Comments on: Coverage does not equal health care http://www.kevinmd.com/blog/2008/10/coverage-does-not-equal-health-care.html medical blog Thu, 18 Mar 2010 01:58:15 -0400 http://wordpress.org/?v=2.8.4 hourly 1 By: The Happy Hospitalist http://www.kevinmd.com/blog/2008/10/coverage-does-not-equal-health-care.html/comment-page-1#comment-87807 The Happy Hospitalist Tue, 28 Oct 2008 00:53:00 +0000 http://clients.emmense.com/kevinmd/2008/10/coverage-does-not-equal-health-care.html#comment-87807 I am convinced, and I blogged about it yesterday, that before trying to fix access to care, we need to fix the cost of care. And that doesn't mean simply paying less for services provided. Because paying less simply results in more volume of care. It means making the delivery of health care cheaper. Health care delivery is so straddled in inefficiencies that the cost of delivering care to the masses could be slashed if us docs weren't so buried in rules and regulations. I could probably double or triple the number of patients I see if the documentation rules required for me to get paid went away. If I only documented what was necessary to care for the patient. Documenting the family history in an 80 year old septic patient is required for me to get paid. Not to care for the patient. Hospitals charge $10 for a Tylenol because they have horribly bloated costs structures mandated by the rules and regulations of our government. 10% of collections for most physicians goes straight to a billing company or staff required to submit claims and deal with the constant barrage of paperwork from third parties. Removing these obstacles would allow the delivery of more affordable care. <br/><br/>You can make health care affordable. And you do that by cutting the cost of delivering that care. Some like to believe that if we insure everyone, that disease will be caught earlier and costs will go down. I don't believe it for a minute. What you will have is a bloated government funded program that will continue to pay for everything in all the wrong places. Stop paying for unnecessary care the we get in a fee for service model. I believe in the bundled care approach. You get X dollars to pay for Mrs Smith Crohns, or diabetes, or CAD. Now it's up to you, doc and hospital, to find a way to make it work. Right now hospitals only make money if people get admitted. And they only make a lot of money if you dishcharge them as quick as possible. It's a completely irrational system. Hospitals and doctors should get paid to keep patients out of the hospital as efficiently as possible. And until that happens, there is no incentive from patient, doctor or hospital to keep a healthy patient. The third party costs are simply passed on through tax payers and higher insurance premiums. Until one day, nobody can afford the price tag, including us docs.<br/><br/>Until we stop paying for everything, not simply paying less for everything, and figure out a way to encourage the patient the doctor and the hospital to spend less, we will continue our way into national bankruptcy. Spending less will never happen under the current fee for service system.<br/><br/>Health care providers depend on third party money to stay alive. I am convinced, and I blogged about it yesterday, that before trying to fix access to care, we need to fix the cost of care. And that doesn’t mean simply paying less for services provided. Because paying less simply results in more volume of care. It means making the delivery of health care cheaper. Health care delivery is so straddled in inefficiencies that the cost of delivering care to the masses could be slashed if us docs weren’t so buried in rules and regulations. I could probably double or triple the number of patients I see if the documentation rules required for me to get paid went away. If I only documented what was necessary to care for the patient. Documenting the family history in an 80 year old septic patient is required for me to get paid. Not to care for the patient. Hospitals charge $10 for a Tylenol because they have horribly bloated costs structures mandated by the rules and regulations of our government. 10% of collections for most physicians goes straight to a billing company or staff required to submit claims and deal with the constant barrage of paperwork from third parties. Removing these obstacles would allow the delivery of more affordable care.

You can make health care affordable. And you do that by cutting the cost of delivering that care. Some like to believe that if we insure everyone, that disease will be caught earlier and costs will go down. I don’t believe it for a minute. What you will have is a bloated government funded program that will continue to pay for everything in all the wrong places. Stop paying for unnecessary care the we get in a fee for service model. I believe in the bundled care approach. You get X dollars to pay for Mrs Smith Crohns, or diabetes, or CAD. Now it’s up to you, doc and hospital, to find a way to make it work. Right now hospitals only make money if people get admitted. And they only make a lot of money if you dishcharge them as quick as possible. It’s a completely irrational system. Hospitals and doctors should get paid to keep patients out of the hospital as efficiently as possible. And until that happens, there is no incentive from patient, doctor or hospital to keep a healthy patient. The third party costs are simply passed on through tax payers and higher insurance premiums. Until one day, nobody can afford the price tag, including us docs.

Until we stop paying for everything, not simply paying less for everything, and figure out a way to encourage the patient the doctor and the hospital to spend less, we will continue our way into national bankruptcy. Spending less will never happen under the current fee for service system.

Health care providers depend on third party money to stay alive.

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