American Elephants

Putting Patients and Doctors in Charge of Health Care by The Elephant's Child

cyzgx68wqaab4xtPresident-elect Donald Trump has chosen Representative Tom Price (R-Ga), a leader in the efforts to replace ObamaCare, to be his Secretary of Health and Human Services. This is a very good nomination, though Democrats are howling, and trying to launch a coalition to save their failed program. Representative Price is an orthopedic surgeon who knows his way around the practice of medicine. He has introduced H.R.2300 the Empowering Patients First Act —legislation that puts patients, families and doctors in charge by focusing on the principles of affordability, accessibility, quality, innovation, choices and responsiveness.

We’ve all read of price increases of 25% and more—reportedly 100% in some cases, laughed grimly at the statement that “If you like your doctor, you can keep your doctor.” But how did it go so wrong for so many people?

The Left has long wanted to control health care, preferably single-payer like Britain’s. Why? The British put in their program not long after WWII, and because it is “free” they have kept voting for Labor in order to keep it. It may not be very good care, and those rich enough to afford private care do so. But old people die in hospital from neglect, or dehydration, yet the people are afraid of changing. The Left really wants regulations that people keep voting for, and they don’t care if it is out of fear of change.

Please read this post from Ricochet by a physician about the death of the primary care physician. He says “We are directed to “practice medicine” strictly according to directives handed down from on high by panels of sanctioned experts, and accordingly we are enjoined from taking into account our professional experience, our intuition informed by judgment when we advise them about their medical issues.” He adds:

We are strictly limited to 7.5 minutes per patient “encounter,” and the content of this brief encounter is determined by certain Pay for Performance checklists which have been given to us by yet other expert committees. These checklists assure that most of our 7.5 minute encounter is spent asking about important medical topics such as the storage of handguns in the home and sodium in the diet, for if we skip any items on the list we define ourselves as substandard caregivers.

This is how the Left operates. They think up a program that will fill all of their emotional needs to do nice things for people. Once they get it made into law, they have to pay for the mess they made, so they start making regulations that will let them pay the medical providers a lot less, because they cost too much. Patient A fell, and thinks she broke a bone in her foot. Doctor sends her off for an X-Ray and gives her a referral to an orthopedic surgeon. That one is under the 7.5 minutes. Patient B is diabetic, overweight, and has a potential heart condition, and needs some major counseling on diet and exercise, and a prescription or two. She’s a nervous type and clearly worried about her health. 7.5 minutes? That truly stupid regulation came from some bureaucrat who knows nothing about medicine, and is concerned only about keeping the budget under control.

Multiply that situation across the practice of medicine, and you see how and why ObamaCare has failed. Doctors are opting out in droves. Seniors have trouble finding someone who will accept Medicare patients, Medicaid patients get sent to nurse practitioners instead of doctors, or are told they can’t be seen until next May.

Have you seen a doctor who has engaged a scribe to take notes of the patient encounter so the doctor can talk to the patient instead of the computer? Read the British papers to see why we should never consider their system. There are few, if any, programs that the federal government bureaucrats can manage successfully. Monica Crowley remarked today that “government has no profit motive, only a power motive.” Excellent insight. Competition, free markets,and small government that does only those few things that bureaucrats can’t manage to screw up.

Here is a link to Dr. Tom Price’s statement, with links to the Empowering Patients First Act and a section by section description of the legislation.

The Weekly Standard’s “After Repeal” about the game plan for undoing ObamaCare.

Commentary Magazine “Cleaning Up Obama’s Health-Care Mess

From AEI: “The four legs of a new health-care system” by James C. , who writes about health care regularly, and Scott Gottlieb M.D.

From the Hoover Institution: “The Unaffordable Care Act” by Richard Epstein.

From the WSJ: “Diagnosing Your Doc”s New Euphoria” Suddenly there’s hope for dismantling ObamaCare—and restoring sanity for doctors and patients

Imagine! A real physician in charge of HHS. I remember when the Democrats pushed through the Affordable Care Act without a single Republican vote, and Obama brought out a troop of doctors (?) in white coats with stethoscopes over their shoulders. (Is that what you would wear as a doctor going to the White House?) So costumed, they sat  on chairs on the lawn while Obama gave a speech.

2 Comments so far
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Many good points here. Agreed that US healthcare reform is in trouble, and hopefully experienced medical practitioners with policy-making experience can fix things.

As a dual US and Canadian citizen, I want to make an important distinction between “socialized medicine” as practiced in the UK, and “single payer” system as practiced in places like Canada, Taiwan, etc.

Single payer refers to nationalizing health care Insurance, not the delivery of health care. In the UK health caretakers are government employees, and facilities are government operated, with the problems you describe above.

In Canada, hospitals, clinics, medical practices are are private enterprises as in the US. The difference is each province has a large and diverse health insurance pool consisting of all citizens residing in that province. Premiums are paid as part of filing tax returns, a health ID card provides access to all treatments, both preventative (like annual checkups), as well as surgeries (like cataract lens or hip replacements). Each province administers the health care claims at a cost about 2% of premiums paid, compared to administrative costs 20%+ in the US system which relies on private health insurers.

The ACA reform attempted to create insurance risk pools at the state level so that people lacking health insurance through their employers could get affordable coverage. However, the missing link is full citizen participation in both the right and the obligation to pay for health care delivery system. When healthy and young people are allowed to opt out, yet must be treated in emergencies, while the risk pool is dominated by older ill people, those ideal state-level insurance markets collapse, coverage becomes unaffordable and health care costs continue to rise out of control.

Up to now, the entrenched private health insurance lobby stands in the way of real reform in the US.


Comment by Ron Clutz

We have lots of examples of people who were denied treatment in Canada, or put on a way too long wait list and came to America for treatment. I want the federal government out of health care entirely. Our federal government is bloated, too big and too many bureaucracies for whom the goal is increased power for their bureaucracy. Our Veterans Health Care system is a disgrace. Indian Health Service is equally disgraceful. Medicare is made far more costly than it needs to be by foolish rules and regulations. I haven’t read Dr. Price’s bill yet, but I worry that there will still be too much federal government. It’s very hard to give up control, especially if you think you are doing it nicely. Real competition would bring costs down, and making insurance national would increase competition. This is an old piece, about the Oklahoma Surgical Center but shows the possibilities”


Comment by The Elephant's Child

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