| Then add to the inflated pricing the health care industry's lavish advertising campaigns and the media's hype on new technologies, and we have a formula for the hyperutilization of expensive services.
What about "entitlement chutzpah," the rationale behind the alleged overutilization and abuse of the system carried out by people who show up at ungodly hours at the ER? The people who demand care for trivial problems because they have Medicaid, and that covers all the charges, so why should they care? So goes the refrain from the docs who complain. | Ronald L. Hoffman, M.D. See book keywords and concepts | You should also be aware of some general trends in the medical profession and the health care industry that have a great deal of influence on quality of care.
One of these trends is rather troubling: surgeons are becoming increasingly competitive, angling for patients and procedures to fill up their schedules. The reason is that we have simply created too many surgeons for the general populace, and they have not been allocated on any rational basis to different parts of the country where they might be needed. |
Attaining Medical Self SufficiencyDuncan Long See book keywords and concepts | | Unlike most other people you'll meet in the health care industry, I have no vested interests — other than giving you the best health advice and medical information I can find.
That's my pledge. That's what I must do to keep earning a living.
Very Good News
The good news, as you'll see after reading this manual, is that while at one time you were at the mercy of doctors and the pharmaceutical companies, that time is past if you have access to the sources of information and alternative health care products that I've given you in this publication. | J.D. Kleinke See book keywords and concepts | Among the many paradoxes of the health care industry, none has been more perplexing than the one affecting the law of inpatient supply and demand, as played out in the Community General Hospitals across the country. Under the faulty market economics of health care, the greater the supply of hospital beds, the higher the total hospital bill for the community. This inversion of normal market functioning is based on perverse collective clinical behavior observed for years across the industry: hospital bed supply drives demand, not the other way around (Starr, 1982). | Leo Galland See book keywords and concepts | The expansion of the health care industry that followed World War II, supported largely by federal grants, had as its primary goal an increase in the number of hospital beds and the affiliation of those beds with research institutions. Other approaches to health care expansion (e.g., development of community-based clinics or preventive health care programs) were passed over.
The growth of expensive, hospital-based medical care attracted commercial indemnity insurance companies. | J.D. Kleinke See book keywords and concepts | Businesses like HCIA and M&R got started because for years nobody in health care had a clue how to measure some of the most basic things. The health care industry is uniquely antiquated in its lack of empirical self-knowledge. We still do not know with any certainty something as simple as the average pay for physicians by specialty. Or which type of hospital provides more charity care, for-profits or not-for-profits. Or what the real medical loss ratio is for most MCOs. In health care, two answers to the same question, often using nearly identical data, never agree. | | Thus it positioned itself as the future Microsoft of a consolidating, integrating health care industry.
In 1998, HBOC sold itself to drug distributor McKesson a few short months before its sprawling business imploded, driving McKesson's stock from a historic high of $95 at the time of the acquisition to a fifty-two-week low of $19, before the damage was fully written off by Wall Street (King, 1999b). The company's fundamental problem was a disconnect between what works in a PowerPoint presentation and what works in a U.S. health care organization. | Gary Null See book keywords and concepts | Patricia Arthur, for instance, believes that the extraordinary cost of health care is due largely to a lack of fair competition in the health care industry. She says, "The nation is headed toward a $1.4 trillion annual health care budget. Each person in the country will be expending more than $3,900 per year on health care costs. Chiropractic is a low-cost substitute for certain segments of medical care. That is the result of a monopoly in the health care field centered around the AMA."
Another plaintiff, Dr. Chester A. | Elaine Feuer See book keywords and concepts | In 1993 the American health care industry generated more than $942.5 billion in expenditures and employed more than 10 million people? million nurses, 650,000 doctors, and 150,000 dentists. The industry supported 126 medical schools, approximately 6,600 hospi-
13 See Appendix A ?The Benefits of Nutrition" —for detailed information on the U.S. Health Care System and its antipathy towards nutrition. tals, 1,100 health insurance companies and 25,600 nursing care facilities. | Leo Galland See book keywords and concepts | Ethicists, educators, statisticians, psychologists, and anthropologists analyzed the health care industry from novel points of view, drawn from expertise intrinsic to their own disciplines. They chastised the medical profession for training too many specialists and for failing to recognize that patients are not just the bearers of diseases, but individuals who become sick within a social, cultural, and demographic context.
Stronger currents opposed and virtually nullified the changes. | J.D. Kleinke See book keywords and concepts | Because the health care industry is not the medical industry, a problem explored in the next chapter. All the energy expended in administrative, policy, and business spheres on health care reform in 1993 was independent from and ignorant of actual medical practice, the same as it is now.
Back in 1993 while the nation's MCOs were gearing up to microman-age everything physicians like Dr. | Bob LeBow, M.D., M.P.H. See book keywords and concepts | Healthy People 2010, the U.S. Public Health Service's blueprint of health goals for America in 2010. This blueprint includes universal coverage as a goal as well as a host of accomplishments in prevention.
Our failure to resolve the problem of uninsurance in America reflects our lack of support for prevention. Because the uninsured lack access to primary care and delay their care, they develop more expensive maladies, which, if treated earlier (preventively) could have been managed for a fraction of the cost. |
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