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Published: Wednesday, Nov. 27 2013 12:00 a.m. MST

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4word thinker
Murray, UT

I just want to go to the doctor I like when I think I need to go, pay a reasonable fee for services rendered, and be able to choose follow up treatment if warranted.

I think Chemo-therapy is barbaric, and I will never consent to have it, so I don't want to pay for insurance that covers it.

I have chosen to live my life addictive-drug free. I have proven myself to not be a drug abuser. I don't want to have to buy insurance to cover drug abuse treatment. I am confident I do not need it.

I do like to engage in sports. I do need insurance to cover any accident/injuries I might get doing that, and I am very willing to pay for it.

This being a 'free' country, I just want to be free to choose my health care and what insurance I will buy.

Irony Guy
Bountiful, Utah

@4Word thinker, you don't like paying for my chemotherapy? I don't play sports and I don't want to pay for your sports injuries.You are in my insurance pool anyway. Why don't you get out? Find an insurance company that covers ONLY sports injuries. Your premiums should be something to behold...

Pagan
Salt Lake City, UT

Viagra is covered under Medicare.

We all pay into Medicare.

ECR
Burke, VA

Wow! The first three comments seem to totally miss the point of the article. What the doctor is saying is that healthcare, as a for profit business, is not good for any of us. When we can get back to letting medical practitioners get back to practicing medicine instead of just being data processors then we will have health care that makes everyone happy.

Tyler D
Meridian, ID

EMR’s – interesting topic (and is anyone going to actually comment on this topic?).

Since we’re relatively new to the game on this, my guess is we could find solutions to this dilemma either in coordinated care clinics (Mayo, etc.) or in many other country’s healthcare delivery models – just need to convince the American Exceptionalism crowd that we’re not always the best at everything and we can learn from others, especially those who have made and now corrected the mistakes we’re currently faced with.

And I hate to break it to you doc but the days of mom & pop shops have been over for most people for a long time. Welcome to the world of high finance, big business & economies of scale.

But in your case, much of the problem might disappear were it not for the fee-for-service reimbursement mechanism.

Owl
Salt Lake City, UT

Insurance premiums are determined by actuarial science based on risk profiles. If we want to discard risk and insure everyone for any risk (pre-existing conditions, private aviation, BASE jumping, and the list goes on) it should be a societal responsibility. Tax everyone to fund a basic level of universal health care, not just the other rate payers in your own plan. This is done in the UK, Canada, Australia and most European countries but they also have private insurance supplements that are based on risk. The US is enamored with "universal health care" without understanding its implications or the fact that the ACA is not universal health care. The ACA roll out also confirms that the government has neither the capacity or expertise to replace insurance companies.

procuradorfiscal
Tooele, UT

Re: "Why don't you get out? Find an insurance company that covers ONLY sports injuries. Your premiums should be something to behold..."

As usual, liberals either miss or, -- more likely -- intentionally obscure, the point, entirely.

Real Americans are accustomed to being free to choose. It's in our nature. We like it. And we hate being told it's un-American to do so.

We've come to this point -- ie., having all our important decisions made by feckless liberals -- with great difficulty. The result of decades of that perfect-storm combination of perfidious liberal politics and an apathy born of noting a governmental drift to the left, not because of a new American list to port, but because of perfidious tactics of a cynical minority on the left.

Many of have come to hope that Obama's destruction of America health care is the liberal overreach that will wake real America from her slumber. And, that's the source of anxious, shrill, liberal screams that it's too late to change Obamacare.

Real America prays it's not too late, however. If it is, it means we're too late to save her.

RedShirt
USS Enterprise, UT

To "Dr. Michael P. Jones" I hope that you are a better Dr, than political observer. In the practice of medicine you should hopefully be competent at diagnosing the root of the problem, and do not just treat the symptoms.

In your letter, you have described the symptoms of trouble in the health insurance and care industires, but you have not quite reached the source of the problems.

The problems come from government mandates. For instance, you complain about the electronic records and the time it takes for nurses to fill those out. The electronic records are being mandated and pushed by government. The ACA includes mandates to establish national databases filled with your health information. As the ACA becomes more fully implemented, things will get worse because there is more government regulation and more mandates that must be met.

Tell us Dr, what is the cure for government mandates forcing businesses to become more inefficient?

Hutterite
American Fork, UT

There is a huge behind the scenes techno bureaucracy that is in place simply to support the health care 'industry' and mostly the insurance industry. None of that, and the paperwork and administration it downloads to health care providers, goes to actually providing health care. A single payer system does away with far and away the majority of this administrative overhead.

4word thinker
Murray, UT

Irony Guy -

My premiums would be zero. Your irony is that the president you love, his program you love, would deem the insurance that you tell me to buy to be substandard and therefore illegal.

Nothing funny about it. I have to pay for COPD, STDs, obesity illnesses, and whole host of other self inflicted illnesses, even though I live a low risk life style, along with a whole host of treatments that I believe are inappropriate and would not subject as dog to, let alone a human being, all because this administration insists they know what health care I need more than I do.

That is your guy, the president you light candles to.

Maybe you should get out and go for a run, or hit a few tennis balls. You might breath the fresh air and see the light.

procuradorfiscal
Tooele, UT

Re: "A single payer system does away with far and away the majority of this administrative overhead."

Yeah. And it does away with the majority of decent health care, as well, reducing medical practice to a trade or craft, engaged in by dullards who can't find, and are not permitted better work.

