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President Trump’s Drug Plan Is On Target

Stanley Feld MD,FACP,MACE

https://www.cbsnews.com/news/trumps-medicare-rx-blueprint-has-a-tricky-wrinkle/    

President Trump’s proposal for lowering drug prices to an affordable range is on target.

I have received a several requests asking me to explain the administrations plan. The “media is the message.” The traditional media has once again missed President Trump’s message completely. I suspect the traditional media has missed President Trump’s message on purpose because of their bias against the president.

The traditional media jumped on Trump’s plan as a non-plan aimed to penalize the middle class for the benefit of the pharmaceutical industry.

Either the traditional media hates Trump and his administration so much that they are against everything he does or they have not read his plan with an open mind because it has too many words in it.

It is pretty clear that Nancy Pelosi did not read President Trump’s drug plan or if she did she did not understand it. She said:

“This weak plan abandons the millions of hard-working families struggling with the crisis of surging drug prices.”

Nancy Pelosi’s statement is otter nonsense.

Her statement is reminiscent of the statement she made about Obamacare;

“You have to pass the plan in order to see what is in it.”

Any thoughtful Democrat should be ashamed that Nancy Pelosi is their leader.

I picked the coverage of only a few of the traditional media, CBS news, The New York Times and the Washington Post’s. All the progressive leaning media are really echo chambers of each other.

Each media outlet missed the Trump administrations’ point. They all are looking through their progressive lens. They believe the only plan that would work is a single party payer system controlled by the government.

They also see a tired public looking forward for the government to take over the complicated issue of healthcare. They have not interest is looking at the unintended consequences of a government takeover of the healthcare system.

A single party payer system will not work because public dependence on bureaucrats and politicians has never worked.

Simple examples are the VA Healthcare System and Medicaid. Government controlled health plans such as the VA system became too inefficient, costly, corrupt and unsustainable. The quality of care decreased and consumer choice and input has been eliminated.

People would never know what President Trump’s drug plan is all about it if they just read about it in the traditional media. If they made it easier for themselves and just read the headlines, as some of my friends have, they would know nothing about Trump’s drug plan.

One must listen carefully and read the source material.

President Trumps YouTube

https://youtu.be/Cds8h9DbTdc

This is the official outline document of the steps that need to be taken to fix the broken drug plan system.

CBS new got it wrong right off the bat.

http://www.cbsnews.com/trumps-medicine-rx-bluprint-has-a-trickly-wrinkle/

“The Trump administration’s “Blueprint” to lower drug prices and reduce patient costs made one thing clear: The government will not directly negotiate with drug companies to secure lower prescription prices. But that doesn’t mean it isn’t proposing changes that would dramatically alter the way Medicare pays for some of the most expensive drugs, and in the process, potentially raise out-of-pocket costs for some of the country’s sickest patients.”

CBS News then brings up an issue that part of President Trump’s solution. The news agency criticizes the administration before it knows the administration’s solution.

A cornerstone of the Trump plan calls for all Medicare drug payments to be consolidated under Medicare Part D, the prescription drug plan for Medicare enrollees administered by private insurers. Under Part D, insurers and middlemen known as pharmacy benefit managers (PBMs) negotiate with drug companies for discounted prices in exchange for the drug companies’ products being included in the PBMs’ list of covered drugs.

But drugs intravenously administered in physicians’ offices, such as chemotherapy and vaccines, are usually covered as a medical treatment under Medicare Part B. Physicians buy these drugs directly from manufacturers, and Medicare reimburses doctors for the drugs’ average sales price plus 6 percent.

A perfect example is the yearly flu shot. Most flu shots are given at local pharmacies and supermarkets for Medicare patients’ convenience.

Medicare Part B pays $120 for a $15 injection dose. How is that for a colossal waste of Medicare dollars?

Pharmaceutical companies are against the idea, partly because they generally are paid more under Part B than Part D.

Alex Azar, Health and Human Services secretary and former president of the U.S. division of pharmaceutical giant Eli Lilly (LLY), has been touting the move to consolidate Medicare drug payments.

“Bringing negotiation to Part B drugs is such a potent way to bring down prices that PhRMA is already protesting the idea,” Azar said in a recent speech at the American Enterprise Institute in which he referred to the drug industry trade group called Pharmacuetical Research and Manufacturers.

Nonetheless, CBS points out a potential paper tiger to leave the message that the plan is no good. The “media is the message” even if it is a lie.

“But Azar and others have shed little light on exactly how this change would take place, leaving patients worried about the potential for astronomically higher out-of-pocket costs”.

The plan is there. CBS news has not read the plan.

“Medicare Part B presently creates incentives for doctors to purchase more expensive drugs to get a higher dollar profit”

This is a negative incentive that the President promised to eliminate. Physicians to not profit from higher drug prices. In the case of the flu shots pharmacies and supermarket pharmacies administering the flu shots profit.

“Azar said; it will create incentive for insurance companies and PBMs in Medicare Part D to negotiate discounts and lower prices and pass them on to patients.”

President Trump said he promises to eliminate the extreme profit the pharmacy benefit managers take from the system.

The New York Times took a different negative slant in order to criticize Present Trump.

“President Trump has the power to sink pharmaceutical stocks with a single jab about high drug prices.”

“But in a much-anticipated speech on the topic on Friday, Mr. Trump largely avoided the issues the industry fears the most, such as allowing Medicare to directly negotiate drug prices, or allowing Americans to import drugs.”

President Trump’s plan is to force pharmacy benefit managers to negotiate the best price for Medicare and patients with private insurance in a free market system and not in a government controlled system.

The government negotiates much lower drug prices for itself in the military and VA systems. The drug companies just cost shift and charge the rest of us a higher price

“Investors noticed: Stocks of major drug companies rose after his speech, as did those of pharmacy benefit managers, or the “middlemen” that Mr. Trump said were getting “very, very rich.”

Last weekend I asked a retired friend what he thought of the Trump plan. He said President Trump is going to make the drug companies and the pharmacy benefit managers very, very, rich.

This is regurgitation of the NY Times coverage from a well-educated man. The media is the message!

 

Time Magazine coverage was no better. It, too, was anti-Trump. Time Magazine did not bother to understand that the Trump drug program is a free market system without cronyism.

“ President Donald Trump’s long-promised plan to bring down drug prices would mostly spare the pharmaceutical industry he previously accused of “getting away with murder.” Instead he focuses on private competition and more openness to reduce America’s prescription pain.”

