A recent editorial The Five Dirty Words of Health Care Reform written by Cody Wasner, a practicing physician for 30 years, and president of the Oregon Rheumatology Alliance gives a great perspective of how America must address problems within our health care system. The basis of his opinion rests on the idea that the way in which the present debate on health care is being framed must remove “five words— five dirty words that are actually just misleading vulgarities.”
Stakeholder
The word “stakeholder” is a problem because “most of these so-called stakeholders are pseudo-stakeholders.” For example, “megalithic hospital conglomerates, auto manufacturers, the government, and health insurance companies are not stakeholders.” What should be obvious to all Americans is that “there are only two real stakeholders in health reform: the patient and the caregiver.”
This means that “90 percent of those in attendance at all of the meetings Obama or Congress has with stakeholders do not care for the sick and will never be at the bedside of a sick patient.” Instead, these ‘stakeholders’ are the businesspeople doing business at its best: making an investment in something that will be profitable such as “fancy hospital rooms, MRIs, endless billing codes, e-prescribing, new computer systems, etc.”
In order for
If we are to make health care more accessible for patients, we cannot continue to include so-called stakeholders who “take profits and deny patients treatments and access while drowning physicians with paperwork and meaning codes for diagnosis and treatment.”
Coverage
When everyone talks about getting people coverage, what most of us forget is that a “vast majority of Americans already have insurance coverage but are not able to get access to medications, procedures or their caregiver of choice.” Even worse, those with coverage “are paying increasingly high deductibles and percentages of charges for less care, less access and increased hassle,” and those with serious illness or injury are left with “crushing medical debt even though they have coverage.” While Congress wants people to believe that lowering insurance premiums will help, “it will only pass the loss on to patients by providing even less service.”
Moreover, the idea that offering coverage to uninsured is only another way for insurance companies to force physicians to see patients for even less time, so that those companies can “maximize profits for their megalithic corporations.” The answer is not spending a trillion dollars to give uninsured “the same broken and dangerous bicycle we already have.”
Provider and Consumer
Health care is all about who pays for what, and a provider is someone who gets paid for “delivering a service, a diagnostic and procedural code that is then sanctified by the insurance company so the all-important money exchange can take place.” As a result, patients are thus treated like consumers when they receive care, and physicians are forced to “call an insurance company to obtain “authorization” for a state-of-the-art treatment.”
What makes this situation worse is that doctors are forced to question years of experience to justify a treatment or decision to someone “with an extremely low level of medical sophistication.” The insurance companies would rather see a patient “first fail on or have negative side-effects from cheaper, older and often less-effective medications before the patient can receive a selected treatment.”
Quality
Although various media want Americans to believe that quality in
Prevention
As the Congressional Budget Office (CBO) has already reported, prevention will not save the health care system. As Dr. Wasner notes, emphasizing preventive care is ineffective because “more than 50 percent of peoples lifetime medical care costs are spent in the last year of life.”
Recommendations
In order to address these problems, Dr. Wasner wants to remove “the special interests” to focus on caregivers and providers. Additionally, he correctly asserts that physicians need to have the freedom to have a trusting relationship with patients. In many instances, a trusting relationship means letting doctors rely on treatments and medicines that they work with and are educated about through relationships in industry, continuing medical education and academia.
This insightful analysis of the word games played by politicians to help pass health care reveals that reform “is too important to be rushed … and too important to be left to pseudo-stakeholders like insurance companies.”
Over the past years health reform has only moved away from helping the patient by making health care into a profitable business at the expense of patients and taxpayers. Our reform efforts for “healing and ministering to the sick do not require coverage, or consumers, providers, billing codes, e-prescribing or the million other financial and bureaucratic annoyances caregivers are asked to perform.”
Ultimately, patients must realize that health insurance companies will not be there to care for you when you are sick, only your physicians will be. Therefore, if we want our physicians to stay around longer to treat us, we need to find better ways to reform our system so that doctors can treat patients with devices and medicines they know are effective from their experience with industry, research, and academia. If the present system is not changed, doctors will be forced to abandon the most innovative breakthroughs and changes in medicine to help us, and they will no longer be able to afford to help us, financially or medically.