Renowned Doctor Says Reform Must "Cut Costs"

[sandnsea]

Abraham Verghese attended President Obama’s recent health care town hall at the White House and shared his thoughts on The Atlantic blog. He is known for several non-fiction books, including My Own Country, which was based on his experiences as a physician treating persons with HIV in Johnson City, Tennessee. Dr. Verghese came to Johnson City from India in 1979 as part of a foreign medical graduate program and completed his residency there. He returned from Boston in 1985 and was surprised to find the signs of the AIDS epidemic which had previously been considered an urban disease. After several award winning books, his focus turned to medical humanities and the importance of bedside medicine. He is currently a tenured professor at Stanford.

The doctor has written a series of articles on health reform and has some of the most clear-eyed analysis of how we got here and where we need to go. He has no sacred cows, including President Obama, of whom he admits he is “an admirer”. An article for the Wall St Journal hits directly at the AMA and their history of sabotaging public health care, going back at least as far as President Truman in 1949. According to Dr. Verghese, the AMA used the famous painting, “The Doctor” on thousands of posters with the caption “Keep Politics Out of this Picture.” Sound familiar?

He goes on to dissect the claim that prevention will reduce costs, and rather says that the cost of services must be reduced, period. “The bottom line is that our health care is costly because it is costly, not because we deliver more care, better care or special care. Alas, a solution that does not address the cost of care, and negotiate new prices for the services offered will not work.."

http://www.obama-mamas.com/blog/?p=295

[uponit7771]

1. Americans know HCI is expensive and rethugs are concentrating on hating Americas government

...and I don't see either side of the political spectrum shading towards the people they represent.

[KakistocracyHater]

2. i.e. wholesale pricing, with contracts for 75 years locked in

I can easily see the federal gov getting that for fed employees & alternate State versions-who would say no to a guarantee of use for 75 years? Before Reagan health care was better & there USED to be a doctor or a dentist in every little shopping center, in fact we had a doctor but not a grocery store in the 70s for a bit. It's the insurance corps. plus the Medicare Drug Disaster Act that purposely denied wholesale pricing. Pass an "undo" of the MDDA /\ that reverts back, step by step, ending with public health coverage.

[Cha]

3. Reform should reduce costs but

I'm a big believer in "prevention".. and, it's certainly reduced my costs to 0.

I also realize there's all kinds of people and my story wouldn't work for everybody but I know of some others over the years who take a strong interest in maintaining their own healthy existence.

[sandnsea]

4. Not that kind of prevention

He's saying that healthy eating and exercise don't cost anything now, so that can't be factored into any savings. The savings from real preventive health care, check-ups and the like, that can actually cost a lot of money and don't do anything except tell the patient what he always should have known - eat better and exercise.

[WeCanWorkItOut]

5. AMA's role in keeping the supply of physicians limited--I wish he had mentioned that

The AMA has been an important reason that our supply of doctors
is relatively low, less than Greece, Italy, and many countries where
physicians are paid less and people live longer.

Reason they restrict supply: to reduce competition and increase doctors' incomes,
clearly. (It's true that now, when so many doctors are thinking
of retiring, they've permitted some expansion.)

Then there's the problem that nurse practitioners cannot practice independently
in many states. That's also because of organized medicine.

I wish that Verghese had addressed these cost-increasers.

I am pleased that he brought up the issue of coronary calcium scans.

But to suggest that someone with high cholesterol quite possibly should not be treated,
because he's feeling fine for now (Verhese alludes to this on page 3
of the WSJ article). . . what was he thinking of? Tremendously oversimplified.

[sandnsea]

7. Is that what he meant?

I think he meant that a cazillion tests for a 50 year old man might not be necessary to put them on a statin. So you know you have heart disease. So what. Do what you should be doing anyway. Eat better, exercise, and get your blood cholesterol at the correct level. That's what I took away from his remarks.

[SuperTrouper]

9. The AMA is in bed with many special interests groups...and they tend to favor

the specialists over the primary care providers. Also do not forget the American Board of Internal Medicine and other Board associations that in the "interest of keeping high quality medicine" they keep many non-Boarded physicians from providing care because many insurance companies do not allow them into their rolls...I have known several "Board-specialized" physicians that are terrible because they were able to pass the boards (written/computer exams) but have no clue on how to approach a clinical problem and they have to rely on the consultants to address simple problems (thus increasing the costs). I say do away with the AMA, ABIM and have a peer review council in a State or municipality to address quality of care among their physicians.

[avaistheone1]

6. We can knock 30% right off the top of health care costs today by

eliminating the health insurance companies' administrative bureaucracy. Which mind-blowing - 30% right out of the gate!!!!

Right now there is a billing clerk for every bed at Duke University. The system is nuts.

We need a strong public option, better yet single payer national health care system.

[SuperTrouper]

8. Medications, ancillary services (MRI, CT scan) specialists services (cardiac catherizations...

chemotherapeutic agents) are too expensive...especially the radiological services. Why should we pay $150.00 a month for a blood pressure medication like Avalide when we can pay $4.00 a month at Walmart or Target for Triamterene/HCTZ which gives similar results? Why should we pay $200+ for an antibiotic like Levaquin when we can pay $4.00 for Doxycycline or Cipro at the mentioned pharmacies and get adequate and similar results? So, yes, we need to rein in cost of services and provide a public option for health insurance AND a public option for malpractice insurance, too.