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Politics : Politics for Pros- moderated -- Ignore unavailable to you. Want to Upgrade?

To: Nadine Carroll who wrote (328260)	10/9/2009 8:47:30 AM
From: skinowski	Read Replies (1) \| Respond to of 793905

Medicare does work, but it is also to blame for many of the problems. Medicare, in effect, shaped and molded our healthcare system. Someone posted on SI recently a description of the way Medicare determines medical fees. For the most part, they follow suggestions from an AMA advisory group, which consists more than 90% of specialists. Not surprisingly, many specialized procedures get paid very well, while the so called "cognitive" services (read - office and hospital visits) are paid at a level which makes it impossible, in many cases, for a traditional practice to survive. One interesting repercussion is the advent of "Hospital Practice". Internists and Family docs are seriously underpaid for their hospital work, to the point that it makes no economic sense to do it. This created a need for an entirely new profession - hospitalists, who are subsidized by hospitals in addition to whatever revenues they generate for their professional work. Hospitals, in turn, under the Medicare system of payment are interested in streamlined workups and treatment, and early discharges - which Hospitalists are able to do better than traditional practitioners. I could spend hours talking about all the ways in which the healthcare system tries to adjust itself to demands from Medicare, and all the unintended consequences of those demands. I wonder - those who claim that Medicare is managed with a 3 or 5% overhead - Do they take into account all those 10's - maybe 100's of thousands of jobs it takes to comply with all those government regulations and demands? I think I said it recently in another post.... When Washington sneezes, the entire healthcare industry catches pneumonia.