John Mackey nails it in “The Whole Foods Alternative to ObamaCare”
Filed under Fundamental Perspectives, Health Care
Tagged as Economic Policy, government intervention, Health Care, John Mackey, regulation
I wish it was that simple. A few comments
1) Significant amount of health care expense is directed by physicians. Cost control will never be maximized until Tort reform passes and physicians don’t feel pressured to practice “CYA” medicine. This is a fact – just ask your doctor.
2) There is significant cost shifting in health care. Medicare and Medicaid don’t pay to hospitals and physicians what it costs to provide that care (plus a little profit). When you add in the uninsured and the people who just don’t pay, that burden is passed onto you, the average guy with insurance.
3) He is correct that a significant part of our health care dollar is spent treating ailments that are nearly completely preventable – related to smoking, obesity, etc. If we can’t get our arms around this, there is no hope. Not quite sure if taxes on cigarettes and cable TV are the answer, but…
4) strict legislation should be passed to prevent Physicians from profiting from self referral. Studies have shown that utilitization of high end tests such as CT and MR increase as much as 8-10 fold when the referring physician has a piece of the action. This happens in almost every multispecialty group or orthopedic group. If you go down the hallway to have your MR, rather that across the street (and often if you do go across the street), chances are your physician makes more on the MR that he does on the office visit.
The biggest loop hole and thus the biggest profit is made in “specialty hospitals”. These are almost always surgical hospitals owned by physicians like neurosurgeons and orthopedic surgeons. They take care of you at their private hospital rather than your community hospital. Orthopedic and neurosurgery operations are by far the most profitable and they have carved this out. They treat you great at these places because they can afford to – the highest profit operations with none of the low profit or even money losing services – like an ER. The funny thing about this is they made it illegal for a family practice MD to own shares of these hospitals because they might make some money if they refer you to a surgeon who is an owner, given the possibility that the surgeon might refer you to the hospital he owns. But it is ok for the surgeon to own the hospital and profit from the surgery he does on you. This practice is really hurting community hospitals. If you have a heart attack while you are staying at one of these specialty hospitals where do they send you? .. to a community hospital.
I agree that Mackey’s solution won’t fix every single problem in the health system. But it sure beats the government run answer in that at least Mackey isn’t proposing to move in the completely wrong direction. Check out Kathleen Parker’s Washington Post editorial: http://www.washingtonpost.com/wp-dyn/content/article/2009/08/18/AR2009081802849.html?wpisrc=newsletter&wpisrc=newsletter.
She’s right that the word “comprehensive” coming from the lips of any politician should be treated as a warning of extreme danger.
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