Comments on: What is responsible for high health care costs? http://www.kevinmd.com/blog/2008/10/what-is-responsible-for-high-health.html medical blog Mon, 15 Mar 2010 04:04:23 -0400 http://wordpress.org/?v=2.8.4 hourly 1 By: Anonymous http://www.kevinmd.com/blog/2008/10/what-is-responsible-for-high-health.html/comment-page-1#comment-87838 Anonymous Wed, 29 Oct 2008 23:59:00 +0000 http://clients.emmense.com/kevinmd/2008/10/what-is-responsible-for-high-health-care-costs.html#comment-87838 If every doctor in the country took nothing home, at at the salvation army, work clothes out of church rag box, and slept on a park bench, that would take out one year's healthcare inflation and then the climb would continue. It is a personal problem for people with envy issue but not a big financial factor. If you could figure out how to make a slight shift in utilization patterns, you could double their incomes and till come out spending less.<br/>Those are facts that can be easily inferred from readily available data.<br/><br/>Another fact well demonstrated by a Dutch study recently was that the common belief that patient lifestyle is the cause for high health cost is completely false. Those who smoke and are fat end up costing less in the end because they die younger--yet entire reform programs are structured around this false belief. Any surprise that they fail?<br/><br/>I'll compare my income to my European colleagues when I can take those 6 to 8 week vacations regularly that they are on when I get to visit with them--instead of 2 desperate weeks spread out over they year paid for by working 60 hours weeks before and after. If every doctor in the country took nothing home, at at the salvation army, work clothes out of church rag box, and slept on a park bench, that would take out one year’s healthcare inflation and then the climb would continue. It is a personal problem for people with envy issue but not a big financial factor. If you could figure out how to make a slight shift in utilization patterns, you could double their incomes and till come out spending less.
Those are facts that can be easily inferred from readily available data.

Another fact well demonstrated by a Dutch study recently was that the common belief that patient lifestyle is the cause for high health cost is completely false. Those who smoke and are fat end up costing less in the end because they die younger–yet entire reform programs are structured around this false belief. Any surprise that they fail?

I’ll compare my income to my European colleagues when I can take those 6 to 8 week vacations regularly that they are on when I get to visit with them–instead of 2 desperate weeks spread out over they year paid for by working 60 hours weeks before and after.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/10/what-is-responsible-for-high-health.html/comment-page-1#comment-87812 Anonymous Tue, 28 Oct 2008 02:48:00 +0000 http://clients.emmense.com/kevinmd/2008/10/what-is-responsible-for-high-health-care-costs.html#comment-87812 It's also the patient's fault. Doctors can advise patients to cut down on saturated fat, alcohol, cigarettes, salt intake, energy drinks, etc., but if the patient does not follow up on the doctor's advise and end up with a costly bypass in excess of $100k, health care gets expensive for all of us. <br/><br/>Who knows. In the future, health insurance may not exist. The health insurance is already forcing more patients to contribute more out of pocket expenses each year. It’s also the patient’s fault. Doctors can advise patients to cut down on saturated fat, alcohol, cigarettes, salt intake, energy drinks, etc., but if the patient does not follow up on the doctor’s advise and end up with a costly bypass in excess of $100k, health care gets expensive for all of us.

Who knows. In the future, health insurance may not exist. The health insurance is already forcing more patients to contribute more out of pocket expenses each year.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/10/what-is-responsible-for-high-health.html/comment-page-1#comment-87810 Anonymous Tue, 28 Oct 2008 01:56:00 +0000 http://clients.emmense.com/kevinmd/2008/10/what-is-responsible-for-high-health-care-costs.html#comment-87810 I would expect a physician to say that physician salaries are not part of the problem. I would expect a physician to say that physician salaries are not part of the problem.

