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Must read about health care myths

Bookworm on Jul 17 2009 at 4:51 pm | Filed under: Uncategorized

Stumbling On Truth has an amusing and devastating deconstruction of the myths fueling the Democratic side of the health care debate. (Hat tip: gpc31) Here’s just a small sample of this longer article:

Myth #1 Health Care Costs are Soaring

No, they are not. The amount we spend on health care has indeed risen, in absolute terms, after inflation, and as a percentage of our incomes and GDP. That does not mean costs are soaring.

You cannot judge the “cost” of something by simply what you spend. You must also judge what you get. I’m reasonably certain the cost of 1950’s level health care has dropped in real terms over the last 60 years (and you can probably have a barber from the year 1500 bleed you for almost nothing nowadays). Of course, with 1950’s health care, lots of things will kill you that 2009 health care could prevent. Also, your quality of life, in many instances, would be far worse, but you will have a little bit more change in your pocket as the cost will be lower. Want to take the deal? In fact, nobody in the US really wants 1950’s health care (or even 1990’s health care). They just want to pay 1950 prices for 2009 health care. They want the latest pills, techniques, therapies, general genius discoveries, and highly skilled labor that would make today’s health care seem like science fiction a few years ago. But alas, successful science fiction costs a lot.

Just one note: I’m not sure that the link I found is a permalink. If you go to the link and can’t immediately find the article on “Health Care Mythology,” I believe that, if you look on the upper left side of the blog, you’ll find a pdf link on the same topic. In other words, if you can’t find the article immediately, don’t abandon hope. Just look around a bit.

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13 Responses to “Must read about health care myths”

on 17 Jul 2009 at 7:17 pm 1Deana

I simply must share with you the experience I recently had with one of my patients in the hospital.

Patient A came in so we could rule out cardiac issues. The patient was a bit difficult as she/he was a drug seeker – wanted pain meds all the time. It was clear that the patient was not motivated to help him/herself.

We performed a stress test, which happens in two parts. We finished with part 1 and, based on the results, the doctor decided that the patient could be discharged and simply return to the hospital a couple days later for the second part.

Upon being informed of the discharge, the patient became furious, informed us that she/he did not want to leave the hospital, and threatened not to return for the second part of the test if he/she were discharged.

So what happened?

The patient was allowed to stay in an expensive room in the hospital for another night. And you know what’s next . . . the patient was a Medicaid patient.

People – this is what you are paying for!!!!! The doctor was too afraid to tell the patient to leave and not come back. We could be sued.

If this patient had been private pay, I ASSURE you that the patient would have been engaged in his/her own care and would have made a VERY different decision about whether or not to leave following the discharge.

This is what happens when patients are not responsible for their own care. This is what happens when patients are able to rely on someone else to pay the bills.

It makes me sick.
on 17 Jul 2009 at 8:17 pm 2Karl

This might work as a permalink:

I tried right-clicking on the frame, and selecting “show only this frame”, and that’s the URL I got.
on 17 Jul 2009 at 8:18 pm 3Karl

Um….. http://www.stumblingontruth.com/articles/Healthcare%20Mythology%202009-07-15.htm.
Let’s try that.
on 18 Jul 2009 at 6:49 am 4Danny Lemieux

Deana – your story is a perfect example of how socialism devolves all of us down to the lowest common denominators in society! Perfect!
on 18 Jul 2009 at 8:50 am 5Zhombre

Deana, that’s a similar story to one I heard years ago from a health professional: public aid patients are the most demanding, least cooperative, and most ungrateful. Getting something for nothing devalues everything.
on 18 Jul 2009 at 8:57 am 6Ymarsakar

It’s the criminal mentality. Because wealth doesn’t come from me, but somebody else to which I must use violence to steal and extort, it doesn’t matter what it costs anybody else. All that matters is that I get the moola.
on 18 Jul 2009 at 10:32 am 7BrianE

In 1985, it cost $35 for a brief visit with a doctor. Last week it cost $105. This is for the opportunity to talk with a doctor– briefly. That’s a three-fold increase for a visit that doesn’t include any 21st century procedures.
Unfortunately during that same time period, my wages haven’t increased three times. To me, health care costs have soared. To me, it isn’t a myth.
Whether or not the increase in medical costs can be attributed to advances in technology is irrelevant if I can no longer afford the costs.
Government paid medical benefits, Medicare and Medicaid, are poised to swamp budgets, both state and federal.
We can blame the excesses of legislative largesse, but even as a Republican congress was attempting to cost contain Medicare through the Advantage plan, it was also passing the largest expansion to Medicare– prescription drug coverage.
Before we too deeply become involved in defending the status quo, we need to be sure what the status quo is.
I certainly don’t have an answer to that, but I am drawn to one conclusion– the medical community is a monopoly, or a guild, if you wish, but scarcity drives prices, and the scarcity of Primary Care Physicians is having it’s part in these increases.