Why can’t the media discuss the facts and let us decide what will work or not work? What is wrong with competition? It works. Government control doesn’t seem to work.

“The administration will pursue a raft of old and new measures intended to improve competition and transparency in the notoriously complex drug pricing system.”

“But most of the measures could take months or years to implement, and none would stop drug makers from setting sky-high initial prices.”

I believe the public is starting to see how the traditional media does not want to understand President Trump’s proposal or how President Trump is going to execute on his promises.

“Trump called his plan the “most sweeping action in history to lower the price of prescription drugs for the American people.”

“But it does not include his campaign pledge to use the massive buying power of the government’s Medicare program to directly negotiate lower prices for seniors.”

Actually President Trump’s drug plan does use the massive buying power of the Medicare program to negotiate lower prices for seniors. He is doing it indirectly but through a free market system.

The traditional media’s prime focus is to criticize President Trump’s programs regardless of the facts.

In fact, with his drug plan, President Trump has published a blueprint that is going to change the metrics of how drugs are priced. His plan will make prices transparent to patients and physicians.

Patients will be given the choice to pick the best price. Physicians will be given the choice to decide if the price charged for new medication is worth the increase in price.

President Trump is going to eliminate the present failed system of pricing medication. It has not worked for consumers.

His blueprint cannot be evaluated in the context of the present pricing system.

I will describe the potential for improving the system with his blueprint in my next article.

All I can say at this point is let us see what is going to happen.

 

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



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Another Fabulous Father Son Weekend

Stanley Feld M.D.,FACP,MACE

Brad and I get together for a father and son weekend each year.

Some of my readers have the impression that we always go to the Consumer Electronic Show in January.

We have gone to a couple of CES because I like seeing the new electronics that are offered.

This year Brad wanted to go to the place where he was born. He was born in 1965 on Blytheville Air Force Base, the home of the 851st Medical Group.

I was stationed at Blytheville Air Force Base from 1965-1967 as a Captain in the Air Force and chief of medicine of its hospital.

Blytheville map

Arkansas International Airport is the old airstrip for the Strategic Air Command base. Brad and I landed there.

 

Cecelia found the hospital bill for Brad’s birth a few years ago. The total bill was 15 dollars

The hospital was a thirty-bed acute care hospital with all the modern equipment for 1965.

B hospital 2018 copy

The hospital seemed much prettier in 1965. There is total rumble within its wall now.

 

Life on the base was great for all of us. It was the first time I made a living wage.

I remember Cecelia walking through this front door with Brad in her arms after he was born to take him to our base housing.

Blythville hospital door

What a thrill to see them walk out of the hospital.

We spent a lot of time playing with Brad in the front of our house at 1924 A Dogwood Dr. Our back yard faced the airfield.

Blytheville in front of 1924 B (1) copy
Cecelia, Brad and Stan. Brad’s 6 months old.

Brad fun on swing Blytheville 1966 copy

Brad at 8 months

Brad and me Blytheville 1965 copy copy

Brad 12 months and me 1966

Brad and I think we found our house during our visit. However, it was impossible to tell. All the street names have been changed.

Blytheville house

This might have not been the actual house but is was the actual configuration.

The government closed the base in the 1998 and gave it to a non-profit charity. Westminster Village of the mid South is now a non-profit a retirement community designed for people 55 years and older with affordable housing. The oldest resident is 101 years old. He is independent and weekly drives himself to a local casino.

All 400 houses on the base were the same. They were duplex Capehart Housing. I flagged down a woman driving a car. She would not take us to see her house. She called the security guard for us. He brought us to the village manager’s office. The manager took us to a guesthouse that had the same configuration our house on 1924A Dogwood Dr.

I showed Brad his first bedroom.

Brad first room repurposed copy 3

This was the place of Brad Feld’s first bedroom. It has obviously been redecorated.

After visiting the remaining notable sites on the base we headed into downtown Blytheville. I could not remember anything about downtown Blytheville except the New York Store. I bought my first Harris tweed jacket in that store fifty-three years ago. It still fits. I wear it on cold winter nights in Dallas.

I was thrilled to visit Blytheville Arkansas.

I know Brad was thrilled with our visit.

Next stop Memphis Tennessee. Brad was hungry so we stopped in Osceola, Arkansas. I could not find the famous Dixie Pig in Blytheville.

After lunch we were on our way to the Hotel Napoleon in downtown Memphis. We checked in and immediately headed for a 4 PM appointment at Sun Studio, the birthplace of Rock and Roll. We did not have an appointment but thankfully they were able to assign us to the 4.30 PM group.

Sun studio copy

Sun Studio is a fascinating place. “Sun Studio is known worldwide as “The Birthplace of Rock’n’roll”.

“ It is the discovery location of musical legends and genres of the 50’s from B.B. King, Howlin’ Wolf and Ike Turner and Elvis Presley to Johnny Cash and Jerry Lee Lewis; from Blues and Gospel to Country and Rock’n’roll.

  Sun studio tickets copy                  Sun studio crowd

One can buy all the old original 45s

 

Sun Studio is a small place with all the memorabilia Rock and Roll freaks only can love.

Sun studio museum copy

Sam Phillips the owner rejected Elvis at first because he was too ordinary. He wanted a new sound. Elvis sang tunes he thought would please Phillips.

When Phillips left the room Elvis started singing tunes he liked to sing. Bingo!, Sam Phillips heard Elvis’ tunes and hired him on the spot. The rest is history.

 

Brad and I did not have our traditional hot fudge sundae. We settled for chocolate ice cream malts at the Sun Studio soda fountain.

We both needed a rest. It was pouring rain outside so rather than walk in the rain we got an Uber to take us to the Hotel Napoleon.

 

Dinner was on Beale Street. Beale Street is exciting. It is a little like Nashville’s Music Street and New Orleans condensed into one city block.

We ate in the BB King building’s top floor at Itta Bena. The live blues music during dinner was wonderful. I had lamb chops. They were great.

http://ittabenadining.com/memphis/?utm_source=tripadvisor&utm_medium=referral

After dinner we walked Beale Street.

Beale St copy

 

 

We stopped into A. Scwab a trading store that was established in 1878 for a real hot fudge sundae.

Soda fountain schwab

Soda fountain big scwab copy

 

 

“In 1876, Jewish immigrant Abraham Schwab opened a store on Beale Street.

Over its 138-year history, A. Schwab has become a Memphis institution, beloved by many generations.

