Health-Care Myths

[Lantana07]

I don't disagree that something needs to happen. I know that one reason (not the only reason, but one of the reasons...) some things in a hospital seem super expensive is they are trying to make up for their charity patients who they agree to treat at no charge. These are usually pretty sick people who's care is not cheap at all. Not defending the practice, just giving a small piece of an explanation.

[Fred]

something needs to be done. Greedy corporations making health-care decisions is no more ideal than the govt doing it.

The problem starts with some jackass deciding to charge $12 for a Tylenol.

Well, you have to remember that an aspirin will cost $12 because of the services and a ton of related costs. Think of it like oil for your car. I buy synthetic oil for less than $20, and change it myself. But if I go to Celebrity in FM, that same synthetic oil change will cost me over $90.

Having worked in a hospital from an I.T. perspective, and seeing the trail of costs within software, I am surprised an aspirin in a hospital only cost $12. The process to dispense that simple little pill will change dozens of hands, legal controls, governmental controls, accounting controls, billing processes, purchasing controls, inventory controls, auditing controls, and on and on and on. We even calculated the time it takes an RN to dispense. That seemed silly to me, until you do the math. 8 minutes were allocated to dispensing a medicine. Time to log into the RN system, time to look up the patient record, time to review the electronic chart, time to submit the request, time to gain approval, time to order, time to physically get the pill, time to walk to and from the patient room, time to give it. At 8 minutes, that added $3.85 to the cost of the pill just for the RN (we used a $60k base, but many made more). There are lengthy calculations used to add the assoiated costs for the software and hardware used in all the processes, the costs for the pharmaceutical departments involvement, costs for insurance. The list goes on and on, and sometimes get down to 1/100 th of a cent. And to top it off, every three years we would reevaluate these costs, which was a project that usually ran over $500,000 to complete.

Yeah, so there's a lot that goes into that $12 aspirin, just as there is a lot that goes into the $90 synthetic oil change at Celebrity. I used to think like most, that the cost was ridiculous... until I saw what goes on behind the scenes. And knowing this make me a firm believer that the government will do no better at ll of this, mainly because there is no capitalistic driver.

[esemerson]

Fred you do well at adding another perspective. It only affirms that it's broke. govt meddling on down.

[Common Sense Al]

Having worked in a hospital from an I.T. perspective, and seeing the trail of costs within software, I am surprised an aspirin in a hospital only cost $12.

Yeah, it should cost $100... the time to locate the bottle ($2), the time to lift it off the shelf ($2), the time to unscrew the cap ($2), the time to turn the bottle upside down ($2), the time for the pill to fall out into the hand ($2), the pill might fall onto the flour so you have to account for that ($2), then you have to screw the cap back on ($2), put the bottle down ($2), make sure it is secure in it's place and doesn't fall ($2), then turn around and walk ($5), open a few doors on your way ($5), bla bla bla, I could go on and on with all the micro steps... when you think of all that, it should probably cost $200.

Great example of what is wrong with the system... micro management, bureaucracy, and waste... figuring out every little thing that needs to be done so that costs can be increased to make more $$$. Do you think they do things like this in other countries? Maybe that's part of the reason why costs are so much more here than elsewhere.

[josh]

Having worked in a hospital from an I.T. perspective, and seeing the trail of costs within software, I am surprised an aspirin in a hospital only cost $12.

Yeah, it should cost $100... the time to locate the bottle ($2), the time to lift it off the shelf ($2), the time to unscrew the cap ($2), the time to turn the bottle upside down ($2), the time for the pill to fall out into the hand ($2), the pill might fall onto the flour so you have to account for that ($2), then you have to screw the cap back on ($2), put the bottle down ($2), make sure it is secure in it's place and doesn't fall ($2), then turn around and walk ($5), open a few doors on your way ($5), bla bla bla, I could go on and on with all the micro steps... when you think of all that, it should probably cost $200.

Great example of what is wrong with the system... micro management, bureaucracy, and waste... figuring out every little thing that needs to be done so that costs can be increased to make more $$$. Do you think they do things like this in other countries? Maybe that's part of the reason why costs are so much more here than elsewhere.

You are right - "bureaucracy, and waste" are two things the ALWAYS go away whenever the government is in charge.

[Common Sense Al]

You are right - "bureaucracy, and waste" are two things the ALWAYS go away whenever the government is in charge.

Correct me if I'm wrong, but I wouldn't say the gov't is in charge of our healthcare system now... you can thank our private system for this bureaucracy and waste! You can thank capitalism (mostly private insurance companies) for creating innovative ways to create "road-blocks" to having to pay claims, micro-managing every detail, and for inventing new charges in order to get the most $$$ from those who need medical attention. Ironic, isn't it?

[Lantana07]

Al, it's pretty apparent you don't understand how healthcare works and how it's about as efficient in our country as you can get. Expensive? For some, yes. But it works.

Explain how our system will be better if the government manages this process. And explain how the government will pay for this little adventure of free healthcare. Explain how a college kid would be incentivized to go to medical school and incur the massive debt to be a doctor is he can't make it up later. There is already a growing shortage of physicians (there is a massive shortage of radiologists everywhere and family docs outside metro areas, for example), this would just make it worse.

[Common Sense Al]

Al, it's pretty apparent you don't understand how healthcare works and how it's about as efficient in our country as you can get. Expensive? For some, yes. But it works.

Yeah, I understand the basics which is why I understand it is excessively expensive, inefficient and wasteful. As for "works", well I guess that depends on one's definition. By my definition, it doesn't work. If you have a great private insurance plan paid for by your employer and oblivious to the costs and have never been really sick or had trouble with the insurance company, then I guess you would say it "works".

