Fourteen Zeroes!

Part 1- the problem.

If you look at our present level of health care spending ($2.6 Trillion), and project it forward, growing at 6% annually for the next 20 years, the total exceeds $100 Trillion.

That’s 14 Zeroes:

  • Just for health care
  • Just in America
  • Just for the next 20 years (if we look at 30 years, the number is over $200 Trillion).

That number is incomprehensible.  Not only is it not sustainable, it is not even possible to finance this number.  Yet, that is the path that we are on.

The present discussion aims to “bend the cost curve” and to somehow shift the burden:

  • Blame the insurers
  • Blame the pharmaceutical companies
  • Reduce provider reimbursement
  • Limit what Medicare pays on behalf of seniors.

Whomever we choose to blame, we are clearly headed for a scenario where we all  work our entire lives just to pay for health care, and when we get old, all of our assets, if there are any left, get paid over to our huge, for-profit health system.

We must fundamentally restructure our health care system, and our expectations of living and of dying, or life will become one long health-care payment treadmill.

Part 2- the discussion.  Please answer the following questions. One answer per question:

What is the responsibility of consumers (the system calls us "patients")?

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What is the responsibility of insurers?

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What is the responsibility of the government?

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What is the responsibility of providers (doctors and hospitals)?

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What is the responsibility of suppliers (pharmaceutical companies and device manufacturers)?

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Now, please consider all of the answers you provided.

What do your answers, taken together, mean for the 14 zeroes in our future?  Something to think about…

Is “bending the health care cost curve” enough, or do we need to do more?

All over the country, people, companies and entire sectors of the economy are experiencing, or will soon experience, drastic cuts.

  • benefits of unionized employees significantly reduced
  • layoffs
  • salary freezes and reductions
  • reductions in state provided services

Yet, in the health care industry, we talk about “bending the cost curve”, which means a reduction in the rate if increase, say, from 6% annual growth to 4% annual growth.

Why is health care exempt from the drastic cuts being made almost everywhere else? (In fact, it is health care costs more than anything else that is forcing states to the brink of bankruptcy).

So is bending the cost curve enough? What do you think?

Is "bending the health care cost curve" enough, or do we need to do more?

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Should physicians have the right to refuse Medicare and Medicaid patients because they are not paid as much as they feel they should be? What options does society have?

This is a tough one…

On the one hand, physicians have to run their practices, which costs money.  They want to live well, as we all do, and that costs money.

On the other hand, they provide a vital service which not just anyone is allowed to provide- so in a way, they are on “protected turf”- protected through licensing and long years of training.

But when physicians refuse to see Medicare or Medicaid patients, those patients have nowhere else to turn.  In fact, the threat of physicians refusing Medicare is often used as a reason not to cut Medicare rates.

This sets up a sort of “health care hostage situation”, where we, as a society, can no longer afford the costs of care, but seem to be powerless to do much about it.

So here is the question.  Actually 2 this time.  What do you think?

In return for the right to practice medicine, should physicians be required to accept at least some Medicare and Medicaid patients?

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As a society, what should we do when physicians refuse to see Medicare and Medicaid patients because the pay isn't high enough, and we have nowhere else to turn? Select up to 3 answers.

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Who owns patient data?

When we visit a doctor, hospital or pharmacy, lots of data is generated:

  • X-rays
  • Lab tests
  • Prescription information
  • Physician notes

That information is exchanged among physicians, hospitals, pharmacists and insurers, all to assist in the care of the patient and to support the billing and payment system.

Yet, there is potential to mis-use this information:

  • Data mining to target potential customers
  • Data used for coverage decisions
  • Data used for research purposes

And further, when a patient moves or simply wants to maintain their own files or health record, they frequently encounter resistance from the doctor or hospital when requesting copies of their record or tests:

  • fees
  • outright refusal
  • “The HIPAA law won’t let me give it to you”

So who owns patient data?

What do you think?

Who owns the data that is generated when an individual visits the doctor, hospital or pharmacy. Check all that apply.

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