  1. Schwab is the only original business remaining on Beale Street.”

It was time to go to sleep. Tomorrow, “We are going to Graceland, Graceland in Memphis Tennessee”.

Graceland is one of the places I have never gone too. I am excited because Elvis was “my man.”

To my surprise Graceland was overwhelming.

Graceland entrance copy

The entrance with gift shops, memorabilia and Eliv’s car collections, clothing collections, electronic collections, airplane collection and auto collections are housed across the street from the mansion. I could spend hours there. We only spend two hours going over the collections.

The Mansion copy

Elvis bought this house in 1957. It was 7,000 square feet. He extended the house to 17,000 square feet. He liked a lot of rooms with a lot of different themes.

Elvis price 1957 copy

He paid $102 500 for the house and 7 acres. The house original cos Dr T Moore 37,636, in 1937.

Cost of graceland 1937 copy

 

Elvis livis room copy

This is the living room at Graceland. It is a little loud but wait until you see more.

Elvis bedroom copy

This was his bedroom. Purple is a good color for a bedspread in the 1950s.

Fun room copy

This is a billiards room and meeting room. Elvis was into color.

Elvis playroom

This was Elvis’ playroom. I still have not figured it out.

Media room copy

This is the media room. He have multiple TV. Everyt ime RCA came out with a new one he good it. His love of music resulted in his buying every new media gadget. He love all the electronics of the time.

 

Elvis was a good looking guy who who was a man of the 1950s and 1960s

He was not a hick copy Another one copy

He knew how to dress when it was appropriate.

He was a great collector of cars, electronics and man toys.

Neet toy

Here is one of the toys he drove around Graceland.

 

His plane copy

Here is a toy he would fly around the word in

That is it folks

That is it folks. 

I apologize for not discussing all the chocolate ice cream on this trip. Let me just say we had plenty. We covered every meal.

Except there is one last thing.

Brad gave me a party present for my love of Elvis and his music.

Me in elvis outfit Back of jumpsuit copy

It is a little big on me because he bought an xx large but some safety pins got it to be presentable.

 

Daniel asked me if we could revisit his birthplace in Boston on one of our next father-son weekend trips. Who could blame him. My answer was why not?

I always have a fabulous time on my weekends with one of my sons.

Remember I lived in Boston for two years when I was an endocrine fellow at the Mass General. I know most of the fun places especially Fenway Park.

Daniel, Boston it is.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.



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Here They Come Again

Stanley Feld M.D.,FACP,MACE

Democrats have tried to pass a single party payer healthcare system since 1935. Slowly, but surely, the American population has been indoctrinated into believing that a single party payer system run by the government is the best healthcare system to have.

Americans have been filled with disinformation about the wild successes of single party payer systems in the rest of the world.

The economics of these single party payer systems are seldom discussed in a coherent way. The American public has no idea of its economic burden to its countries.

The fact that these governments continue to raise taxes to pay for their single party payer system while decreasing their citizens’ access to care is hardly ever discussed. Only the favorable statistics that fit the progressive narrative are published.

In Norway the income tax rate is 50%. This is mostly because of its universal single party payer healthcare system. Norwegians seem happy with the system. If they get sick they have nothing to worry about. Their health care is free.

The fact is nothing is free and only 20% of the population interacts with the healthcare system at any one time.

In Britain taxpayers are unhappy with the National Health Services. Consumers recognize the bureaucratic waste in their healthcare system. They also suffer from decreased access to care. Wait times for health care and surgery are ridiculously long.

The private healthcare system is flourishing in Britain for those who can afford it.

The British healthcare system is unsustainable. The British government cannot figure out how to make it more efficient.

America has a single party payer system for Medicare, Medicaid, SCHIP and the VA system.

Seniors love Medicare. They could not afford to get treatment if there was not a Medicare System. Policy wonks and Democrats refuse to recognize that in 1965 after Medicare was enacted, healthcare prices exploded. The price of healthcare has continued to explode yearly.

Congress has ignored the basic defects that have caused this explosion. A few congressmen are making feeble attempts to correct this continuing price explosion.

The political establishment largely ignores these congressmen.

As attempts are made to try to control costs through regulations the bureaucracy grows and the system becomes more inefficient. The reduction of reimbursement to physicians has resulted in the explosion of concierge medicine.

The result is an increase in costs and greater opportunity for abuse by the insurance industry, the pharmaceutical industry, hospitals and healthcare providers and government.

Medicaid has experienced the same increasing costs. It also created a shortage of physicians because of low reimbursement. Obamacare has expanded Medicaid. This has decreased the availability of medical care for Medicaid patients.

President Obama’s law increased the number of Medicaid recipients but did not cure the reasons for the lack of providers. Many clever Medicaid providers have figured out how to exploit Medicaid rules only to suffer from investigations and government penalties in the long run.

The VA system is the purest example of sheer failure. Not only are the patients unhappy but the providing administrative bureaucracy is riddled with inefficiency, corruption and waste.

The inefficiency, corruption and waste have not been able to be fixed but many notable private sector executives. They have all ultimately resigned or were fired.

The VA system’s single party payer system remains an incurable failure.

These examples have proven to me that a single party payer system is unsustainable and not economically feasible. The government continues to make the same mistakes over and over again.

Are these mistakes intentional?

The government’s goals are to gain power and have control over the population. If its goals were to have an efficient and effective healthcare system, it would provide the resources to permit all consumers to drive the healthcare system. It would create a system that would motivate consumers to be responsible for their healthcare.

What is happening now?

The healthcare policy ideologists are using the New York Times as their propaganda vehicle to promote a single party payer system.

The article, Back to the Health Policy Drawing Board” is intellectually simulating to readers of the Sunday Times. However, many of its details are untrue.

After one casually reads the article on a pleasant Sunday morning it would seem much simpler to have a single party healthcare system controlled by the government than the chaotic system that presently exists.

However, the cost of the Medicare system is out of control. America cannot continue to print money forever. America’s political class is ignoring this fact.

It is so out of control political wonks are starting to talk about having another Debt Jubilee.

https://en.wikipedia.org/wiki/Jubilee_Debt_Coalition

The New York Times article starts by saying:

The Affordable Care Act needs help.

It sure does. The problem is there are too many defects in the structure of Obamacare that led to the increases in costs to the government and consumers. Obamacare is beyond repair.

After scores of failed repeal attempts, Congress enacted legislation late last year that eliminated one of the law’s central features, the mandate requiring people to buy insurance.

