticed that while driving on any major road in America you see billboards touting that the local hospital is in the top 100 as certified by this or that “prestigious” firm or accounting group? Hospitals are paying multiple millions of dollars to these “prestigious” companies enabling them to make these claims. The hospitals work hard to meet the firm’s criteria, enabling the company to say that the hospital is outstanding in this or that quality so as to increase the hospital’s prestige relative to its competitors and attract more patients. This is another costly advertising practice increasing our nation’s health care costs. In reality, there is no such thing as “the best” hospital. Every patient is unique and the special skills needed for that particular person may or may not be available in the hospital that has been declared “the best”. Maximizing benefit for the patient is served by having a trusted, knowledgeable, objective physician who knows her/his needs who then recommends the best place to meet that need. One way to decrease medical costs, therefore, is by having the public not place any credence to this form of advertising leading to its eventual demise.

Tuesday, April 12, 2011

Beneficial Care

Technology must be used wisely. There are instances where the application of procedures, for example heart catheterization and stents in selected patients, are extremely helpful. However, medical treatments are all too often employed when they are not indicated which neither helps and even harms the patient. This practice wastes Medicare resources. For example, it is estimated that up to 30% of all Medicare costs are spent on procedures and therapies that are not helpful. Procedures and tests such as heart stents, CAT scans, MRIs and intensive care, while in many circumstances appropriate, are frequently not necessary, with no chance of benefit to the patient. Refining Medicare to reduce excessive procedures and expenditures would eliminate the need to cut benefits to seniors. The PPACA, recently passed by Congress, is primarily funded by progressive decreases in Medicare payments which will result in significant decreases in care. This would not be necessary if we practiced thoughtful beneficial care.

Monday, April 4, 2011

Necessity of an Appropriate Care Committee

Seniors will not get the medical care they need because of the PPACA. Our government is broke, so is cutting care to save money. Instead, our government could institute a salaried, three person committee in each hospital to ensure that only beneficial care is provided. This could save up to 30% of Medicare health care costs, or around $145 billion dollars, that is otherwise spent on care of no value.

***Benefit of Appropriate Care Form***

Procedures that are not indicated result in more suffering. The addition of an admission form will help the patients, physicians and salaried medical team make rational decisions for beneficial care while avoiding the patient solely managing the complexities while they are sick and distraught. In the long term this will help hospitals and physicians because Medicare payments will not be cut.

Saturday, April 2, 2011

Can Medicare As We Know It Be Saved?

Medicare is in deep financial trouble. Federal spending for this program in 2011 is expected to be $487.9 billion. This amount is projected by the Congressional Budget Office to increase to over one trillion dollars by 2020 which, if not addressed, would bankrupt the federal government. In response to this projection, the deficit and the desire for universal coverage, the newly enacted Patient Protection and Affordable Care Act will arbitrarily decrease Medicare payments, cutting spending by $523 billion over the next ten years. This will decrease care for many if not most Medicare patients by severely limiting their access to physicians and hospitals.

There is a better way to control Medicare’s costs and provide universal coverage. A great deal of our total medical expenditures, almost one-third by several different estimates, is for non-beneficial inappropriate care. A physician committee in each hospital to help provide only beneficial care individualized for each patient would avoid over-treatment, decreasing Medicare costs by at least 20-25%. As therapies of no benefit expose the patient only to risks, this would also improve outcomes. Resources would then become available to fully fund Medicare, provide universal coverage and maintain the financial viability of the federal government.