Are High Health Care Costs Tied To Evidence-Based Medicine?

Did you ever wonder exactly what evidence-based medicine is? The National Center for Clinical Excellence bases it in on the philosophy “that as much medical practice as possible ought to be carried out using proven algorithms based on empirically valid evidence from controlled scientific experiments, rather than individual clinical judgment.”

Congressional health care reform relies heavily on both Evidence-based guidelines and evidence-based individual decision making to set the standards of care for medical treatment and outcomes. In fact, House bill 3962, in an effort to control costs, creates a new layer of government bureaucracy that inserts itself between the doctor and the patient. A national health commissioner and task forces will evaluate and decide everything from what medications a physician will be allowed to prescribe for a patient, to what surgery will be approved, to what outcomes will be expected for a particular medical condition. The ‘universal healthcare Czar’ along with the task forces will also decide whether or not hospitals will be reimbursed for care rendered based on predetermined outcomes. For example, if a patient is re-admitted within a prescribed number of days after discharge, the hospital will not be reimbursed for care given. It does not take into account factors such as how ill a patient may be. This new layer of government effectively removes the power of the individual physician and patient to decide what is the best course of treatment.

Why should you care?

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Tags: bending the cost curve, Congress healthcare bill, evidence based medicine, Health Costs, healthcare reform
Posted Feb 17th 2010 at 7:03 am in Congress, Economics, Healthcare, Politics | 7599847 Commentshttp://biggovernment.com/egeorge/2010/02/17/are-high-health-care-costs-tied-to-evidence-based-medicine/Are+High+Health+Care+Costs+Tied+To+Evidence-Based+Medicine%3F2010-02-17+15%3A03%3A35Dr.+Elaina+++George

Medicare Is Already Rationing Care

Rationing Medicare will not require clandestine meetings in smoke filled rooms. Simply reduce physician reimbursement to below the cost of delivering quality care, and free market forces will take care of the rest.

Medicare has already begun the process of backdoor rationing. Facing overwhelming budget shortfalls, Medicare needs to trim its books. Washington found a clever solution: eliminate the billing code for “physician consults.”

As a hospital physician, I often admit Medicare patients with chest pain or shortness of breath. If my patient needs urgent help from a cardiologist, I call a colleague for assistance.

Until December 31, 2009 the cardiologist could charge a “physician consult” fee for getting out of bed, coming to the hospital, and evaluating a patient with a potentially life threatening problem. Medicare paid $195.76 for this middle-of-the-night work (the same rate as when done during the day).

By eliminating the “physician consult” billing code, Medicare now advises the specialist to charge for a “hospital admission.” For two more months, Medicare will pay $175.67 for this service. However, without a change in current law, the physician’s reimbursement for a “hospital admission” will drop to $141.63 on March 1. This is why the “Doc Fix” is so important for working physicians and their Medicare patients.

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Tags: baby boomers, bending the cost curve, death panels, Doc Fix, health savings account
Posted Jan 4th 2010 at 8:13 am in Healthcare | 55062117 Commentshttp://biggovernment.com/clgray/2010/01/04/medicare-is-already-rationing-care/Medicare+Is+Already+Rationing+Care2010-01-04+16%3A13%3A20Dr.+C.L.++Gray

The Senate Healthcare Bill: Throw It Up On A Wall And See If It Sticks

In a recent article published in The Atlantic Jonathan Gruber, an economist from MIT was enthused over the Senate’s healthcare bill because of its kitchen sink approach to the problem of rising healthcare costs. “I can’t think of a thing to try that they didn’t try. They really make the best effort anyone has ever made. Everything is in here….I can’t think of anything I’d do that they are not doing in the bill.” This quote is a distillation of the problem I have with the whole healthcare reform effort. It seems like a case of throw it up on a wall and see if it sticks.

