Health Care Survivors in the New Government Age

I ran across an interesting blog article today.  In it the author tells us that the major players in the health care arena must learn to change themselves by 2015 or risk being run over by the bus, metaphorically speaking of course.  You can read the entire article here.  The tale he tells is one where the new Health Care legislation, along with its regulations and government oversight, will make life a living hell for those players who did not see the change coming or make adjustments for it, well in advance.  And there truly is no reason that everyone shouldn’t be prepared.  We have all been told over and over “it’s” coming.

What I have some issue with is the idea that insurers would forsake profit  for their plan members.  On the contrary, they will be the first to figure out new and yet unrealized loopholes to keep the faucet of profit flowing. Insurance is an interesting industry where you decide how much profit you’d like to make then increase your premiums to make that profit.  Nice. If only the rest of us could do the same.  I wrote a previous blog about a different kind of insured model that would hold the insurers accountable to their customers.  I still think it is a workable model in the upcoming health care market,  AND it requires some form of government oversight.  But without the government trying to run it.

Another player in the market expected to make a change are hospitals.  Contrary to popular belief, hospitals don’t make their money on you when you are a patient.  Rather, they make their money off of outpatient procedures that are performed at the hospital.  The true benefit of being a hospital is the additional reimbursement received for using their facilities or for outpatient procedures.

For example; several surgeon get together and open an ambulatory surgery center (ASC).  They use state of the art equipment, the best staff, and receive JCAHO certification.  They perform the same procedures as the hospital, but the hospital gets reimbursed more than the surgery center.  Even if the ASC has better patient outcomes and lower post operative complications, they still receive less reimbursement.  The result is that many surgery centers are closing and surgeons are making deals with hospitals to share profits if they utilize hospital operating rooms and staff.

The very government that says they are trying to save you money, while providing “quality” health care is rewarding the more expensive hospital, that in all likelihood has less favorable outcomes.

Doc B

My opinion is free.

Advice is worth exactly what you pay for it.

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2 Responses to “Health Care Survivors in the New Government Age”

  1. Typo in your title.

  2. Reminds me of an attorney I know. Thanks!

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