Friday, July 24, 2009

Is there a Doctor in the House?

On Wednesday night, the President addressed the country on his mandate to reform the US Healthcare System. On Thursday morning we started the process of attempting to make sense of how this will affect our personal lives and careers. Have you ever heard the saying; "Change is Good." You know, the one that CEO's in our industry love to use. Well, based on the response that we hear, change is really not good, at least for most Americans. America continues to carry the curse of our puritanical ancestors of having no flexibility and being much more conservative than we like to admit. Before discussing this new healthcare paradigm, some things need to be brought to light regardless of what side of the political spectrum the reader sits on.


Whether you liked what the President had to say or not, 46 million Americans do not have healthcare insurance. I am not going to argue about what category these uninsured people fall into, 46 million is 46 million. (I'll leave that debate to the spin doctor analysts). The U.S. spends more dollars on healthcare than any other advanced nation without better outcomes. Why? Is it because our doctors are poorly trained? No! Is it because we don't have state of the art technology available to us? No! Is it because our hospitals are not managed properly? Yes! Is it because insurance companies are publicly traded and driven by Wall Street's insanity? Yes! Is it because Americans in general don't take care of themselves? Yes! Or, is it because we have become a litigious society?


Just look at our industry, lawyers love medicine, healthcare and the medical device industry. When the President stated that a fee-for-service system creates an incentive for physicians to run more tests and perform additional operations, whether these procedures actually help the patient, misses the point. Yes, there are physicians that know how to manipulate the reimbursement system, but why does the government choose to place a "bullseye" on their back when there are others that need to be held accountable.


Until the Congress and Mr. Obama (a Harvard lawyer by education) comprehend the magnitude of Tort Reform, nothing will be resolved. The fact remains that many physicians are an open target for potential litigation when they do not "CTA" by ordering more tests and potentially not operating. But before we castigate Mr. Obama, let's not forget what Mr. Bush did when he was in office. He claimed to be against excessive government expenditures and did absolutely nothing to rein in the single largest contributor to the federal deficit, Medicare. In addition, "W" was irresponsible when it came to the plight of the uninsured or the concern regarding the cost of healthcare when he stated; "People have access to healthcare, all they have to do is go to an emergency room." But I'm not writing to make a pitch for Obama nor to bury Bush. I'm writing because we need to figure out how to provide healthcare for an estimated 15 million illegal immigrants (do we deport them if they don't become citizens), millions of unemployed college graduates (why isn't Wall Street and Corporate America doing something to help these kids), and people who have fallen through the cracks whether they are between jobs or not.


The potential backlash of not hammering out a realistic public plan could potentially have greater collateral damage than imaginable. Unfortunately, no one likes change, nor does everyone involved want to make concessions. The fact remains that if there is an overhaul of the current healthcare model our industry will pay a price. Why isn't the AMA, the Orthopedic and Neuro lobbying groups, and our own industry addressing the socioeconomic benefit to providing state of the art healthcare to Americans? There has to be a reason why our outcomes aren't better. Could it be that Americans in general don't take good care of themselves? Why don't these lobbyist talk about how the insurance industries main objective has always been to make doctors employees or wards of the state? Why would you take the incentive (fee for service) away from a free-market healthcare system? The bottom line is we're on the clock and if our industry along with its physician allies don't step up, it will be too late once a plan is enacted. The Spine Blogger wants to know what you Cowboys and Cowgirls think?


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