tag:blogger.com,1999:blog-7323692122514281455.post6113826434862147613..comments2024-03-18T17:51:23.018-04:00Comments on MD Whistleblower: Obama's Health Care Reform: Let the Games BeginMichael Kirsch, M.D.http://www.blogger.com/profile/07555280388086931097noreply@blogger.comBlogger21125tag:blogger.com,1999:blog-7323692122514281455.post-11856868300803762742010-01-22T08:02:39.138-05:002010-01-22T08:02:39.138-05:00This comment has been removed by a blog administrator.Leonard Okothhttp://www.limosbusesjets.comnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-31762995779948880772009-08-26T17:34:53.763-04:002009-08-26T17:34:53.763-04:00then reply!!!!!!then reply!!!!!!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-63920854738750728022009-07-30T07:51:59.267-04:002009-07-30T07:51:59.267-04:00If I were really scared, then I wouldn't be an...If I were really scared, then I wouldn't be anonymous.Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-62323026069441788332009-07-30T00:51:48.306-04:002009-07-30T00:51:48.306-04:00I see the owner of the site got scared over his sa...I see the owner of the site got scared over his salary and is not replying to my comments.<br /><br />Another lying limousine liberal who wants to brand himself with this site into the next Atul Gawanade.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-54559844990786157052009-07-16T17:46:40.052-04:002009-07-16T17:46:40.052-04:00And this:
http://www.jpands.org/vol14no2/kurisko....And this:<br /><br />http://www.jpands.org/vol14no2/kurisko.pdfAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-24862951617637771472009-07-16T17:23:37.041-04:002009-07-16T17:23:37.041-04:00should be read by every patient
http://www.jpands...should be read by every patient<br /><br />http://www.jpands.org/vol11no4/gervais.pdfAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-86539589905005131802009-07-16T14:27:50.096-04:002009-07-16T14:27:50.096-04:00correction to the previous post:
For some reason,...correction to the previous post:<br /><br />For some reason, Congress does NOT institute price controls on lawyers, even though legal services are next to a necessity in American society.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-82332640133344102262009-07-16T14:20:46.758-04:002009-07-16T14:20:46.758-04:00To all the doctors that want a single-payer option...To all the doctors that want a single-payer option:<br /><br />Again, from Ben Stein:<br />"You do not get rich by a lifetime of work in any field in which there are government price caps on earnings."<br /><br />The ignorance among physicians about economics is staggering. <br />Good luck greedy lazy disorganized physicians! <br /><br />For some reason, Congress does institute price controls on lawyers, even though legal services are next to a necessity in American society.<br /><br />Good luck to the new and recent graduates :-)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-80272801396997435202009-07-16T14:14:55.447-04:002009-07-16T14:14:55.447-04:00Again, from Ben Stein:
You get rich by working in...Again, from Ben Stein:<br /><br />You get rich by working in fields in which you can fix your wages, preferably with the government’s help. These include law, where you need a license to practice, and thereby can lift yourself out of working for free-market wages. (Everyone in this country pays homage to the free market, but no one wants to work for free-market wages.) They also include medicine, where a far more difficult license is required, and where desperate patients will pay almost anything to look and feel good. They also include accounting at the C.P.A. level.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-31051066729012664892009-07-16T14:05:30.417-04:002009-07-16T14:05:30.417-04:00In Minnesota, where every major health insurer now...In Minnesota, where every major health insurer now offers high-deductible plans, nearly half a million enrollees, or 10 percent are now covered by such insurance.<br /><br />That's created an explosion in demand for price information - which used to be treated like industry secrets. Now, law requires clinics and hospitals to give an estimate whenever a patient asks for it.<br /><br />Last year, overall medical spending in Minnesota grew at just 6 percent, the smallest increase in a decade, according to the Department of Health. At companies that switched to HSA-type plans, the slowdown was even more dramatic, with some reporting actual drops in medical spending.