Of course, that's the goal of socialism -- reduce us all to fungible, dependent dullards, confined to a monotone, gray society, toiling away, hopeless, insensate, in a soviet-style gulag, to the glory of its ruling plutocrats.

Nate
Pleasant Grove, UT

@ECR "What the doctor is saying is that healthcare, as a for profit business, is not good for any of us."

He has said nothing about profit. His complaint is against the idiots who try to control the way he does his job, when they know nothing about how to do his job. This is a pervasive feature of centrally planned economies, whether the control comes through governments or crony corporations.

@Hutterite "A single payer system does away with far and away the majority of this administrative overhead."

...and replaces it with additional layers of bureaucratic government overhead.

ECR
Burke, VA

Nate said, "He has said nothing about profit. His complaint is against the idiots who try to control the way he does his job..."

What he actually said was, "There’s a huge difference between that and the health care industry, which is more about industry than health or care. Third-party payors don’t really care what happens in an exam room. The visit that you, as a patient, have been anxiously waiting for could just as easily be shoes or oranges or pork bellies to these folks. It’s just a commodity. It’s just data. And now the industry wants it documented in a format that works for billers and statisticians but not so much for doctors: the electronic medical record."

You are right Nate, he never mentioned the word 'profit' but what he described is everything related to profit. That's how 'healthcare industry' differs from just plain healthcare. What the good doctor wants to do is practice medicine, plain and simple, and he's finding it difficult to do in our current setup where institutions that know nothing about how to do his job" have all the power because they make all the profit.

marxist
Salt Lake City, UT

"Of course, that's the goal of socialism -- reduce us all to fungible, dependent dullards, confined to a monotone, gray society, toiling away, hopeless, insensate, in a soviet-style gulag, to the glory of its ruling plutocrats."

The goal of most of the socialists I know is to have worker managed and owned enterprises, where they have some say in the manner of work they do. What is to be done away is the accumulation of capital through the exploitation of labor. Labor must own the means of production. The Soviet Union didn't deliver the goods because the status of labor under that system didn't change the status quo - they still worked for an employer (government). And yes life was pretty dreary in the old Soviet system, like at Wal-Mart today.,

gmlewis
Houston, TX

Years ago, "expert systems" were attempted to automate medical diagnosis. You just answer a few questions and presto! you get a diagnosis. Fairly quickly, it was realized that it takes an experienced doctor to detect the correct answers to those questions, and that the questions vary greatly depending upon other health conditions.

To a certain extent, I find these Electronic Medical Records to be failing for the same reason: overkill. A common, interactive system for all health situations is going to include a whole lot of detail that isn't pertenent to individual situations.

The health company I work for had developed an automated medical record system that suited us just fine for many years. Obamacare required us to scrap that wonderful system and buy an Obamacare-approved system. Price tag? About 40 million dollars. Efficiency and effectiveness? Out the window!

procuradorfiscal
Tooele, UT

Re: "And yes life was pretty dreary in the old Soviet system . . . ."

Which is the reason I can't understand modern marxists. EVERY time it's been tried marxism-lenninism has resulted in death, destruction, and untold misery.

How could otherwise intelligent people possibly advocate a system with such a lousy and vicious track record?

Nate
Pleasant Grove, UT

@ECR "What the good doctor wants to do is practice medicine, plain and simple...."

Right. What he didn't say was that he wishes he could practice medicine without making any money. He has a profit motive, and he wants to do his job right. The two are not mutually exclusive.

Truthseeker
SLO, CA

There are many great advantages to EHRs, especially coordination of care. Any Dr. treating a pt. can have immediate access to the medical record, including the results of tests, scans, lab work etc. Having worked in a hospital, which involved reading (or more often, trying to decipher) Drs, notes, I can see many benefits to having EHRs.

That said, I can also see disadvantages if the system means Drs spend most of the exam staring at a computer screen and little time examining and making eye-contact with their pts. Programs/systems need to be user-friendly.

"Countries with national health-care systems such as Denmark, Sweden, and New Zealand have largely dispensed with records on paper. According to a study by the Commonwealth Fund, Danish doctors reported in the late 1990s that they were saving 30 minutes a day by prescribing drugs and ordering lab reports electronically.

In the U.S., things are different. Some providers, such as Kaiser, the Mayo Clinic, and, interestingly, the VA have installed sophisticated data systems. "
(Bloomberg)

ECR
Burke, VA

Nate - I wish folks would study what the term "for profit" means before they comment on the subject. The doctor doesn't need to make a profit to survive. He can operate a practice, pay his staff and himself well, make all his payments for services and equipment without making a profit. He can do it and break even.

There are non-profit companies that exist everywhere where the individuals working there are paid handsome salaries. It is the need for profit to buy expensive estates and playthings that drive up the cost of any business. My guess is that Dr. Jones is not only happy with the circumstances of his practice but he is most likely making more money than he did working in the "healthcare industry." I hope you understand the difference.

Nate
Pleasant Grove, UT

@ECR "The doctor doesn't need to make a profit to survive."

Whether or not he makes a profit is for him to decide. Again, profit wasn't what he was complaining about. It was about third party payers who get between doctors and their patients by pushing the use of electronic medical records, thus degrading quality in the examination room.

When he complains about the "industry" doing this to him, he is talking about our newly-nationalized health insurance system. His article is an indictment of Obamacare, not free enterprise. It is Obamacare which is demanding the use of electronic medical records, by rewarding those who use them, and punishing those who don't. The "third party payors" who "don't really care what happens in the exam room" are behaving as they do because of Obamacare.

He is making a point which has been made many times before: Obamacare enhances neither health nor care.

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