There was only one failed repeal attempt not scores of repeal attempts. The one repeal attempt failed by one vote. It seemed to me to be a vindictive vote. It was not on the bills lack of merit. It seemed to me to be on John McCain’s personal animosity toward President Donald Trump.

There has been a total lack of bipartisanship in trying to repair Obamacare. The have been no ideas offered by Democrats. Its goal was to stymie the Republican administration.

Many establishment Republicans’ goal was to also stymie the Republican administration.

Obamacare had three principal features:

  • Insurers could not charge higher prices to people with pre-existing conditions.
  • Those without coverage had to pay a penalty to the government (the “mandate”).

President Trump slipped the elimination of the mandate into the tax bill to bring a speedier death to Obamacare.

  • Low-income people would be eligible for subsidies.

Each feature represented a death bell from the onset

A June 2017 poll showed that 60 percent of Americans said the government should provide universal coverage, and support for single-payer insurance rose more than one-third since 2014.

Americans are frustrated with the dysfunction in the healthcare system. Premiums have increased tremendously since Obamacare. Its regulations and defective principles increased dysfunction.

Enormous deductibles have resulted in individual buying defective insurance policies. Consumers have ended up with essentially no insurance coverage except for catastrophic illness. Only people at risk for high cost treatment have bought these policies.

I cannot imagine what the 60% who want a single party payer were thinking. Can a government run system improve the inherent inefficiency, waste, abuse and unsustainability of Obamacare or a VA like healthcare system?

A government run single party payer system can only make things worse.

The healthcare system will not improve until congress acts to level the playing field and fix the defects inherent in our present healthcare system.

I believe a universal consumer driven healthcare system, available to all, can “Repair the Healthcare System” at a much lower cost to society and individual consumers than a single party payer system.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

 All Rights Reserved © 2006 – 2018 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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How Jeff Bezos, Warren Buffett and Jamie Diamond Can Disrupt The Healthcare System

Stanley Feld M.D., FACP,MACE

Jeff Bezos, Warren Buffett and Jamie Diamond should try this disruptive approach in their venture into healthcare reform.

All the other approaches that have been tried have not worked or have become unsustainable. Most of the approaches have been unfair to consumers and the majority of taxpaying Americans.

The only way to empower all the consumers in a healthcare system is to encourage them to become responsible for their health and healthcare dollars.

I believe it can only be accomplished by providing easily understandable financial incentives for consumers to save money for themselves.

Providing financial incentives to consumers to save money for themselves can be disruptive to the present models used to pay for medical services just as Amazon has been disruptive to retail sales.

The delivery of medical and surgical care has advanced tremendously in the last sixty years.

At the same time medical care has become unaffordable and the cost of healthcare has become unsustainable.

The incidence of obesity has risen every year. Over fifty percent of Americans are obese.

Obesity begets many chronic diseases and subsequently the complications of these diseases.

Physicians can treat these complications fairly well. However the treatment of chronic disease complications are costly.

How do you decrease the incidence of obesity in America?

Physicians must attack the core causes of obesity.

Among those causes are excess food intake, lack of daily exercise, mental depression, cultural milieu and/or a combination of all of the above.

The cure of obesity depends on the ability to eliminate these core drivers. Financial incentives can get patients involved in eliminating the core drivers of obesity.

The responsibility for obese patients’ healthcare depends on patients’ lifestyle, popular cultural milieu, and patient education.

In America, it is almost impossible to buy a meal in any level restaurant without excess calories.

How do you get people to be responsible for their health and healthcare dollars?

The one key element ignored by policy makers to decrease obesity is to give obese consumers of healthcare financial incentives to concentrate on trying to lose weight.

Obamacare went in the wrong direction. It limits personal liability for their obesity. It does not promote personal responsibility

The only incentive Obamacare provided was the incentive to overuse the healthcare system.

This was especially true for patients on Medicaid. They had zero premiums and deductibles. The only deterrent to accessing medical care was physician availability.

Physicians refused to participate in Medicaid because of low professional reimbursement. Low reimbursement by the government was necessary because of the decreases in funding and participant overuse of the system.

Obamacare planned to cure the shortage of “medical providers” by increasing the number of “valid medical providers” who could bill on their own, such as nurse practitioners and certified physician assistants.

However, the defect there is that patients were not under the supervision of physicians engaged in their care. It ignores the patient physician relationship that is so important to effective medical care.

If Jeff Bezo, Warren Buffet and Jamie Diamond (BBD group) are serious about Repairing the Healthcare System for their employees as a nonprofit organization, they should consider my Ideal Medical Savings Account.

http://stanfeld.com/?s=My+Ideal+Medical+Savings+Account

The Ideal Medical Savings Accounts (MSA) are tax-sheltered accounts used to pay for non-catastrophic medical expenses. These non catastrophic medical expenses account for the bulk of the cost of medical care.

Money left from the Medical Savings Account at the end of the year is put into a consumer’s retirement account.

The MSA provides the financial incentive to not overuse the healthcare system.

Warren Buffet understands the money making potential of re-insurance. He is heavily invested in re-insurance companies.

If one of the BBD Groups employee’s gets sick and spends of all of his MSA money, reinsurance provides first dollar coverage for the illness.

The BBD Group could teach employees how to shop for price and value. Insurance companies are supposed to shop for value. However the shopping is never to the patient’s advantage. It is to the advantage of the insurance company.

 Critics always claim this is unrealistic:

  1. The claim is that patients are not smart enough to shop for price and value. 2. Are you supposed to shop around from the back of the ambulance?

 The critics’ use the ambulance argument to eliminate the possibility of consumers using their own judgment to make price decisions.

Patients are smart enough to figure out which hospital they want to go to before they get into the ambulance.

Emergency care represents only 6% of health care expenditures.

But emergency care represents only 6% of health expenditures.”

“For privately insured adults under 65, almost 60% of spending is on elective outpatient care. “

ttps://www.wsj.com/articles/the-health-reform-that-hasnt-been-tried-1507071808

The critics argument is that consumers do not know how to shop prices. Consumers are smarter than the critics think. It would be easy to teach consumers to shop prices.”

ttp://stanfeld.com/the-failure-of-the-republican-establishment-to-repeal-and-replace-obamacare/

“My Ideal Medical Saving Account provides that financial incentive to not overuse the healthcare system. All the articles about my ideal medical saving accounts are attached to this link.

http://stanfeld.com/?s=My+ideal+Medical+Savings+Accounts

 Likewise, nearly 60% of Medicaid money goes to outpatient care.”