<br /><br />For Jeff Palumbo of Grant, Minn., the epiphany came this year when he took his son in for ringworm. Palumbo had just switched to his employer's high-deductible plan. Despite multiple phone calls to his clinic and his insurer to ask the price of a doctor visit, he kept getting the same maddening answer: It depends. Finally, someone told him it would cost at least $85. When Palumbo ended up getting billed $125 for the visit - "For seven minutes!" - he called to complain.<br /><br />Next time, he said, he'll go to a MinuteClinic. (It charges $59 for ringworm.) Despite the frustrations, Palumbo likes his control over spending. "It makes you ask more questions," he said.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-3066100107196607542009-07-16T13:56:08.279-04:002009-07-16T13:56:08.279-04:00The high-feature deductible is already available. ...The high-feature deductible is already available. If I am not mistaken, there are undercover insurance policies available to physicians with high-deductibles and low premiums. General population of course has no access to such policies :-) Doctors are preying on people's ignorance and Congress lawyers are milking physicians for their greed.<br /><br />I liked the observation of Ben Stein: "Everyone in this country pays homage to the free market, but no one wants to work for free market wages." :-)Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-20337007287350938022009-07-15T21:10:56.141-04:002009-07-15T21:10:56.141-04:00While I do not endorse abolishing medical insuranc...While I do not endorse abolishing medical insurance entirely,the high deductible feature is worthy of consideration. When patients have some 'skin in the game', they are much more discriminating about their physicians' recommendations. When patients bear some financial responsibility, they will not automatically acquiesce to their doctors' casual suggestions to proceed with an MRI for back pain or a colonoscopy after a day of constipation. Conversely, when medical care is on someone else's tab, then neither the doctor nor the patient have any incentive to proceed conservatively. This is similar to businessmen who dine out on the company's expense account. I suspect that they order much differently than if they were paying the bill personally.Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-51909234306683785552009-07-15T19:17:27.974-04:002009-07-15T19:17:27.974-04:00Everyone is wrong.
Medicare and all the other medi...Everyone is wrong.<br />Medicare and all the other medical insurance companies should be completely abolished!<br /><br />How can you call medical insurance market competitive when it is dominated by less than a dozen insurers?<br /><br />Medical care should be delivered for cash in order to reduce costs. <br /><br />Imagine a patient coming to see a doctor who quotes him a price of $150+ for an eye exam. The patient will not accept this highway robbery. He'll say, here is $30, take it or leave it. :-) COSTS DOWN!!!<br /><br />750,000 physicians competing against each other over pricing of their services will bring the costs down and offer truly universal coverage.<br /><br />Also, it is of no secret that physicians price their services according to the Medicare RVUs. Just like a pharmaceutical company, a physician (at a minimum!) expects to be paid according to the government-set standard.<br />Excuse me, but Medicare effectively creates a price floor for physician and pharmaceutical compensation. This is fraud, because government has in effect created a trust with physicians and pharmaceutical companies.<br /><br />In a free market, the price floor for a good or service is determined by the consumer's demand for that service at the quoted price.<br /><br />I hardly think most people would be willing to pay $150 to see a doctor for a derm exam.<br /><br />Single-payer system will lower the standard of care in US, for sure. No government can predict how to price the market. Soviet Union, anyone? 70-year experiment in the making.<br /><br />Also, do you think Canadians/English/Japanese/Swiss doctors and economists are dumber than their American counterparts? But they cannot make their systems rival that of US in terms of quality of service. Decades of government pricing models for healthcare brought nothing but a decline in the quality of service and availability of treatments.<br /><br />All medical insurance should be eliminated. Doctors will with time agree to lower CASH fees in order to protect their practices. Consumers will benefit immediately.<br /><br />Also, I am sure that at least 10% of the physicians will immediately defect from the herd and form consumer advocate groups that will advise on whether a particular physician service is reasonably priced and whether a doctor is taking advantage of a patient by sending him for an MRI over a minor headache.