By: Alieta Eck, MD
From the patients in my office
we can learn why Medicare and Medicaid cannot control costs. Neither the
President, the Congress, nor learned journals are telling these
stories.
A spry, cheerful patient told
me that she had fainted under the hair dryer in her beauty salon. The
rescue squad rushed her to the emergency room of the nearest hospital.
On the way, she was alert and speaking clearly with no weakness of her
arms or legs. She told the rescuers that this had happened once before a
few years ago.
All indications pointed to a
simple fainting spell. Maybe she was dehydrated. The warmth from the
hair dryer probably caused blood vessels to dilate and her blood
pressure to drop.
Nevertheless, she spent three
days in the hospital with EKG monitoring, and underwent a CT scan, an
MRI, an EEG, and endless blood tests— all normal. Several specialists
were called in for this “complicated” case. Finally, the patient
insisted on going home even though some advised her to stay a little
longer. She commented on how she probably would never have even been
admitted had she not been covered by Medicare. And Medicare (working
people and their as-yet-unborn grandchildren) will probably pay more
than $20,000.
A television commercial states,
“Last year, 9 out of 10 people got their Hoveround for little or no
money.” A perfectly healthy appearing actress, sitting in her fancy
scooter, folding her wash, says, “With Medicare and my insurance, I paid
nothing out of pocket.” Those commercials ignore the fact that someone
is paying for those expensive scooters— just not the actual users.
In a free clinic, one patient
told me she preferred the brand name to the much lower cost generic.
“Why?” I asked. “My friend told me the brand name is better.” Her
prescriptions are covered by Medicaid, so all her medicines are paid for
by someone else. I respectfully declined to write, “brand medically
necessary,” and explained that although the medicine was free to her,
the State of New Jersey is out of money and the generic will probably
work just as well.
Are these patients or their
physicians committing fraud? No. They are simply acting legally to
enhance their own well-being, following the incentives set up by the
unwieldy system. People with “coverage” do not care what costs they
incur, and those who provide services benefit by providing more. As with
the oil rig in the Gulf, there is a lot of pressure behind the leak.
Adding more pressure —as with the Democrats’ idea of saving money by
covering everybody—is not the answer. It can only make things worse.
We have in fact already tried
it– in Massachusetts. The one-state version of ObamaCare functions only
because of heavy federal subsidies. Massachusetts has tried to limit
fees, and still the state is hemorrhaging cash. Massachusetts Medicaid
went from $1 billion to $1.75 billion in 4 short years and the federal
government—actually the taxpayers from the other 49 states— subsidized
half that increase.
Will it take a bomb to stop the
leak before we are smothered in oil or debt that our grandchildren will
never be able to repay? What will be the result of the looming 21% cut
in Medicare payments to physicians?
Doctors who have been accepting
steadily diminishing payments to care for the elderly are increasingly
bolting out of the system. Savvy Medicare recipients will continue to
secure their free Hoverounds, but the weaker, more confused, sicker, and
more vulnerable will find that fewer physicians will be able to care
for them. Once the nation is bankrupt, hospitals have closed, and
physicians have found alternate ways to earn a living, real medical
needs will not be met. The best medical care in the world will simply
cease to exist. Then all Americans, young and old, will feel the pain.
There is a better answer,
pointed out by Rep. Ron Paul, M.D. (R-TX):
“We need a system in America
where patients pay cash for basic services, and carry insurance only for
serious illnesses and accidents. ‘Health maintenance’ is the
responsibility of each of us individually. We cannot continue to
collectivize the costs of healthcare and expect things to get better.”
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