 Medicaid patients also overuse the healthcare system.

Most Medicaid patients can understand the MSA’s financial incentive.

“ For the top 1% of spenders—a group responsible for more than a quarter of all health expenditures—a full 45% is outpatient.”

These patients can be identified as outliers and educational vehicles can be created to decrease this overuse of the system. It would save the re-insurance company a great deal of money.

In my opinion Medical Savings Account are better than Health Savings Accounts. Medical Savings Accounts take the money out of the healthcare insurance company’s hands and deliver it to consumers retirement accounts.

Both HSA’s and MSAs have the unique advantage of providing the financial incentive to for consumers to save money for themselves.

When people have savings to protect in HSAs, the cost of care drops without harmful effects on health. 

 The financial incentives decrease the overuse of the healthcare system.

According to a 2012 study in Health Affairs if even half of Americans with employer-sponsored insurance enrolled in this kind of coverage, U.S. health expenditures would fall by an estimated $57 billion a year.”

 https://www.healthaffairs.org/do/10.1377/hpb20160204.950878/full/

 My ideal Medical Savings Accounts provide an even a greater financial incentive and should decrease costs even further.

“ MSAs should be available to all Americans, including seniors on Medicare. Given that seniors use the most health care, motivating them to seek value is crucial to driving prices lower.”

MSAs should also apply to Medicaid recipients. The details for Medicaid recipients can be found in my article “My Ideal Medical Savings Accounts Is Democratic. “

The maximum contribution to MSAs should be raised to $6000 or $7000 dollars. If a consumer gets sick and experiences a cost of more that $6000 he should receive 100% (first dollar) coverage through the BBD group’s provided reinsurance policy. A reinsurance policy would cost the BBD Group less than $6000 a year.

The total insurance package to BBG Group employees should cost the BBD Group $12,000 rather than the present cost of $18,000.

BBD is a self insured association. The association has elimated the multiple middlemen in the present healthcare system.

 When a person with an MSA dies, the funds should be allowed to roll over tax-free to surviving family members.

This financial incentive should be included in My Ideal Medical Savings Account.

“The information that patients require to assess value must be made more transparent. 

2014 study on magnetic resonance imaging showed that price-transparency programs reduced costs by 18.7%.”

A consumer driven system would force providers to compete for patients. Information on price could easily be provided to consumers by the government and the healthcare insurance industry.

At present healthcare prices are not transparent. Consumers are not motivated to shop prices. The BBD Groups leverage with its employees would force transparency.

“The most compelling motivation for doctors and hospitals to post rates would be knowing that they are competing for price-conscious patients empowered with control of their own money.”

 In this age of technology and rapid communication telemedicine should be promoted and paid for. One way to do it is to permit physicians to practice telemedicine across state lines. It would supply instant access to expertize at an affordable cost.

Everything possible should be done to encourage consumer responsibility and provider competition.

The present tax code does the opposite. Consumers in-group plans provided by large and small corporations receive their healthcare insurance from the corporation with tax-free dollars.

The larger the corporation the more leverage the corporation has for negotiating the premiums with the healthcare insurance companies.

The BBD Groups volume of consumers would have tremendous leverage with providers.

The younger and healthier the corporate employees are the lower the premiums.

The formation of associations with large memberships of all ages would lower the cost of healthcare. Large associations would have great leverage in negotiating price with providers. They would also spread the risk.

Self- insured associations such as the BBD Group would also spread the risk and lower the cost.

Tax deductibility must be given to these “individual” insurance policy holders and association policy holders so they are, in reality, paying for healthcare insurance with pre-tax dollars the same as the corporate group plan policy holders.

These simple changes in the law would result in an affordable healthcare system that was market driven by consumers. The changes would force providers and the healthcare insurance industry to become competitive.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

 All Rights Reserved © 2006 – 2018 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

 

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The Healthcare System Needs Disruption

Stanley Feld M.D.,FACP,MACE

The announcement that Amazon.com, JP Morgan Chase and Berkshire Hathaway are forming a non-profit company to try to improve the American healthcare system caused some ripples in the stock market.

The mere specter of its disruptive potential was enough to send some investors scurrying away from large payer providers like UnitedHealth, Aetna and Humana.

The reason for the panic is obvious. These large insurance companies have been ripping off the healthcare system for decades. They have had their fortunes improved with Obamacare and its regulations. They are afraid they are going to lose their stronghold.

The three innovations, Jeff Bezos, Warren Buffet and Jamie Diamond are disruptors that might destroy UnitedHealth, Aetna, and Humana’s kingdom.

Mitch McConnell has supposedly taken Repeal of Obamacare off the agenda for 2018.

I believe Mitch McConnell doesn’t know what to do about Obamacare. He is hoping that it fails on its own. He has passed the budget that will force the government to cover the tremendous financial short falls the defectives in the structure of Obamacare is going to precipitate.

Only then will the public hear about Obamacare’s effect on America’s budget deficit.

The American taxpayer will be force to continue to fund this failed program.

Obamacare has failed because of its structure. It encourages over use of the healthcare system by sick people. It does not encourage consumers to be responsible for their health and healthcare dollars.

The Democrats and the Republican establishment have failed the American consumer again.

Bravo to three of America’s premier disruptors Jeff Bezos, Warren Buffet and Jamie Diamond.

If they bother to understand the elements of medical care and the reasons for the healthcare systems dysfunction they have a chance for success.

If they follow the previous attempts to repair the healthcare system by the government, healthcare insurance industry and hospital systems they will fail miserably just as these other institutions have failed.

“The industry certainly offers plenty of opportunities for reinvention, of course. Healthcare in the United States is expensive, and its quality varies wildly.” says Christopher Rowe, managing director at Korn Ferry.

Jeff Bezos has the best shot at reducing drug price significantly. The government cannot negotiate prices. The private carriers through drug benefit plans do a little better.

The military and the VA system do 30 to 75% better than Medicare Part D and the private sector.

Jeff Bezos knows how to market via the Internet. With the large cadre of consumer employees of Jeff Bezos Warren Buffet and Jamie Diamond, Mr. Bezos can probably negotiate the drug prices down by at least 50%. I’ll bet he can negotiate drug prices almost as low as the VA system and also provide the pharmaceutical companies an increase in reimbursement for their drugs.

Mr. Bezos usually eliminates most of the middlemen. He will be able to offer the medication at a 40 or 50% lower price than Medicare Part D and the private benefit managers and still make a sizable profit while providing a better quality of service.