In 2006, the American College of Physicians, representing both PCPs and specialists, warned, “Primary care, the backbone of the nation’s health care system, is at grave risk of collapse.”[9] From 1997 to 2005, the number of U.S. medical school graduates entering family medicine residencies dropped by 50 percent.[10] In 1998, 54 percent of internal medicine residents planned careers in primary care rather than specialty medicine; by 2004, only 25 percent entered primary care.[11] Over the past ten years, medical subspecialty fellowship positions have increased by 40 percent, and the number of hospitalists, many of whom are internists, has risen from 500 to 15,000. The proportion of patient care physicians in primary care has dropped from 1997 to 2005, while the proportion of specialists has increased.[12] Not only is the PCP pipeline drying up, but one study found that 21 percent of primary care internists are leaving their practices after only fifteen or twenty years.[13] Lower incomes and a stressful work life discourage medical students and young physicians from choosing primary care careers.[14]

While the influx of international medical graduates (IMGs) has mitigated these trends, the proportion of IMGs entering primary care careers declined from 2001 to 2005, with an increasing number migrating into specialty fields.[15] IMGs help serve the 20 percent of the U.S. population living in medically underserved areas, but health centers in those areas report many PCP vacancies and major challenges recruiting PCPs.[16] The percentage of patients unable to obtain a timely primary care appointment has grown rapidly over the past ten years.[17]

The income of PCPs, adjusted for inflation, dropped by 10.2 percent from 1995 to 2003, while the amount of work increased.[18] Median specialist income in 2004 was $297,000, which is 180 percent of primary care income ($162,000). Unadjusted for inflation, specialist income grew almost 4 percent per year from 1995 to 2004, while primary care income grew 2 percent per year. The income of major medical subspecialties is more than 200 percent of general internal medicine income, with gastroenterology and oncology income, $369,000 and $350,000, respectively, growing more than 7 percent per year during those years.[19] Thus, the primary care–specialty income gap is growing. A specialist spending thirty minutes performing a surgical procedure, a diagnostic test, or an imaging study is often paid three times as much as a PCP conducting a thirty-minute visit with a patient who has diabetes, heart failure, headache, or depression.[20] It is these realities that define the crisis of primary care.

http://www.medscape.com/viewarticle/568921_3
Why this is occurring is multi-faceted. With the overwhelming cost of medical school, it’s understandable doctors would choose specialties that have greater ROI. Nurse practitioners may become a source of PCP in the future. HMO’s, generally viewed negatively, may not look so bad in the light of a government monopoly on health insurance.
on 18 Jul 2009 at 10:55 am 8BrianE

More data favoring family doctors.

Dozens of studies show that a strong primary care sector is associated with lower health care costs and improved quality. Peter Franks and Kevin Fiscella examined surveys from a nationally representative group of 13,270 adults who were asked if their personal physician was a PCP or a specialist. People with a PCP rather than a specialist as a personal physician had 33 percent lower annual health care spending and 19 percent lower mortality; cost and mortality data were adjusted for age, sex, ethnicity, health insurance status, reported diagnoses, and smoking status.[21] Other studies confirm that patients with a regular PCP have lower health care costs than those without.[22]
on 18 Jul 2009 at 12:44 pm 9Ymarsakar

Since people are not getting any younger, the demand is growing. thus you are not just paying the doctor’s costs. You are bidding for his services against other people who are willing to pay more. This drives up price.

