Even with Medicare’s problems…

… it is light years ahead of private medicine!

By Jack E. Lohman

U.S. doctors and hospitals are absolutely the best, but we have a serious problem with making them accessible to all of our population.

It doesn’t help that our public Medicare system has politicians that have tried to price it out of the market. With, for example, the $780 billion giveaway to the drug industry.

Then they have the gall to complain that it’s going broke!

Clearly, reducing access moves more people onto the taxpayer dole, and we taxpayers pick up the tab nonetheless. So why don’t we fix the system and move on to addressing our other concerns?

It would be useful to have politicians that were not taking campaign cash from the medical insurance industry, because that bureaucracy is our biggest chunk of waste. And the last thing they want is efficiency. Over 31% of health care dollars are spent on insurance administration and profits, but to eliminate this waste means tackling the health care interests that fund the elections.

Neither are perfect but more problems exist on the private side of medicine than with Medicare. Costs are higher and fraud and overuse is higher because it usually doesn’t involve jail time.

There are a number of ways to fix the system:

1) Move to a Medicare-for-all system and eliminate the unnecessary billing waste and bureaucracy that totals 31% of today’s private health care costs. This will provide first-class Cheney-care to 100% of the population and still save the nation $400 billion in health care costs.

Problem is, the insurance industry won’t like this because they would lose much of the 31%, and they give politicians contributions needed for their re-election. So they have a loud voice, even if it is against the best interests of the nation.

2) Make all hospitals non-profit and require that they divest in their physician-employee conflicts of interest.

Problem is, the for-profit hospitals won’t like this a bit, and they also help fund the elections. And by having physicians on staff they can reward them for unnecessary patient admissions and ordering of expensive tests, because they control their salaries.

3) Stop overuse of expensive testing: Limit Medicare payments for lab tests (echocardiograms, ultrasounds, x-ray, MRIs, etc) to hospitals or independent testing labs (which provide excellent competition to hospitals).

Problem is, physicians who have purchased lab equipment for the purpose of increasing in-house revenues will object. And while they should be paid well — even better than CEOs — it should not be on the basis of how many tests they order for the patient.

4) Return the control of the patient to the physician: Only one person, the patient’s physician, should determine what tests, procedures and medications the patient should have.

Problem is, under our for-profit system, the insurers and CEOs want to take in dollars and not pay out dollars, so they often override the physician’s treatment choices.

5) Implement a common, national patient database:

Only one common vendor is required, like using the VA’s VistA system which the taxpayers have already funded. We don’t need the mish-mash of hundreds of software vendors.

6) Stop unnecessary hospital expansions: Reinstate the certificate of need (CON) to stop building hospitals where competition is not needed or even effective. Actually, in 100% of the cases where an additional hospital has been built, hospital fees have increased!

Problem is, well, if there are no more for-profit hospitals, there’s nobody left to object.

7) Stop fraudulent billing: This exists at all levels, even nursing homes that have put patients in front of a TV and billed Medicare for a therapeutic session. Mandate that any entity that bills Medicare put 100% of their employees through a fraud educational seminar, then strengthen whistleblower laws so employees provide the oversight and are rewarded for reporting fraud.

Problem is, no entity making its profits on the level of fraud they get away with will like this a bit, and I feel really bad about that. That’s free oversight without taxpayer expense!!!  But with this “inside team” there will be no more fraud. Employers won’t even go there.

8 ) Reform the medical-legal system: Doctors should defend themselves in front of a skilled three-judge panel of peers, not 12 lay people where doctor and lawyer personalities get in the way of facts.

Problem is, the lawyers won’t like that a bit. ‘Nough said.

 

How to fix it? Eliminate our cash-and-carry political system and make congressional health care like ours. You know, eliminate coverage for 15% of them and under-insure another 15%. Then we’ll see it fixed overnight.

— Disclosure: Lohman spent 40 years in the health care industry and is now a retired CEO. He is also a very happy Medicare patient.

7 Responses to Even with Medicare’s problems…

  1. An excellent point by point solution to the problem. Too easy though, isn’t it.

    The mythical “tort reform” issue Republicans like to bring up from time to time is a non-issue with your proposed peer panel of judges. Legitimizing guilt, while keeping the same penalties, should be the deterrent needed to insure better results.

  2. Yea, John, it’s too easy because it addresses the health care “issues” and not the over-$100 million the health care industry has given to politicians in campaign contributions to leave the system as it is… broken but profitable. Because the politicians actually get a piece of the action going forward (in campaign contributions).

    As well, I could expand the malpractice part to say that “punitive damages,” if any, should go into the health care fund rather than to lawyers and patients who have already been financially compensated.

  3. ezag says:

    In your single payer calculation, include the results in MA. The waiting time to get a primary care doctor is several weeks. The reason is the surge in patients (an argument for better care), and the poor financial results for doctors….they lose money on each public insured patient.

    This link covers some of the reimbursement issues around Medicare.

    Not to worry, Chris Dodd’s wife made $2 million last year as a member of various medical company boards. I’m sure she will give that up just as soon as there is public finance of elections.

  4. I agree that Medicare is not the highest, and a 5% increase in reimbursements would be appropriate. And I agree that Massachusetts is bad, but that’s because the politicians rolled over for the insurance industry.

    Remember that our problem isn’t health care, because if it were we’d fix it overnight. Our problem is a corrupt political system fueled by insurance industry campaign contributions. Cash bribes that bought the “mandated insurance” law and cash bribes trying to keep the law in place.

    Remember that these cash bribes originated from patient insurance premiums, a part of which were passed to the politicians. Your politicians are, simply, getting a piece of the private health care action. And the longer Massachusetts keeps mandates in place the longer they will share in the booty.

    That’s the way the game is played. That’s what’s driving the Blue Dogs to fight against reform. That’s what’s driving Baucus and the senate to oppose an efficient fix.

    Politicians prefer privatization over government services because one can give campaign contributions and the other can’t.

    Fighting for health care reform without first passing campaign reform is like fishing without a hook.

  5. ezag says:

    Why wouldn’t public campaign finance be corrupted like anything else political? We need constitutional change that restricts what politicians can do. We need tax and spend reform. We need it in such a way that voters have a meaningful vote. Patching this or that is always undone in the next election cycle.

  6. Because private companies can give campaign contributions and public entities can’t. Private industries can buy your politician, doesn’t that give you confidence in our political system?

  7. […] the Certificate of Need: Repealed thanks to massive campaign contributions from hospitals, this state law required legislative approval before hospitals could build needlessly in areas — not because […]

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