Explain how our system will be better if the government manages this process.

Get rid of the waste and many of the problems... electronic medical records, GOOD regulation, bla, bla, bla... I've explained this many times before.

And explain how the government will pay for this little adventure of free healthcare.

Taxes... like they pay for things like national defense. I suspect the net cost to many though would be positive since issues would be treated before they got out of hand and the system would be much more efficient with less waste.

Explain how a college kid would be incentivized to go to medical school and incur the massive debt to be a doctor is he can't make it up later.

Create programs that give you a free doctor education in return for working X number of years afterwards for only $X. And there's no reason doctor's can make good money, especially if everyone is insured and they always get paid. And better prevention of frivolous lawsuits would help as well.

There is already a growing shortage of physicians (there is a massive shortage of radiologists everywhere and family docs outside metro areas, for example), this would just make it worse.

If our private system is so great, then why is there a growing shortage? Maybe a good system would alleviate shortage issues?

[Lantana07]

There's a shortage because the GOVERNMENT is making it harder and harder for a doc to turn a profit and the word is filtering down to prosective students. The private sector is not responsible for the regulatory issues, the tracking and the time that is required to do certain things. It's the government who makes those rules.

I have been sick and had surgeries I didn't particularly want to have in the last couple of years. Thankfully, I had insurance that paid the vast majority of the bill...and I didn't have to wait any longer for the procedure than it took to get an available slot on the schedule. In one case just in June, it was decided Thursday afternoon I would go under the knife and Friday afternoon there I was. And no, it wasn't emergent. I would guess there isn't a Canadian who has that option, is there.

[Common Sense Al]

Is Your Hospital on Your Health Plan?

When you choose a health plan, you typically check the panel of doctors it pays for. Now you need to check which hospitals and diagnostic facilities it covers too. And keep in mind, the list can change at any time. The unfairness of this bait-and-switch game — to both patients and doctors — is pretty nasty. The hospitals and facilities you signed up for originally might suddenly be replaced by facilities that are — you guessed it — cheaper. While your premium (and the CEO's bonus) goes up, the dollar value of what you're getting — i.e., what the company will pay your hospital or doctor for their services — goes down.

Isn't private insurance great? Your premiums go up, CEO's bonus and salaries go up, but what your insurance company pays goes down. That's great innovation (at least for the insurance companies)!

[josh]

An example of the type of government efficiency that will result if Dems get their way:

http://docs.house.gov/gopleader/House-Democrats-Health-Plan.pdf

[admin]

From Rep. Michael C. Burgess:

Earlier this week, Speaker Pelosi and House Democrats released the bill for their health care reform plan. There are still huge holes in the bill, and I have many questions on several issues, including how much the plan will cost and how to pay for it, how many Americans it will give health insurance to, and what it will mean for patients, doctors and nurses. I am hopeful I will have the chance to hear answers to many of my questions over the next few days, when the House Energy and Commerce Committee, which I am a member of, holds a mark-up of the bill.

From what I have seen of the bill, though, it will drastically expand the federal government’s control over health care through expansions in Medicaid, the creation of a “public”, or rather, government-run health insurance option, mandates on individuals and businesses, and higher taxes.

At the same time, the bill does absolutely nothing to address serious issues plaguing the current system. The bill does not reform the outdated and broken payment system the government uses to pay doctors who treat Medicare patients, ignores medical justice reform, and fails to provide additional assistance to ensure the future physician workforce our country’s health care system will rely upon.

Most importantly, my 25 years of service as a doctor in North Texas tells me that this bill will not improve the quality of health care in America. In fact, the Democrats’ plan will drastically decrease the quality of health care in this country by taking the decision-making powers away from patients like you and doctors like me and putting it in the hands of government bureaucrats.

This is not what I had hoped to see in the Majority’s health care reform proposal, and it is certainly not what North Texans and the American people asked for. In the coming weeks, you can be assured that I will take every opportunity available to attempt to improve this deeply flawed plan. I did not give up a successful and worthwhile twenty-five year medical practice in North Texas to come up here to Washington and sit on the sidelines of the health care debate. I remain committed to helping the millions of Americans who want health care coverage find it, and to lowering costs and improving quality for everyone.

To learn more about my work on health care, including LIVE blog updates from the committee mark-up this week and next, please visit http://www.healthcaucus.org.

For more information on these and other topics, go directly to my web site (http://burgess.house.gov). To view floor speeches, interviews and other video messages from me, please visit my YouTube Channel (www.youtube.com/michaelcburgessmd). You can also follow me on Twitter (http://twitter.com/michaelcburgess). It is an honor to serve you in the United States House of Representatives.

Sincerely,

Rep. Michael C. Burgess, M.D.

[esemerson]

An example of the type of government efficiency that will result if Dems get their way:

http://docs.house.gov/gopleader/House-Democrats-Health-Plan.pdf

add visio to the list of things the GOP is terrible at doing.

[esemerson]

From Rep. Michael C. Burgess:

Earlier this week, Speaker Pelosi and House Democrats...

good to see Dr. Burgess has been issued the talking points. interesting that he brought up that doctors need to be paid more efficiently.

What gets me is how partisan the issue has become. both sides need to get a grip.

[Common Sense Al]

Good... hopefully Rep. Michael C. Burgess, M.D. can help improve the bill... but he better leave the public option in there.

...taking the decision-making powers away from patients like you and doctors like me and putting it in the hands of government bureaucrats.

I guess he's got a nice private insurance policy compliments of US taxpayers. The day people and doctors really can make their own choices is the day when people don't have to visit an "approved provider" and don't have to worry about getting an "OK" from an insurance company.