Tag: "doctors"

The Silly Appeal of Expanding Medicaid for All

DocsMeanMany people believe Obamacare was a conspiracy, with asinine design features intended to cause the program to fail. The primary goal in the minds of conspiracy buffs’ was to usher in a single-payer program of Medicare for All once Obamacare collapsed under adverse selection. The theory goes something like this: with nowhere to turn except the government, Americans would finally throw up their hands and acquiesce to government intervention. Seniors purportedly all love their Medicare, so why not expand the program to cover even more people?

The Opioid Crisis Obeys the Law of Unintended Consequences

Capture71A letter to the editor of the New England Journal of Medicine back in 1980 is thought to have been the nudge that set the opioid crisis in motion. The letter claimed only four addictions were documented out of nearly 40,000 patients who were prescribed powerful opioid pain pills. The article arguing addiction to prescription opioids is rare has been cited 600 times — often incorrectly.  Doctors and drug makers used this as evidence that it was safe to prescribed opioids to more patients with chronic pain.

Technology & Cost Containment—Why Doesn’t Medical Technology Bring Down the Cost of Healthcare?

Capture14Technology is a significant driver of high health care spending. For instance, many treatments common today were not available 40 years ago. Yet, treatments and therapies that have been in use for decades are still quite expensive. In typical consumer markets, the quality of technology gets progressively better while the (real) inflation-adjusted prices often fall as older technology is surpassed by newer technology. This is especially true of consumer electronics but also of true of automobiles, appliances and other types of consumer goods. The inflation-adjusted prices of consumer goods have held steady because consumers are price sensitive, rewarding the firms who successfully compete for their business.

Is Health Care A Right? Or a Privilege?

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Adapted from my upcoming book: Your Money AND Your Life, coming Spring 2017.

In 1992, Dr. Kathryn Anastos was quoted as saying:

“It is unconscionable that we ration health care by the ability to pay… Health care should be a given.”

She’s not alone in her opinion. Even today, politicians, activists, and even physicians on the Left claim that health care is a fundamental right, that should be guaranteed to all by our government. This underlies the concept of socialized medicine, where the state becomes the provider of health care to the entire population.

These liberal progressives also make the point that anyone who opposes their idea of health care being a right, must view it as a privilege. In other words, reserved only for those lucky few who can afford to pay for it.

So which label is correct? Is health care a right? Or is it a privilege?

Actually, it’s neither. And to prove my point, let’s compare this philosophy to how we view some of life’s basic needs.

When I was in grade school, I remember being taught about three things that are essential for living: food, water, and shelter.

Never were truer words spoken. We have to have food and water to survive, and without shelter we would be exposed to the dangers of the elements, wild animals, and our fellow humans intent on doing harm.

And yet, none of these essentials is considered a right.

Our founding documents do establish a number of rights, such as to life, liberty and the pursuit of happiness; to the freedom of speech and of religion; and the right to bear arms. But nowhere did the framers mention the right to eat, the right to drink, or the right to housing.

Don’t keep up with your rent or mortgage? You can be legally evicted.

Ignore the water bill? The local utility company will come to your house and shut it off.

Likewise, I don’t know of any grocery stores or restaurants that would accept “It’s my right to eat!” as a form of payment.

While it’s true that the government does assist the elderly, the poor, and the disabled in obtaining these basic necessities, these programs don’t apply to everyone. To receive such state assistance, one must first qualify by meeting certain criteria.

So there is no right to have food, water, or shelter, and even most liberals stop short of saying that it is the responsibility of the government to provide them to everyone.

But does that mean that they are privileges? Hardly.

A privilege can be defined as a “special right or advantage, available only to a particular group of people.”

Clearly, there is no privileged group of Americans who are the only ones that can find food, water, or shelter; the majority of us are able to eat, drink, and live comfortably, without any financial help from the government whatsoever.

So if some of our most basic needs are neither rights – nor privileges – then what exactly are they?

They are necessities, and nothing more. Because we need them to live.

Not so with health care, though. Unlike food, water, or shelter, health care is not a necessity. Health care may be able to make us healthier, alleviate pain and suffering, and prolong life, but it isn’t essential on a day-to-day, or even routine basis.

In fact, I’ve met many Americans who’ve gone for years, decades, and sometimes most of their lives without receiving any professional health care.

But if health care isn’t absolutely necessary for life, then why is it even spoken of in terms of being a right, vs a privilege?

Because it’s a great platform for big government proponents on the Left to take a moral stance, and promote their agenda by claiming that only the government can fix our broken health care system.

