When leaders of the hospital, insurance, drug and device industries pledged to cut billions of dollars in wasteful spending, “few people believed” their promise, and with Congress unsure how to finance health care, this promise “will be impossible to fulfill.”
Consequently, Dr. Sandeep Jauhar, a cardiologist on Long Island, believes that “it is doubtful for doctors and other medical professionals to voluntarily cut their own income” to fulfill their side of the ‘promise,’ especially given the current economic situation. For example, physicians at academic medical centers supplement their income through private practice on the weekends. As a result, it is not easy for them to ignore reimbursement when prescribing tests. In fact, physicians wrote in The New England Journal of Medicine that “price tags are being applied to every aspect of a doctor’s day, creating an acute awareness of costs and reimbursement.”
Accordingly, this transformation of medicine into ‘commerce’ is not only “ballooning costs, and fraying the traditional doctor-patient relationship,” it is also creating anxiety in the profession. Seemingly, although profit motives in medicine are normal, financial considerations today are more prominent “because so many hospitals and doctors are in financial trouble.”
Adding deeper stress at hospitals is the uncompensated care that is increasing as patients suffering from the economic downturn lose health insurance, “while admissions and elective procedures — big moneymakers — are declining.” This causes many of the fundamental tenants of practicing medicine to be twisted by market exchanges at the expense of patient care and progress.
One thought on cost savings in health care reform is tonight I was with an executive who at one time had worked for Kaiser Permanente in New England, at Kaiser they had real outcomes, and practiced evidenced based medicine. In the end they were more expensive than other traditional plans and were financially forced to pull up stakes and move elsewhere. Were they cheaper (no), did practicing evidenced based medicine save money (no), did healthcare IT save them (no).
Ultimately, with politicians and industry conflicted on how to pay for health care reform, unemployment consistently growing, and skyrocketing prices for medicine it seems obvious where the solutions are: private industry and physicians. Industry and doctors need to join forces to figure out a better reimbursement system that does not force physicians to make decisions based solely on money. If we can allow the doctors to focus more on their patients while allowing industry to focus on how to create cost effective treatment the outcome will be certain: better patient care.
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