He knows the customer is the consumer.

When it comes to the delivery of medical care and the use of technology in the delivery of medical care, I am not sure Bezos, Buffet and Diamond know who the real customers are.

I am not sure they know how to get around the stronghold the healthcare insurance industry, the federal government and the hospital systems have over the control of healthcare.

Many other corporations have tried to break the stronghold and have failed.

I will try to tell Jeff Bezos, Warren Buffet and Jamie Diamond what they have to do in my next blog.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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 Changing The Rules: It Is Just The Beginning

 Stanley Feld M.D.,FACP, MACE

A proposal to cut Medicaid payments to some insurers with excessive reserves stirs concern from healthcare insurers.

Progressive politicians refuse to believe that entitlement programs like Medicaid are not viable. Politicians should be looking at creative ways to structure the Medicaid form of insurance for both physicians and patients.

https://www.politico.com/states/new-york/albany/story/2018/01/22/proposal-to-cut-medicaid-payments-to-some-insurers-with-excessive-reserves-stirs-concern-206875

I have not written a blog lately because both the Democrats and the establishment Republicans in both the house and the senate disillusion me. Neither house or senate members are interested in being creative.

Neither body knows how medicine works.

These politicians have no interest in doing what is best for the people who elected them. They are only interested in maintaining power and extending their power over the people they govern.

The result will be to decrease to quality of care to patients forever.

In the meantime there have been news stories on how different corporate organization and big businesses are trying to take over medicine.

Many readers have noticed that emergency clinics are popping up in every city and town.

I believe these emergency clinics centers are in reality real estate plays waiting for so that big corporations, like Aetna; to buy them out in order to expand their plans to take over medical care.

It feels similar to the proliferation of small banks in the 1980’s. These new small banks’ plan was to grow and be bought out at a premium by larger banks in order to enlarge the sale premium.

When the defective program (Medicaid) is a failure one should learn from that failure. One should not continue to try fixes to the program (Medicaid) when each fix creates greater dysfunction.

One should institute another plan that might work. However, government officials continuously apply an additional patch that leads to more unintentional consequences.

This week New York State governor Andrew Cuomo put another patch on its failed Medicaid system. I predict this patch will lead to more unintended consequences. The result will be to make Medicaid coverage worse for its New York State’s Medicaid recipients.

Governor’s Cuomo’s initial mistake was expanding Medicaid at President Obama’s request. He then compounded the mistake by subsequently allowing illegal immigrants in the state to receive Medicaid coverage.

It is not wise to take a financially failed system and expand it. It is much better to change the system.

Now Governor Andrew Cuomo’s budget is proposing to cut Medicaid payments to certain health insurance companies with excess reserves, a move that is alarming insurers because of its intent and its ambiguity.

“The proposal, part of the $168.2 billion executive budget released last week, says that any Medicaid managed care or long-term care Health Maintenance Organization that has excess reserves across all lines of business would be subject to a prospective cut in Medicaid rates.”

 Why would an insurance company want to participate in these programs?

The immediate unintended consequence is that the insurance company that found a defect in the payment schedule for HMO’s and managed care would leave the Medicaid market.

The second unintended consequence is it would discourage companies from having incentive to make a profit.

“Under current law, all Health Maintenance Organizations are subject to minimum reserve requirements,” said Erin Silk, a spokeswoman for the Department of Health. “This policy will provide the commissioner with the discretion to make rate adjustments to plans holding reserves in excess of the statutory requirements for reasons that cannot be explained or justified.”

The state did not project any savings from this proposal.”

The state cannot run Medicaid without insurance companies being the administrative service providers. It is the same old story. This comes on top of a proposed fourteen percent tax on for-profit insurers as well as the state receiving a cut of the proceeds when a nonprofit insurer converts to a for-profit insurer as a result of the new tax law.

Governor Coumo wants this additional money because he thinks the insurance industry is going to have a windfall from President Trump’s new tax law. He figures the state will collect $640 million dollars more as a result of this move.

“There were 3 million New Yorkers enrolled in these types of plans in 2014, according to a report from the United Hospital Fund.”

The insurance industry gave the usual illogical reason for opposing Cuomo’s proposals.

These insurance companies are there to make money. They are not going to let Coumo out of his commitment. I believe they will walk away from providing administrative services for the states Medicaid insurance coverage.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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It Is Getting Worse

Stanley Feld M.D.,FACP,MACE

Charles Gabe’s graph of enrollment as of 12/9/2017 was published with only six days of open enrollment left.

There are only 5,894,342 confirmed enrollees. There is no indication of how many enrollees paid the first month’s premium. The low-ball estimate was 7.2 million.

Of those enrolled only 3,604,44 were enrolled in President Obama’s Health Insurance Exchanges to buy healthcare insurance.

2,289,902 were enrolled in Medicaid. The number of illegal immigrants in that number is unknown.

December 15th is the deadline for enrollment in 42 states. Eight states have already extended the deadline.

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This is an extremely disappointing outcome for Democrats who refuse to believe Obamacare has failed. Last year the Democrats and President Obama were bragging that Obamacare provided healthcare insurance for 20 million people.

The problem was that 13 million of those 20 million were enrolled in Medicaid and of the 9 million who bought insurance through the health insurance exchange many did not complete their premium payment for the whole year.

The government subsidized eighty-five percent of those people who bought healthcare insurance through the health insurance exchanges.

Organized medicine has not provided leadership for the medical and surgical community or its patients.

In turn medical professional feel powerless. I believe the profession is about to give up on trying to influence positive change in the healthcare system for its benefit and its patients benefit.

A reader, D.F. M.D., responded to my last blog writing;

“That nothing much is happening in Washington re: healthcare reform may be one of the largest blessings our country has seen this year.”

It might be a blessing because the politicians do not have a clue as to what can be done to repair the healthcare system.

Politicians are not interested in listening to physicians or patients. The people that stand to lose the most in this dilemma are patients.

D.F., M.D. goes on,

 “ We are agreed that our congress hasn’t done much, but there are other activities afoot that will almost certainly be game changers and they are largely un-noticed when it comes to their impact on healthcare services.”

his is very true. When President Trump was running for president he kept declaring that the “government” made the worse deals for the American people with NAFTA, Iran nuclear deal, and the pacific trade deal. He essentially called President Obama and congress stupid.

Now congress is asking big business to help them out of the healthcare mess. The pending take over of medicine by big business is going to destroy medical care in America while they are claiming to save the healthcare system.