From the beginning of the debate and the resultant bills in Congress there has been no thought put into the root cause of the high cost of healthcare. As usual the players who were allowed to sit at the table were the ones who had the most to lose if the status quo really changed. Special interest groups (i.e., unions, hospitals corporation, medical insurance industry, pharmaceutical industry, and the AMA) each flooded Washington with money and controlled both the argument, and the perceived solutions for the mess that has become our healthcare system. At no point were physicians on the front line who deliver patient care or patients who are victims of the health insurance maze given a voice in the process let alone a seat at the table.

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Tags: bending the cost curve, healthcare reform, insurance mandate, Medicaid, Medicare
Posted Dec 16th 2009 at 12:19 pm in Congress, Economics, Healthcare, Politics | 4743836 Commentshttp://biggovernment.com/egeorge/2009/12/16/the-senate-healthcare-bill-throw-it-up-on-a-wall-and-see-if-it-sticks/The+Senate+Healthcare+Bill%3A+Throw+It+Up+On+A+Wall+And+See+If+It+Sticks2009-12-16+20%3A19%3A51Dr.+Elaina+++George

ObamaCare: Let the Rationing Begin

Last week,  the Federal Government Ivory Tower trumpeted important news.  One of its illustrious Task Forces has decided that women in their 40’s would be the first to experience “Medical Darwinism.”

The United States Preventive Services Task Force, comprised of 16 appointees, decreed that:

1.       Women in their 40’s no longer need routine yearly mammograms

2.       Women aged 50-74 are to have mammograms only every other year

3.       Self breast exams are no longer to be done at any age

Of note, this Task Force does NOT have even one member who is a cancer specialist or oncologist, let alone a breast cancer specialist. This panel based its recommendations NOT on comprehensive new clinical studies or research, but rather on computer projections of certain data points.  A review of previous recommendations by the same Federal Government reveals that these recommendations are diametrically at odds with recommendations made just six months ago. So, what changed in six months?

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Tags: Arlen Specter, bending the cost curve, breast cancer, breast cancer screening, cost containment
Posted Nov 29th 2009 at 6:35 pm in Congress, Healthcare, Obama, Politics | 3791476 Commentshttp://biggovernment.com/djanda/2009/11/29/obamacare-let-the-rationing-begin/ObamaCare%3A+Let+the+Rationing+Begin2009-11-30+01%3A35%3A18Dr.+David+Janda

ObamaCare Won’t Work as Promised: Here’s the Proof

The controversy surrounding the recent mammography guidelines issued by the U.S. Preventive Services Task Force is a recommendation for swift and decisive defeat of efforts to expand federal oversight of health care.  It almost seems as if this was designed as a laboratory experiment to learn exactly what will happen under Obamacare.  The results validate some of the most compelling arguments that opponents have made over the past few months.

When opponents claim that Obamacare will lead to rationing of medical services, defenders counter with an irrelevant but true retort that care is already rationed by insurance companies.  By this logic, everything is rationed by economics.  Housing is rationed by the availability of capital to invest in housing which is a collective market choice.  Cars are rationed in that you can’t just walk into a dealer and drive off the lot.  So, yes, currently the health care market, mostly in the form of third-party payers (insurers and public programs), rations care in that there are finite resources to pay for treatments and everyone cannot have everything any time they wish.

The reason that argument is irrelevant is that the debate here is about government rationing of care, which represents an entire new level of restrictions on individuals.  When the government sets up panels of “experts” to make recommendations of what kind of care is appropriate under what circumstances and those recommendations are implemented in the form of regulations over what care will and will not be paid for by both private and public insurance, it limits the rights of patients to control their care in consultation with their physicians.  It also destroys the market for those excluded treatments which then become either prohibitively expensive or entirely unavailable.

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Tags: American Cancer Society, bending the cost curve, breast cancer, cost containment, federal health care spending
Posted Nov 29th 2009 at 7:31 am in Congress, Featured Story, Healthcare, News, Obama, Politics | 3393856 Commentshttp://biggovernment.com/dobrien/2009/11/29/obamacare-wont-work-as-promised-heres-the-proof/ObamaCare+Won%27t+Work+as+Promised%3A+Here%27s+the+Proof2009-11-29+14%3A31%3A47Doug+O%26%2339%3BBrien