MEDICARE, WTF?

Our health care system is all for profit. Just the opposite should be true to insure that everyone has the same access.

The most vulnerable are seldom treated with respect, access to beneficial medicines, healthful food and personal attention. All those things cost money. When a doctor receives a bonus for the fewest prescriptions and tests given, he or she will opt for the money. I know a few who refuse to be part of the system, but they are in a minority.

Diane wrote:

Our health care system is all for profit. Just the opposite should be true to insure that everyone has the same access.

The most vulnerable are seldom treated with respect, access to beneficial medicines, healthful food and personal attention. All those things cost money. When a doctor receives a bonus for the fewest prescriptions and tests given, he or she will opt for the money. I know a few who refuse to be part of the system, but they are in a minority.

Diane- I agree with you that our medical system has gotten to a place where doctors are caught between a rock and a hard place. One of the problems is managed care, where you have yet another layer of (unnecessary) bureaucracy that wants to be paid.

I certainly can be sensitive to your feelings on account of your experiences with your brother. The reality is that is is not only the disabled who are often given short shrift from the medical community. The elderly and the infirm, who are incapable of advocating for themselves often have the same problem.

I do disagree that all people are entitled to equal access. Doctors are not priests, and are not in the business of charity, although there are many good doctors who do offer some of their time gratis in order to serve poor people in clinics.

Doctors have put a great deal of time and money into their education, and setting up an office. Because of the medical situation today, many good people who would have gone into medicine are opting for other careers. As a result, I am seeing, over the last couple of decades, a spate
of mediocre physicians with whom I would not trust my life and health.

I am totally against universal health care. If that ever happened, I could forsee a time where the best and the brightest would not even consider medicine as a career, and the country would be left with even more mediocrities in the medical field.

Diane wrote:

... When a doctor receives a bonus for the fewest prescriptions and tests given...

Does this make sense?

Why should a physician receive a bonus, when increased medical expense as a result of patient illness ( due to fewer Rxs and tests ), is the result?

When a mammogram or a colonoscopy is ordered for a patient and the patient follows through with the exams, this is money in the bank for the healthcare facility providing the tests to the tune of about $500/mammogram and $2000+/colonoscopy, all paid for by most if not all health insurance plans.

So...why would the physicians order fewer tests?

I am totally against universal health care. If that ever happened, I could forsee a time where the best and the brightest would not even consider medicine as a career, and the country would be left with even more mediocrities in the medical field.

Phoenix32890 wrote:

I am totally against universal health care. If that ever happened, I could forsee a time where the best and the brightest would not even consider medicine as a career, and the country would be left with even more mediocrities in the medical field.

So you think that we've got here in Germany only under-average doctors ... since more than 120 years?

Gelisgesti- Interesting. I would be interested in the parameters that were used in that list.

Miller wrote:

Diane wrote:

... When a doctor receives a bonus for the fewest prescriptions and tests given...

Does this make sense?

Why should a physician receive a bonus, when increased medical expense as a result of patient illness ( due to fewer Rxs and tests ), is the result?

When a mammogram or a colonoscopy is ordered for a patient and the patient follows through with the exams, this is money in the bank for the healthcare facility providing the tests to the tune of about $500/mammogram and $2000+/colonoscopy, all paid for by most if not all health insurance plans.

So...why would the physicians order fewer tests?

I think that you need to go back a few decades (probably the 1970's- 1980's or so) to get a handle on this. Many doctors were fearful of malpractice lawsuits. As a result, some doctors would order unnecessary and expensive tests, just to cover their butts.

When managed care came in, supposedly to reduce costs, often doctors were "encouraged financially" to be more judicious in their ordering of tests. Problem is, that this swung the problem in the other direction, with some HMO members not being prescribed tests that might, in the long run, be beneficial financially to the insurance companies.

In the mid '80's through my work, I attended a seminar on DRGs. For those who are unfamiliar with the term, it means, "diagnostic related groups", and was originally used by Medicare. Each illness has a particular length of stay in the hospital. The system was meant to cut out unnecessary costs.

Over the years, other insurance companies have followed the DRG guidelines. That is why people are rushed out of the hospital, when often they need more care.