D.F. MD writes

“The CVS/Aetna merger, and today’s announcement that United Healthcare is buying DaVita, a healthcare group with over 300 sites of service to add to it’s Optum, segment, with 1,100 care sites of various sorts, not to mention US Oncology, owned by McKesson, that sees about 14-15% of patients with cancer in the US.”

The corporate take over of medical care is growing daily. Without physicians and patients there would not be a need for a healthcare system. Physicians have voluntarily given up their intellectual property and freedom to use their own clinical judgment to the will of corporations.

America is in the early stages of this phenomenon. Medical care is becoming a commodity. Physicians and patients have given up the thought of a personal relationship embodied in the physician patient relationship. Good medical care (in my opinion) is predicated on the patient physician relationship because much morbidity and negative emotional responses to treatment can vanish with an effective patient physician relationship.

Truly, corporate medicine, once outlawed in many states, (for good reason) is on track to become the biggest player in healthcare.  Add to that the report that 60% of physicians are now employed by hospitals, which is in some ways creating a body of spokespersons for healthcare that has not been seen before.”

The result is massive Medicare and Medicaid cost overruns that are not approved by congress. The Democrats are trying hard to blame the costs overruns and Obamacare’s failure on President Trump without good reason.

However, the media is the message and the media is on President Obama and the Democrats side.

D.F., MD continues,

“I have always believed that the medical profession though organized medicine has been remiss by maintaining a low profile where change is concerned, either in the development of programs or the creation and passing of legislation.”

Edward Annis M.D. a former president of the AMA was organized medicine leaders who lead the fight to outlaw corporate take over of the healthcare system and the takeover of medical practice. Dr. Annis wrote an excellent book called Code Blue in 1993.

A reviewer,  Frank J. Primich M.D. in 1994 wrote;

“Code Blue takes its name from the most common term used by hospital public address systems to signify cardiac arrest.

The announcement sends an assortment of specially trained personnel scurrying to the designated site. Modern techniques and technology, when given the timely opportunity, have been highly successful in restoring life.”

“The protagonist in Dr. Annis’s book is the private practice of medicine, which has been declared dead by some of its adversaries. Resuscitation requires an understanding of what has gone wrong, and what can be done about it.”

Dr. Annis was right on target. No one involved in organized medicine has taken this stand presently.

The reviewer goes on;

“In every field, there is an internal rating system. Ed Annis is the acknowledged superstar of those of us who have pleaded the cause of fee-for-service medical practice and maintenance of the traditional doctor-patient relationship.”

All of the healthcare policy wonks and congress people ignore the importance of the physician patient relationship. When they get sick and do not have a patient physician relationship they yearn for one.

“The same time span has seen a steady encroachment into the process from a variety of third parties, particularly government.”

“The concept of socialized medicine, discredited elsewhere in the world, has been introduced, through gradualism, to the point where we are now, in effect, semi- socialized. The current proposals for national health care threaten to push us beyond the point of no return.”

These quotes were taken from the article written in 1994 at the peak of the Hillary-care debate. Wilbur Mills started the socialized medicine debate in America in 1935.

D.F. MD note goes on to say,

“Now they are increasingly tied to large business entities one sort or another.”

 Soon, advocates for patients with no financial axe to grind may end up being only us old retired docs, some of whom have retired because of “improvements” like the electronic medical records which have managed to make their developers rich while not doing all that much to enhance patient care. Unfortunately the old docs lack organization, money, and voice.”

Organized medicine has not provided leadership to help patients understand that when large corporations take over the infrastructure of medicine medical care will be totally commoditized and the important physician patient relationship will be lost forever.

 “Then there are the CBO projections https://www.cbo.gov/publication/53090 which are sometimes wide of the mark, but which the liberal media trumpet as the gospel in projecting the effect on patient care is certain healthcare reforms are enacted and implemented.”

 “The result of all that is that almost anything that is proffered as change is shouted down by one interest group or another, often by people who don’t have much of a clue re: what they are protesting about.”

DF, MD

The only thing that can turn this trend around is patients and a consumer driven healthcare system along with some organized medicine leadership.

   

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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Is Anyone Confused Or Convinced?

Stanley Feld M.D.,FACP, MACE

Obamacare has failed. You wouldn’t know it by the massive misrepresentation by the mainstream media.

The mainstream impression is that registration during the open enrollment period for 2018 ending December 15,2017 is doing well.

I have not written a blog in about a month because there has been nothing to write about.

I have laid out my ideas about what is necessary to repair the healthcare system. It is all about personal responsibility and physician/patient relationships for both acute and chronic diseases.

It is the only way to control costs and decrease waste in the healthcare system.

Frankly, I am saddened that our representatives in congress don’t give a damn about the costs to the American people.

They simply want Americans to be dependent on government. The government wants to control Americans rather than Americans controlling the government.

Both the Republican and Democratic establishment have been brain dead on how to effectively repair our healthcare system.

Republicans had seven years to figure out an efficient system. The have controlled the house for two terms. They have controlled the senate for one term.

Then they failed. Almost 100 bills passed the house. any passed both houses and were vetoed by President Obama.

Why couldn’t they send one of those bills to President Trump?

Tom Price M.D. had some ideas on how to repair the healthcare system. However he was disposed of by claims of misuse of government funds.

There has been little published since the Republican establishment failed it its effort to repeal and replace Obamacare in November 2017.

It is unclear to me whether the Republican effort failed because it was a step in the wrong direction or the Republican establishment hates Donald Trump.

In any case the Democratic establishment is trying to blame Donald Trump for the Obamacare failure.

They claim it is Donald Trump’s fault the healthcare insurance industry is not being paid the unauthorized supplement President Obama promised but could not pay. He could not find the money.

It is the House of Representative that authorizes expenditures. The cost of those promised subsidies that were unauthorized was 88% short of the healthcare insurance industry’s claims.

The Obamacare cost overruns were gigantic. It must be remembered that the Health Insurance Exchanges only provided insurance for less than 10 million people in the individual healthcare market.

Many factors added to the cost overruns including subsidizes of over $15,000 dollars a year for these premiums in the individual market. The 2018 subsides will be over $20,000.

The healthcare system has become such a partisan issue that the truth about Obamacare’s failure is not the point anymore.

It seems that the Republican establishment is not any smarter than the Democrat establishment in trying to repair the system.

The end of the open enrollment period for 2018 is supposed to be December 15, 2017.