<br /><br />Abolish Medicare and all the look-alikes. Make people pay for regular/chronic care and allow catastrophic insurance option with a high deductible.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-46069857008057846352009-05-17T22:01:00.000-04:002009-05-17T22:01:00.000-04:00I do not agree with your comment, "Health insuranc...I do not agree with your comment, "Health insurance companies make their profit by denying health care to sick people." Do supermarkets earn their profit by denying food to those who need it? Are construction companies obligated to solve homelessness? I agree that the current system has inequities and variations in care that demand reform. I also agree, and have posted repeatedly, that we are wasting billions of dollars in excessive medical care. These two facts are inarguable. The dispute is over the best path to pursue to reach the objective. Single payer, your solution, addresses many deficiencies but could be a cure much worse than the disease. If we had single payer with universal access and mediocre medical quality, would you be satisfied?Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-64898503661924220922009-05-16T20:16:00.000-04:002009-05-16T20:16:00.000-04:00There are two main arguments in favor of single pa...There are two main arguments in favor of single payer health care.<br /><br />THE MORAL ETHICAL ARGUMENT<br /><br />The first is the ethical moral argument. Health insurance companies make their profit by denying health care to sick people. That is immoral and unethical.<br /><br />THE ECONOMIC ARGUMENT<br /><br />The second compelling argument is economic. Our current system of for-profit corporate health insurance has created an unbearable economic burden on the nation.<br /><br />There are over 100 separate health insurance companies operating under different sets of rules creating a huge 30 % administrative overhead. For comparison, administrative overhead for Medicare is only 2%.<br /><br />By converting to a single payer system, we immediately save 300 billion dollars in administrative overhead. Medicare is a 40 year example of a successful single payer system which has an administrative overhead of 2%, not 30%.<br /><br />As a nation, we are now paying twice what other countries pay for health care, yet we do not have universal health coverage here in the US. 50 million Americans are without healthcare and 87 million Americans without health insurance at some point in the past 2 years. Almost half the bankruptcies currently filed in the United States are because of medical bills. <br /><br />Despite the costs we pay, the United States ranks LAST on a list of 19 industrialized nations in preventable deaths, and 29th of 37 in infant mortality. The World Health Organization ranks the US at 72nd for healthcare accessibility and efficiency. We can no longer maintain the status quo for the ways we currently provide and pay for health care.<br /><br />WHY WE DON'T HAVE SINGLE PAYER NOW<br /><br />These two arguments in favor of a single payer heath insurance system (moral and economic) are so compelling, that one must conclude the only reason we don't have single payer now is because of lack of representative government. The obvious conclusion is that our government does not serve the people who elected them. Rather, our elected government officials serve the special interests of the health insurance industry and other corporations who make massive campaign contributions.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-52378017445175872342009-05-16T18:52:00.000-04:002009-05-16T18:52:00.000-04:00As a physician, I do not need a study to inform me...As a physician, I do not need a study to inform me what I experience every day in practice. Spending time on medication formulary issues is torture. However, it is constitutionally permissible since it is cruel but not unusual. I agree that it is an enormous waste of time and money and drains office morale. My frustration, however, is not sufficient for me to advocate for a single-payer system. Medicare is a model of a single payer and has its own mountain of useless paperwork and bureaucratic morass to wade through. Physicians are opting out of Medicare or pursuing concierge practices to escape its onerous requirements and ever diminishing reimbursements. I agree with the anonymous commenter above that my profession is aching for deserved relief on this issue. What other profession has to hire a separate staff just to figure out what we should be paid?Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-47405494279858462032009-05-16T18:10:00.000-04:002009-05-16T18:10:00.000-04:00A national study of nearly 900 U.S. physicians and...A national study of nearly 900 U.S. physicians and medical group administrators found that physicians spent on average 142 hours annually interacting with health plans, at an annual cost to physician practices of $31 billion, or $68,274 on average per physician, per year.<br /> <br /> Key Findings:<br /><br />• Physicians, on average, spent 142.3 hours per year interacting with health plans, or 3.0 hours per week and 2.7 physician work weeks per year. Primary care physicians spent significantly more time (164.9 hours per year) than medical specialists (123.7 hours) or surgical specialists (100.3 hours).<br />• Nursing staff spent an additional 23 weeks per year per physician interacting with health plans, while clerical staff spent 44 weeks and senior administrators spent 2.6 weeks doing so.<br />• Compared with other interactions, physicians, on average, spent more time dealing with formularies (78.2 hours for primary care doctors, for example), and the least on submitting or reviewing health plan quality data (1.9 hours annually for all physicians).<br /><br />Converted into dollars, practices spent an average of $68,274 per physician per year interacting with health plans; primary care practices spent $64,859 annually per physician, nearly one-third of the income, plus benefits, of the typical primary care physician.<br /><br />The Bottom Line:<br /><br />Although health plans claim to have reduced the administrative burden they place on physicians, evidence shows that the average physician spends nearly three weeks a year interacting with plans, at an estimated annual cost to practices of $31 billion. Primary care physicians, especially those in small practices, spend larger amounts of time interacting with plans than those in other specialties.<br /><br />Citation:<br /><br />L. P. Casalino, S. Nicholson, D. N. Gans et al., "What Does It Cost Physician Practices to Interact with Health Insurance Plans?" Health Affairs Web Exclusive, May 14, 2009, w533-w543. http://content.healthaffairs.org/cgi/content/abstract/hlthaff.28.4.w533Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-34489007078801273352009-05-16T17:29:00.000-04:002009-05-16T17:29:00.000-04:00My posting predicted that the 'love wouldn't last'...My posting predicted that the 'love wouldn't last', but the speed of the annulment is impressive. My fear of single-payer is that we will end up with medical mediocrity in exchange for universal access. Where do you get better service, Federal Express or the Division of Motor Vehicles? I agree that we should be suspicious of the insurance companies. The pursuit of profit is not inherently evil. Every player in the game - including the public - has an angle and an agenda. I'm not sure that anyone at the table is pure.Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-91596111945631939942009-05-16T14:40:00.000-04:002009-05-16T14:40:00.000-04:00THE HEALTH INSURANCE INDUSTRY HAS TAKEN BACK THEIR...THE HEALTH INSURANCE INDUSTRY HAS TAKEN BACK THEIR ‘PROMISE TO CONTROL COSTS. It would affect their profits. . . <br /><br />Read about it here: http://www.nytimes.com/2009/05/15/health/policy/15health.html?_r=2&partner=rssnyt&emc=rss<br /><br />It’s what we’ve known all along: we can't trust the insurance industry with health care reform.<br /><br />Only a single-payer approach to healthcare reform will end the inhumanity of our failed healthcare insurance system, where <I>profits are more important than patients’ health, and where people die because of it.</I>Our fight for equal access to healthcare for all is about democracy, human rights, civil rights, and basic human decency.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-42367664132219722482009-05-15T17:01:00.000-04:002009-05-15T17:01:00.000-04:00Consider all of the players in the medical arena. ...Consider all of the players in the medical arena. Which ones are truly on the patients' side?Michael Kirsch, M.D.https://www.blogger.com/profile/07555280388086931097noreply@blogger.comtag:blogger.com,1999:blog-7323692122514281455.post-9332921140410390902009-05-15T08:57:00.000-04:002009-05-15T08:57:00.000-04:00How right you are . As a "primary care" Internist,...How right you are . As a "primary care" Internist,Health Affairs just informed me that I contribute approximately $68,000 of scut uncompensated labor every year to support these greedy clowns.<br />Uncompensated physician labor in this country contributes $21-30 billion yearly to a private health industryAshok V. Daftary, MD, FACP.https://www.blogger.com/profile/05315782364982338542noreply@blogger.com