]]> By: Doc99 http://www.kevinmd.com/blog/2008/10/what-is-responsible-for-high-health.html/comment-page-1#comment-87809 Doc99 Tue, 28 Oct 2008 01:36:00 +0000 http://clients.emmense.com/kevinmd/2008/10/what-is-responsible-for-high-health-care-costs.html#comment-87809 High physician salaries? I must have missed them. Thanks to the MCO's in my neck of the woods, the days of high physician salaries are gone. I know some docs who periodically need loans to make payroll. <br/><br/>As far as med tech, it's been my observation that technology is additive - new technology supplements not replaces older technology.<br/><br/>Finally, use of new technology seems spurred more by patient demand, liability fears or both. Both aspects need to be addressed before costs can come down. By that time, I hope we can still find a Kevin MD to see our patients. High physician salaries? I must have missed them. Thanks to the MCO’s in my neck of the woods, the days of high physician salaries are gone. I know some docs who periodically need loans to make payroll.

As far as med tech, it’s been my observation that technology is additive – new technology supplements not replaces older technology.

Finally, use of new technology seems spurred more by patient demand, liability fears or both. Both aspects need to be addressed before costs can come down. By that time, I hope we can still find a Kevin MD to see our patients.

]]> By: The Happy Hospitalist http://www.kevinmd.com/blog/2008/10/what-is-responsible-for-high-health.html/comment-page-1#comment-87806 The Happy Hospitalist Tue, 28 Oct 2008 00:31:00 +0000 http://clients.emmense.com/kevinmd/2008/10/what-is-responsible-for-high-health-care-costs.html#comment-87806 Maggie often talks about supply leading the way for rising costs. I look at things in the exact opposite way. Demand is causing the supply. And the demand is from third parties. The only reason we have MRI's on every street corner is because insurance pays for it. Medicare, Medicaid, Blue Cross. All of them. I remember as a resident, nobody paid for PET scan technology. Even though I had patient after patient with metastatic cancer, I couldn't order a PET scan because patients couldn't afford to pay cash up front, and no third parties would pay for them. Now, you can find PET scanners everywhere. Not until they are paid for did they become so common. The same will happen with CT scanners used for cardiac calcium scores. When nobody pays for them, nobody builds them. With the new payment rules, I'm sure they will be everywhere. <br/><br/>It's not supply that leads demand, it's the other way around. When you have a third party paying for everything, you get exactly what you ask for. Maggie often talks about supply leading the way for rising costs. I look at things in the exact opposite way. Demand is causing the supply. And the demand is from third parties. The only reason we have MRI’s on every street corner is because insurance pays for it. Medicare, Medicaid, Blue Cross. All of them. I remember as a resident, nobody paid for PET scan technology. Even though I had patient after patient with metastatic cancer, I couldn’t order a PET scan because patients couldn’t afford to pay cash up front, and no third parties would pay for them. Now, you can find PET scanners everywhere. Not until they are paid for did they become so common. The same will happen with CT scanners used for cardiac calcium scores. When nobody pays for them, nobody builds them. With the new payment rules, I’m sure they will be everywhere.

It’s not supply that leads demand, it’s the other way around. When you have a third party paying for everything, you get exactly what you ask for.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/10/what-is-responsible-for-high-health.html/comment-page-1#comment-87803 Anonymous Tue, 28 Oct 2008 00:11:00 +0000 http://clients.emmense.com/kevinmd/2008/10/what-is-responsible-for-high-health-care-costs.html#comment-87803 should a pcp who didn't have to take call in the 2nd and 3rd year of residency like at my institution and also who got out after 3 years get paid the same as a ct surgeon who had to spend 10 years in residency? should a pcp who didn’t have to take call in the 2nd and 3rd year of residency like at my institution and also who got out after 3 years get paid the same as a ct surgeon who had to spend 10 years in residency?

]]> By: Anonymous http://www.kevinmd.com/blog/2008/10/what-is-responsible-for-high-health.html/comment-page-1#comment-87802 Anonymous Tue, 28 Oct 2008 00:06:00 +0000 http://clients.emmense.com/kevinmd/2008/10/what-is-responsible-for-high-health-care-costs.html#comment-87802 Why not say the same for nurses? Or for that matter, IT workers? Why not say the same for nurses? Or for that matter, IT workers?

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