I posted two graphs in this post. One represents enrollment until 11/25/2017 and the second represents enrollment until 12/2/2017.

They bring out several points about Obamacare’s failure.

Seven states of the 39 states have already extended their open enrollment period. California has extended open enrollment until 1/31/2018.

On 11/25/2017 confirmed but not paid enrollment was only 2,660,938 with only 2,277,079 through Healthcare.gov and 383,859 for Medicaid.

Open enrollment projected for 11/25/2017 was 4.2 million with 2.6 million through Healtcare.gov. and 1.6 million through Medicaid.

These projected numbers were revised upward during the summer of 2017 to 4.6 million with 2.8 million through Healthcare.gov and1.8 million through Medicaid.

This represents a 500,000 person enrollment short fall for healthcare.gov. It also must be remember that 85% of the people enrolling through healthcare.gov have preexisting illnesses and are subsidized by the government.

  Chart 1 3 8

The open enrollment numbers look worse on December 2, 2017 although there is not a word of it in the mainstream media.

On 12/2/2017 confirmed but not paid enrollment was 3,491,164 with only 2,751,260 through Healthcare.gov and 709,904 for Medicaid.

Open enrollment projected for 12/2/2017 was 5.1 million with 3.5 million through Healtcare.gov. and 1.6 million through Medicaid.

These projected numbers were revised upward during the summer of 2017 to 5.8 million with 4 million through Healthcare.gov and1.8 million through Medicaid.

This represents a 1,248,840 (4,000,000-2,751,260= 1,248,840) person short fall for healthcare.gov with 13 days to go for the open enrollment period.

Chart 2

It is difficult seeing these numbers by casually studying these charts.

Obamacare is an unmitigated failure. Democrats want to throw more money at it.

Republicans do not know what to do.

I suggest they look at my blog entitled The Ideal Medical Saving Accounts are democratic.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

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Consumers Need To Take Back Their Medical Care And Healthcare Dollars

Stanley Feld M.D.,FACP,MACE

A consumer driven healthcare system is the solution to the dysfunctional and unaffordable healthcare system that americans are presently experiencing.

President Trump wants to create the conditions for consumers to take responsibility for their medical care and their healthcare dollars.

The negative noise in the mainstream media should be ignored.

The Obamacare health insurance exchanges have failed. The Democrats and establishment Republicans should realize that the health insurance exchange plan was a defective system that it can not be repaired with patches and more money.

President Trump has signed an executive order to permit private associations to sell insurance. There are many associations that a person could belong too. Consumers could shop for the right association at the right price.

Democrats are behaving as if associations are a foreign enemy.

UnitedHealth has contracted with AARP (an association) to sell Medicare supplemental insurance. UnitedHealth sells this insurance across state lines.

USAA has contracted with Humana to sell Medicare supplemental insurance and Medicare Drug coverage.

There are many supplemental plans that consumers can choose from in these associations. These plans are sold across state lines and are competitive.

The government has to change the tax law to treat individual healthcare insurance plans bought through the associations to be paid for with pre-tax dollars just as the employer sponsored group plans do.

However, associations selling healthcare insurance are only the first step in empowering consumers.

A well-known retired physician (DEF M.D.) sent me his view on what consumers need to be aware of to survive any healthcare system. He calls it

“My Three Rules For Survival”

Remember my three rules for survival:

1) Stay the hell away from doctors.

They always either want to do something or prescribe something, and all too frequently do both.

A large part of this physician reflex is their need to practive defensive medicine. Physicians are afraid they might miss something and get sued.

Major tort reform is necessary in most states. Defensive medicine accounts for $250 billion to $700 billion dollars in unnecessary expenses each year.

I have outlined the steps necessary to remedy the malpractice (tort) crisis and its resulting overuse of testing and medication.

If anyone in President Trump’s administration wants to review the issue in full click on this link.

http://stanfeld.com/?s=Tort+reform

Nobody confronts the reality you mentioned , people are too fat, they drink too much and smoke, AND they don’t even think about the importance of, and benefits from, exercise.

 I started a war on obesity many years ago. Public officials and poly wonks have ignored my suggestions.

It would be worthwhile to read my post about obesity.

http://stanfeld.com/?s=war+on+obesity

The cost to all of us (including them) of all this denial of personal responsibility is huge!  We need to find ways to get people to focus on taking care of themselves, or to create cost incentives that will encourage them to do so.

While you are in this reading mood you should check out my pleas for the importance of patient responsibility.

ttp://stanfeld.com/?s=patient+responsibility

We simply cannot continue on the path we are on. I don’t recall ever seeing a patient on a “scooter”, and many in wheelchairs that are obese, and only getting fatter and fatter over time.

     2) Take as little medicine as you can.

Pharmaceutical manufacturers are continuing to drive up the cost of their products and are making enormous profits as a result.  Data is available re: the necessity of people getting medicines that they don’t really need, especially if taken long term on an ongoing basis.

To that, one can add the cost of unnecessary procedures that often leave patients worse off than they were before.  Direct to the public advertising of prescription medications creates demand that is often unaccompanied by benefit.

More and more current information regarding side effects and late effects of medications need to be provided, and not just put into the “fine print” on the package stuffers.

     3) Stay out of hospitals.

 They are dangerous places, with a high prevalence of patient injuries and deaths due to various sorts of medical errors that occur all too frequently, despite a host of quality improvement projects that are well-intended, but would be better in terms of effectiveness if they were made public on a regular basis.

 Scott Atlas makes good arguments for encouraging patients to “price shop” for services they must have.  To that information should be appended information about outcomes of what is proposed, which could, over time, become both hospital-specific and physician-specific.

I have expanded on Scott Atlas’ Wall Street Journal article in my last blog.

http://stanfeld.com/the-plan-to-empower-consumers-of-healthcare/

Most doctors and most hospitals have not much of a clue as to the outcomes of the services they provide their patients.

And, that is probably plenty for today.  DEF”

Consumers need to be educated to become aware of the many pitfalls involved in their new responsibility.

The educational process can be accomplished with online information and chat sessions. The government could provide the education necessary.

Consumers also need financial incentives to be encouraged to be responsible for their care and their healthcare dollars

This can be accomplished with my ideal medical saving accounts.

http://stanfeld.com/?s=ideal+medical+savings+accounts

Then and only then can we have a consumer driven healthcare system that will lower the cost of healthcare.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone

 All Rights Reserved © 2006 – 2017 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE

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