@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.
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.
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 "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.
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?
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!
"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
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.
@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.
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
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.
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.
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?
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.
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
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.
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.
Viagra is covered under Medicare. We all pay into Medicare.
@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...
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.