Shockingly the one area of healthcare that hasn’t been addressed is cost. We simply spend too much. We have solid gold demands and a tin credit card. During this whole discussion no one will talk about the 1000 pound gorilla in the room.

Healthcare spending equals 16% of our GDP. Twenty years ago it was 6%. By 2020 it will be 25% on a projected basis. We have the best healthcare system in the world. BS. At 78.1 years, our life expectancy stands at 33^rd in the world. At 70.0 years, our healthy years are 33^rd. In infant mortality rate we rank 34^th. Next question?

I am not advocating socialized medicine but there is a strong case to be made. Since the advent of Medicare we have seen the medical/industrial complex evolve. We have simply made a business out of disease and medical treatment. As widely held stocks we have pushed these companies to show profit growth. Ergo, the sicker, the longer, the more complex, the better.

Today we bring out new drugs at higher prices. They in many cases are only marginally better than the old one. They advertise. The doctor is not going to argue with a patient that wants this or that. What does he care? Prescription drug benefits don’t quibble. Pay for all but God forbid there would be a bidding process to lower Medicare costs. How tacky.

Machines can look into anything. Studies have shown hospitals with the latest and greatest gizmo see a huge growth in usage. To make people better? No, to pay for the damn thing. There are sophisticated operating rooms. Gotta pay for them. Oncology, cardio, orthopedics, obstetrics… We have to have the best. But we have got to pay for them. Don’t forget the same is being done at two or three other hospitals across town.

One would think that competition would be could. No way. Rather than being a cost lowering piece we raise costs well above inflation. We have to make profits so we raise prices because nobody cares or checks. We can jam more procedures into a two day stay than you can shake a stick at.

Now enter the doctor. Now docs are wonderful people and many are friends at least until now. He is a traffic cop. He treats. He refers. He will prescribe tests, MRI’s and treatment. And don’t you dare question him. Sure you can seek a second opinion he says but you may die in the meantime. No one wants to be a GP because there is no money in it. Besides I want a specialty where I don’t have to work weekends or be on call.

Sounds cruel but you have to question someone who has a proprietary interest in an outpatient surgical suite, MRI machine or blood testing center. Ask the question next time. You will be shocked.

Enter the patient. If you have cancer it can be a daunting task just to get a straight answer about your odds. Docs and hospitals don’t like to talk about death. It is truly against their oath. The characterization of “death squads” really pissed me off. Sitting down with two or three specialists discussing your disease, your outcomes and treatments doesn’t sound scary to me.

I am not pulling plugs but I am trying to be rational. If it is profitable to keep me alive at all cost and no matter what my degeneration stage might be, then we have 65 million problems coming up real fast.

Today we don’t run hospitals for charity. If you are owned by a big corporation you have got to show profits. Fill those beds with paying customers. Show them the latest and greatest no matter what. But if you are an insurance company you cut this down to the bone. Fight them every inch of the way. But still you pay for all the overreach and if it is Medicare, bill them for anything. Oops, I put in the wrong code that changed that treatment from $500 to $10,000. Tylenol? Of course they are $14.73 per tablet.

We heal older people only to have them develop something else.

We don’t want to give up but it gets into the realm of the absurd. There was a 92 year old woman in final stages of cancer. She was being seen by 15 specialists, including a psychiatrist…..and she even has a Pabst Smear. I’d laugh if it wasn’t so sad.

It is said that 30% of our $2.5 trillion annual medical costs is wasted on unnecessary procedures. That is $750 BILLION. They say malpractice insurance and suits only account for 7% of medical costs. What was I thinking? That’s only $150 billion.

Once again I have nothing against medical professionals making money. But when the whole process is bloated by oversupply of facilities and machines there is something terribly wrong. We can see the heavy hand saying if you don’t do this you are going to die. I say if we keep doing this we are going to die any way.

As Always

Ted The Great

Factoid…sort of

Many of you know I work in hospice. I am there as people “pass on” as the new phraseology states. I asked one of the nurses if the person was not in hospice how long could they be kept alive on ventilators, feeding tubes etc? She said depending on the disease progression and treatment it could be anywhere from one month to over a year. I said “what about quality of life”?. There was no answer.

Medicare Fraud:

It is estimated that between $60-90 billion of Medicare costs are the result of fraud. Because of regulations to protect bona fide business owners many of those who defraud the government are back in business almost immediately or are not prosecuted because the staff members do not show up for hearings. I can’t make this stuff up.