Calling health care a right also sets up a false argument against conservatives: anyone who opposes the idea of “health care for all,” must take the cruel and heartless stance that health care is deserved only by a few.

Except our system, even as it exists now belies that theory. Just as the elderly, the poor, and the disabled receive help in obtaining their food, water, and shelter, so do we have massive government programs in place to assist them with – health care.

A lot of it. In fact, over 1/3 of Americans with health insurance get their coverage through the government, and these programs pay for virtually all of those recipients’ health care.

Yet by claiming that health care is a right, liberals seek to extend this government-funded – and thus government controlled – health insurance to cover most, if not all citizens.

There’s no need to, however. Because health care isn’t a privilege. Nor is it a right.

Health care is simply a service industry, like many others.

When the framers of our Constitution enumerated their list of unalienable rights, Thomas Jefferson said it best: the government’s role is “to secure these Rights,” and not to create new ones.

Including, the misguided notion of there being a right to health care.

It’s not the COSTS of health care that are outrageous…it’s the CHARGES.

Kevin Wacasey, M.D. Bio here.

 

An earlier version of this appeared on Healthcareonomics.

Interactive Group Therapy in the Information Age

Laptop and Stethoscope --- Image by © Royalty-Free/Corbis

Laptop and Stethoscope — Image by © Royalty-Free/Corbis

Imagine attending private lectures and taking all your college exams in your professors’ offices individually, one-on-one. Your instructors lecture you, then pepper you with questions, grading your answers and recording your scores. This is not unlike traditional physician visits. Contrast this to attending classroom lectures and taking online multiple choice exams where a computer algorithm tallies your answers and calculates your grade. Classroom instruction with standardized testing is much more efficient that private tutoring. Hundreds of people can learn and take their online exams simultaneously. What if medical productivity could be similarly improved?

FDA Backs Selling Hearing Aids Over the Counter

UntitledghgThe U.S. Food and Drug Administration (FDA) just announced it is taking steps to make hearing aids available over the counter. The FDA plans to immediately stop enforcing a requirement that patients must have a medical evaluation prior to obtaining a hearing aid. The Agency also hopes its move will stimulate a new category of OTC hearing aid products that cost less.  In this regard, hearing aids will function in a manner similar to reading glasses. The move was likely due to prodding by Senators Elizabeth Warren (D-MA) and Chuck Grassley (R-IA), who recently introduced legislation along these lines.

The Big Government Conspiracy to Protect Rich Guys

moneyI am not a proponent of conspiracy theories. That said: some conspiracies are real — and designed to protect the wealthy at everyone else’s expense. I’m referring, of course, to the conspiracy by the medical industrial complex to keep medicine costly. The conspiracy insulates the industry and its practitioners from competition using regulatory barriers and exclusive licensure cartels. At first glance these may all seem reasonable, but they extort one-fifth of our national income.

How Long Should You Have to Wait to See a Doctor?

dogvetwait

How long should you have to wait to see a doctor? Why not just call a doctor?

The patient in the photo was able to get a same-day appointment within 15 minutes of the request and was seen within 10 minutes after arriving. But that is an exception in the United States. A recent article in the American Journal of Managed Care estimated the average physician visit takes two hours (121 minutes). That includes travel time (37 minutes), waiting time (about an hour) and treatment time (10 to 20 minutes). Of course, that’s once you get an appointment.

California’s Surprise Medical Bill Law Papers Over A Systemic Problem

Doctors Rushing Patient down Hall(A version of this Health Alert was published by Fox & Hounds.)

Insured patients who go into hospital for scheduled surgery are often shocked to find they owe bills well beyond what they expected to pay, especially if they understood the hospital and surgeon to be in their health plan’s network. The problem usually occurs when an anesthesiologist or other specialist involved in the procedure is not in the insurer’s network. Until now, when it came to the amount the out-of-network specialist could charge, the sky was the limit. A recent Consumers Union survey found nearly one third of Americans who had hospital visits or surgery in the past two years were charged an out-of-network fee when they thought all care was in-network.

Is Obamacare’s Failure Intentional, to Promote Medicaid-for-All?

A recent commentary in the Wall Street Journal announced, “Obamacare’s meltdown has arrived.” Health insurance premiums all over the country have skyrocketed. Numerous insurers have pulled out of state and federal exchange marketplaces. Many consumers have only one choice of health insurer and can choose from only a couple different plans. State health insurance CO-OPs have been falling like dominos and the program is now all but defunct.

None of this should have come as a surprise. Over the years I’ve heard conspiracy theories that Obamacare was designed to fail to nudge a reluctant nation one step closer to a single-payer system of socialized medicine. Think of this as Medicaid-for-All.