The supply of medical services is artificially decreased by lawyers, government regulations, and medical insurance rates.
on 18 Jul 2009 at 12:55 pm 10Gringo

Off topic, from Babalu Blog, which translated this from an online paper from Catalonia province in Spain, breaking news from Honduras:

“The National Directors of Criminal Investigation seized various computers from the Presidential Palace that had recorded the supposed results of the referendum to reform the constitution that the deposed leader, Manuel Zelaya, was planning to conduct on July 28, the day he was removed from office.
The official investigation now deals with the possible crime of fraud and falsification of documents due to the fact that some of the certified voting results had been filled with the personal information of individuals that supposedly participated in the failed referendum that did not take place because of the coup.
One of the district attorneys that participated in the operation that took place this Friday showed reporters an official voting result from the Technical Institute Luis Bogran, of Tegucigalpa, in which the specific number of people that participated in table 345, where there were 550 ballots, 450 of which were votes in favor of Zelaya’s proposal and 30 were against, in addition to 20 blank ballots and 30 ballots, which were nullified.
The seizure took place on the third floor of the building attached to the Ministry of the Presidency that had been rented to the ex-minister of the Interior, Enrique Flores Lanza. The deputy district attorney, Roberto Ramirez, declared this area as a “crime scene” and, although he did not want to provide further details, said that further evidence had been found that could be categorized as crimes of fraud, embezzlement of funds, falsification of documents, and abuse of authority. ”

As others have asked, how long will this take to get into the ENGLISH LANGUAGE press, such as AP, Reuters, etc.?
on 18 Jul 2009 at 1:44 pm 11Ymarsakar

The Left was against democracy in Iraq because they didn’t control the election, thus they couldn’t simply do whatever they felt like and put in their own puppet, as they usually do.
on 18 Jul 2009 at 1:57 pm 12BrianE

Since people are not getting any younger, the demand is growing. thus you are not just paying the doctor’s costs. You are bidding for his services against other people who are willing to pay more. This drives up price.

The supply of medical services is artificially decreased by lawyers, government regulations, and medical insurance rates.-Y

You’ve left out another culprit, the AMA. The AMA acts like a guild, controlling access to the profession.

AMA HAS SOLD OUT PATIENTS & THE PROFESSION \
FOR A FEW BUCKS

Washington DC — The Association of American Physicians and Surgeons issued the following statement from Kathryn Serkes, Director of Policy and Public Affairs, in response to the AMA’s endorsement of House Bill 3200:

“The American Medical Association has sold out patients and the profession by endorsing House bill that supports government medicine.

“Why did the AMA do it? For a few dollars increase in Medicare reimbursement rates. In effect, it’s told patients, ‘It’s about the money, stupid.’

“We don’t think that a miniscule raise – one that can be revoked at any time on Congressional whim — is worth selling out for government control of medicine. The AMA has sold patient choice, patient privacy and patient control to the highest bidder.

“The AMA had the unbridled nerve to stand up with the President and pledge to reduce costs – on the very day that it sent out an alert to its members urging them to contact Congress in support of a physician pay raise.

“The AMA is trying to paint any doctors who oppose them as being ‘anti-reform,’ but that’s not true. Our doctors are for reform – real reform that puts patients and doctors in control, not the government.

“The AMA is not alone. Organized medicine has been spineless. Today a surgeon from Arkansas told me that he is appalled that the American College of Surgeons sent him an email saying, in effect, that they wanted a seat at the table, and were willing to endorse the bill if that’s what it took to get that seat.

“Today we’ve heard comments like: ‘The AMA is a disgrace.’ ‘All physicians who care for patients should drop out of the AMA immediately.’ ‘…has a track record of toadying up to government in exchange for handouts to its cronies that, in turn, are extorted from us as taxpayers and as honestly working physicians.’

“Thousands of doctors are joining the ‘Dump the AMA’ bandwagon. Signatures are pouring in to the ‘Take Back Medicine’ petition to Congress and the President. (See http://www.TakeBackMedicine.com) These are the doctors who really care about their patients.”

http://www.aapsonline.org/press/ama-sells-out-doctors.php
on 19 Jul 2009 at 4:53 pm 13Ymarsakar

I don’t count on Unions to look out for the best interests of anyone. They, like most institutions of power and influence in this nation, have been corrupted. They no longer serve the people, they just serve themselves and their small select minority of aristocrats at the top.

When the Whole of America is corrupted, down to the very public education system cranking out new ideologies and Jugends, why shouldn’t the AMA and Unions also go the same way? Might as well go on the band wagon while the going lasts.