Thursday, April 8, 2010

Better stop doing what works!

One of the things that has helped decrease costs was the rise of the ambulatory surgery centers. These are outpatient centers that can do many different types of surgeries. Because they do not have the overhead of the hospitals, they were able to do surgeries for far lest cost. Medicare and insurance companies recognized this and reimbursed them less, but since these were private enterprises, they flourised. A great example, is that a cholecystectomy costs is 2/3 cheaper to have in a surgery center. So, in their great healthcare bill, what did Congress and the President do? Medicare will no longer allow cases to be done in surgery centers. So, it wants to pay 2 times as much for the same thing! Good thing these guys are in charge of the economy!


SeaSpray said...


I don't understand why they would decide to do that. ???

In the last 6 months I have been to an excellent surgical ctr and much prefer the experience over going to the hospital. I have recently brought two other friends to another surg ctr in the area and they feel the same way. So ..Ive been on both ends of it.

As a patient is more comfortable, private, staff is more attentive which translated as feeling better cared for. Not to knock hospital staff because I've had mostly good experiences..but if possible a surgery center is the way to go if you are a good candidate for it. My husband had a better experience too and preferred it over bringing me to the hospital. And I think it was much easier bringing my friends to a surgical center. I would think most patients would prefer that option. It is definitely more convenient.

So far as patients go's cheaper and all of the things I said above and more.

Physicians can make more money if they have ownership.

Small business thriving/making profit ..employs people ..good for the economy.

MDCR and insurance companies save money.

Sounds like a win, win, win, win. So what is the problem? Hospitals can't be happy. Maybe they are *in bed with the hospitals*?

Wait ..didn't the hospital lobbyists get some kind of deal regarding the HC bill with this administration? Before Christmas ..I thought I heard something about that ..around the same time I heard the seic unions would not have a 40% tax on their insurance premiums. Why else would they pay twice as much? Must be getting a kickback in some way.

I get an outpatient surgery site in my e-mail and there was an article about potential conflict of interest with physician ownership/clinical care/patients surgery government wants to reduce payments.

"Physician-owners of ASCs perform twice as many surgeries as their non-owner colleagues do, according to research appearing in the April issue of Health Affairs.

The study's authors say that discrepancy could be remedied by changes in federal law that would reduce facility fee payments to dilute ownership incentives and government reforms that would discourage the overuse of fee-for-service payment rewards."

Here is the link:

This "reduce facility fee payments to dilute ownership incentives" bothers me. I understand the main thrust of the article is to protect patients ..but I can't help but question if they also have other motives. ??? Why penalize doctors that aren't doing that? What is wrong with making a profit? Free enterprise?

And if they cut incentives ..then what is the incentive to operate independently? (no pun intended:)having the responsibility of a private business?

Throckmorton ..I'm not in the business, but it really does seem there has to be a greater gain for mdcr/ins companies that isn't readily apparent ..because otherwise it doesn't make any sense.

SeaSpray said...
This comment has been removed by the author.
Andrew_M_Garland said...

SeaSpray mentioned the main motivation: eliminating profit.

According to the Socialist mindset:

Evil: A surgeon makes a profit when he operates at a center that he partly owns.

Bad: A surgeon earns a fee each time he operates.

Good: A surgeon is paid a flat salary to be available for any operations that may be needed.

In the "Good" case, an altruistic, detached technician applies his skills at a rate that is optimal for good delivery of care. Not too fast or slowly. Not motivated by profit to do too much without proper rest, relaxation, and vacation. Not doing too little according to a deep sense of responsibility to the public and his employing agency.

This pattern of work and reward has been thoroughly tested in Government, where it has been found to be the best. The best part is eliminating any profit, a completely useless and expensive charge that is the embodiment of "extra".

Without profit, things would be so much cheaper. Or, maybe not. I once met a person who blamed a bakery for selling her a cake. You see, thay made a profit off of her.

They Are Profiting From My Needs

Andrew_M_Garland said...

Via -->InsureBlog - The Myth of the Rich Doctor
At -->Daily Caller - Arizona doctor says Obamacare will force him to close shop

- - -
edited] Democrats’ argue that much of the waste in health-care comes from the profit motive of physicians. Dr. Scherzer criticizes that argument.

Scherzer: The point of socialized medicine is for the government to limit the percentage of GDP spent on medical care. They won't admit they are rationing care. So, they accuse doctors of increasing their income by ordering too many tests. But, the vast majority of physicians are ethical and do not knowingly order unnecessary tests.
- - -

AMG: Eliminate the evils of profit, and the costs of medicine will come tumbling down, to match the obvious efficiency of government agencies. (smile)