Skip to main content

Health Care Reform 2017 Solved!

Have you noticed over the past several weeks that reforming the health care system must be slightly more complicated that we were told?  The promise that Obamacare would be repealed and replaced on Day 1 seems to have been met with a few minor obstacles.  In other words, it’s dead in the water.

Whose fault is it?  It’s like Agathe Christie’s Murder on the Orient Express [Spoiler alert!] – everyone is guilty!

The Freedom Caucus stiff-armed the Speaker of the House.  The GOP House moderates dissed the Freedom Caucus.  President Trump learned that being the leader of the free world is not quite the same as being a CEO of a private company.  If the repeal plan was adjusted to capture a few more hard line GOP members, then moderate GOPers jumped ship.  The Democrats gloated at the GOP’s failure, although their smiles became slightly more taut once Judge Neil Gosruch was confirmed to occupy the GOP’s 'stolen' Supreme Court seat. 

Remember John Boehner?   He’s the happiest man on the planet!

Now, I don’t pretend that the Whistleblower can reform the health care system in a blog post, although I don’t think my results could be worse than the GOP controlled House of Representatives.


Health Care Reform - Searching for Low Hanging Fruit

As a medical insider, consider a few issues listed below that would save zillions and improve our health.  They are not controversial.  Why then, aren’t we pursuing ideas that every medical professional supports?  Perhaps, one of my erudite readers can enlighten us, as I am stumped.   
  • Tens of millions of dollars are wasted on unnecessary antibiotics, which result in serious side effects and are creating superbugs. 
  • We are spending too much money on end-of-life and futile medical care.
  • Every physician who is breathing orders CAT scans, stress tests and colonoscopies that are not truly necessary.
  • Patients are punctured much too often for blood tests, particularly in the hospital when multiple specialists (like me) are on the prowl.  Most patients need only occasional blood tests.
  • Patients, particularly our elderly, are overmedicated.  The length of some of their medication lists are staggering.  Any wonder they are routinely sent to gastroenterologist to explain their nausea and other side-effects?
  • Whatever happened to watchful waiting?  Does every complaint that a patient brings to the office have to result in test or a prescription?   How often does a patient’s medical issue simply resolve on its own?
  • The PSA, prostate specific antigen has single handedly harmed more men and wasted more money than perhaps any other screening test.  Despite mountains of evidence supporting my contention, the diehards are still hanging on.
That was a quick list of some very low hanging fruit.  I’ll wager that if all of them were implemented, that we could reform the entire system and have enough money left over to subsidize obscenely high drug prices.   The absurdity is that the above bullet items would be supported, if not championed, by every reasonable physician, informed patient and health care policy pro.  Here’s the riddle.  Why do we persist in behaviors that we all agree are destructive?   Why do we keep furiously digging in the same hole that leads nowhere?






Comments

Popular posts from this blog

Stop Medical Malpractice: The White Coat Wall of Silence

Photo Credit Leisure Guy, one of my most faithful commenters, opines that I am omitting an important aspect of the tort reform argument. He has implored me repeatedly to read a particular book that I suspect buttresses his views, but this worthy pursuit is simply not near the top of my priority pyramid. Since he’s retired, he enjoys the luxury of burrowing deeply into the base of his priority pyramid. With 4 tuitions to go, retirement is a distant mirage for me. I’m can be a ‘leisure guy’, but only in my dreams. I have written throughout this blog and elsewhere that there are too many frivolous lawsuits against physicians. I have admitted that caps on non-economic damages are not ideal, because they deny some worthy plaintiffs of complete compensation, but I support them because I believe they serve the greater good. I have ranted that there is no effective filter to screen out physicians who should never be invited to the litigation party in the first place. I believe that the...

When Should Doctors Retire?

I am asked with some regularity whether I am aiming to retire in the near term.  Years ago, I never received such inquiries.  Why now?   Might it be because my coiffure and goatee – although finely-manicured – has long entered the gray area?  Could it be because many other even younger physicians have given up their stethoscopes for lives of leisure? (Hopefully, my inquiring patients are not suspecting me of professional performance lapses!) Interestingly, a nurse in my office recently approached me and asked me sotto voce that she heard I was retiring.    “Interesting,” I remarked.   Since I was unaware of this retirement news, I asked her when would be my last day at work.   I have no idea where this erroneous rumor originated from.   I requested that my nurse-friend contact her flawed intel source and set him or her straight.   Retirement might seem tempting to me as I have so many other interests.   Indeed, reading and ...

Prostate Cancer Screening: Stop The PSA Train!

About 10 years ago, my dad was to see his general internist. I have always refrained from giving medical advice to my family, for all of the reasons why doctors should not treat or advise their relatives. But, on this occasion, I did give Dad some unsolicited advice, particularly as I knew that his physician fired the diagnostic testing trigger readily. “Dad, please make sure that he doesn’t check the PSA (prostate specific antigen) test.” Dad indicated that he would convey my concern to his doctor, who ran the test on him anyway. Apparently, he includes the PSA test as a matter of routine on all men over a certain age. Twenty-five years ago as a curious, but skeptical medical student, I learned about prostate cancer. I learned that every man will develop it if he lives long enough. I learned that most cases of prostate cancer remain silent and never interfere with the individual’s life. I learned that the treatment for these cancers involves either major surgery or radiation, both of ...