Wal-Mart: The New Determinant in Medical Care
Ladies and Gentlemen - we have a problem. I don't care if you are a physician, a dentist or a patient you've got to read an article in today's New York Times entitled "High Medicare Costs, Courtesy of Congress."
The article discusses the fact that as of July 1, companies will have to submit bids to compete with one another if they want to continue selling products to Medicare. While on the surface this may seem to be an excellent cost-cutting idea, low bid medical care is a dangerous precedent for several reasons. First, because it equates the quality of all devices with a similar function. For example, one of the items on the list (Chart is not available online) is CPAP. Currently Medicare pays $105 a month for a CPAP, the proposed cut will bring the monthly cost down to $67 a month. There's no distinction, in this chart, between CPAP, BiPAP, DPAP, humidfied units etc. it's just called CPAP. Will you get the device you really need?
Dangerous precedent - second reason for worry: we are on the verge of a national health care system. When will a Wal-Mart model be advocated for ALL health care? When will your doctor be forced to bid for the right to treat you? When will ALL doctors be forced into fields of medicine and dentistry that are not covered by a national health system in order to earn a decent income?
A recent press release emphasizes the possibility that more doctors and more research dollars will be spent on non-covered services than on those that are within the realm of government coverage:
"Rejuvenating newly identified fat compartments in the facial cheeks can help reduce the hollowed look of the face as it ages, according to new research by plastic surgeons at UT Southwestern Medical Center...'This anatomic fat cheek compartment completely changes how we look at facial aging,' said Dr. Rod Rohrich, chairman of plastic surgery at UT Southwestern and lead author of the study. 'The process to correct facial aging is now dramatically changed as well. No longer do we remove fat without pre-op analysis or merely lift the cheek; we must now lift and fill the face to restore a natural youthful, unoperated appearance.'
The research is part of an ongoing project among UT Southwestern plastic surgeons to better map fat compartments in the face and body.
'Research to identify specific fat compartments for surgeons to target helps provide more predictable results in the ongoing fight against facial aging,' Dr. Pessa said."
The appearance of facial aging as opposed to the health of individuals covered by Medicare... hmmm... let's figure out where the best medical minds would be more appropriately applied. But then again, cosmetic surgery is not and will not be covered by any government health care agency.
Think I'm being paranoid?
Another article in today's New York Times is titled "House Votes to Block Cut in Doctor's Medicare Fees." Again on the surface, a noble effort. But blocking a cut would reduce federal payments to Medicare Advantage plans that many retirees depend on for health care.
Doctor's fees, under Medicare, are ridiculously low anyhow - the projected increase of 1.1 percent in fees is not going to keep any physician in the system. With or without further cuts in compensation, many of the country's docs are opting out of Medicare. Personally, my wife's gynecologist and my cardiologist have opted out of Medicare and I have no option even of paying more for insurance in order to be able to utilize their services. Our internist was unable to continue rent payments to her landlord which forced her to close her private office and seek employment elsewhere.
With the thrust by both political parties to provide a national health plan that covers everyone (again, a noble goal) how far away are we from a medical system in which no bright individual wants to enter the field of medicine? How many excellent physicians, surgeons, dentists (who will sooner or later be forced into the system as well) will opt for cosmetics rather than treating your apnea, your heart disease, your diabetes?
And while we're on the subject, oral appliances for the treatment of snoring and apnea are considered durable medical equipment as well and are billed for under medical insurance. Will you be able to continue with your doctor's choice of appliance, or will you, under the new Medicare and National Health insurance, be forced to use a simple, ineffective boil and bite appliance because Wal-Mart sells them cheaply?
I don't know the answers but I know that we, as patients, physicians and dentists, need to start asking tough questions of our elected officials on both a national and local level. We've got to regain control of what was once the best medical care anywhere in the world.
Wal-Mart cannot be the shining star of health care to which we, as a country, aspire.
Dr. Barsh
The article discusses the fact that as of July 1, companies will have to submit bids to compete with one another if they want to continue selling products to Medicare. While on the surface this may seem to be an excellent cost-cutting idea, low bid medical care is a dangerous precedent for several reasons. First, because it equates the quality of all devices with a similar function. For example, one of the items on the list (Chart is not available online) is CPAP. Currently Medicare pays $105 a month for a CPAP, the proposed cut will bring the monthly cost down to $67 a month. There's no distinction, in this chart, between CPAP, BiPAP, DPAP, humidfied units etc. it's just called CPAP. Will you get the device you really need?
Dangerous precedent - second reason for worry: we are on the verge of a national health care system. When will a Wal-Mart model be advocated for ALL health care? When will your doctor be forced to bid for the right to treat you? When will ALL doctors be forced into fields of medicine and dentistry that are not covered by a national health system in order to earn a decent income?
A recent press release emphasizes the possibility that more doctors and more research dollars will be spent on non-covered services than on those that are within the realm of government coverage:
"Rejuvenating newly identified fat compartments in the facial cheeks can help reduce the hollowed look of the face as it ages, according to new research by plastic surgeons at UT Southwestern Medical Center...'This anatomic fat cheek compartment completely changes how we look at facial aging,' said Dr. Rod Rohrich, chairman of plastic surgery at UT Southwestern and lead author of the study. 'The process to correct facial aging is now dramatically changed as well. No longer do we remove fat without pre-op analysis or merely lift the cheek; we must now lift and fill the face to restore a natural youthful, unoperated appearance.'
The research is part of an ongoing project among UT Southwestern plastic surgeons to better map fat compartments in the face and body.
'Research to identify specific fat compartments for surgeons to target helps provide more predictable results in the ongoing fight against facial aging,' Dr. Pessa said."
The appearance of facial aging as opposed to the health of individuals covered by Medicare... hmmm... let's figure out where the best medical minds would be more appropriately applied. But then again, cosmetic surgery is not and will not be covered by any government health care agency.
Think I'm being paranoid?
Another article in today's New York Times is titled "House Votes to Block Cut in Doctor's Medicare Fees." Again on the surface, a noble effort. But blocking a cut would reduce federal payments to Medicare Advantage plans that many retirees depend on for health care.
Doctor's fees, under Medicare, are ridiculously low anyhow - the projected increase of 1.1 percent in fees is not going to keep any physician in the system. With or without further cuts in compensation, many of the country's docs are opting out of Medicare. Personally, my wife's gynecologist and my cardiologist have opted out of Medicare and I have no option even of paying more for insurance in order to be able to utilize their services. Our internist was unable to continue rent payments to her landlord which forced her to close her private office and seek employment elsewhere.
With the thrust by both political parties to provide a national health plan that covers everyone (again, a noble goal) how far away are we from a medical system in which no bright individual wants to enter the field of medicine? How many excellent physicians, surgeons, dentists (who will sooner or later be forced into the system as well) will opt for cosmetics rather than treating your apnea, your heart disease, your diabetes?
And while we're on the subject, oral appliances for the treatment of snoring and apnea are considered durable medical equipment as well and are billed for under medical insurance. Will you be able to continue with your doctor's choice of appliance, or will you, under the new Medicare and National Health insurance, be forced to use a simple, ineffective boil and bite appliance because Wal-Mart sells them cheaply?
I don't know the answers but I know that we, as patients, physicians and dentists, need to start asking tough questions of our elected officials on both a national and local level. We've got to regain control of what was once the best medical care anywhere in the world.
Wal-Mart cannot be the shining star of health care to which we, as a country, aspire.
Dr. Barsh
posted by Dr. Larry Barsh at
8:40 AM
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