Democrats and Republicans are working towards compromises that will help see the passage of a real healthcare reform bill this year. Over the weekend, Democrats floated the idea of a cooperative that would offer another option other than the hated (by consumers, physicians, etc) commercial companies. You know – the ones who don’t dictate price, clinical practices, and lovingly care for people. Those guys.
The Republicans have been throwing their arsenal at reform, but nothing is sticking. The claims? 1: A public option is socialism, a government takeover and control of healthcare. Answer? We’re talking about social insurance (such as Social Security),
2. Look how badly Medicare runs. Answer: In what way? The fees are a function of budget, the financial forecast a function of demographics and some of the very problems the Obama led reforms seek to address. Too many services, too many services that don’t help, and, I dare to say, the private sector stealing and cheating (eg fraud).
3. Look how badly the digital TV conversion was handled. Really? Hiccups, of course, but there was a widespread effort, particularly from industry, to push people to act. Only when against wire did many people act.
The insurance companies are deathly afraid of a public option because they know that Medicare is a much more efficient operation, running roughly 6% overhead versus 15% or more for commercial companies. Physicians are afraid that a public option plan would pay Medicare like rates, which are low.
The President acknowledged the malpractice issues need reform, but caps were not the way. This will please physicians, and there are very sound reasons for everyone to want to reform the current way we handle negligence. There have been studies that suggest that there is little relationship between a person being injured and a suit that results in damages being paid. Patients sue when they are angry. Somehow, moving towards a non-adversarial system, which workers comp is supposed to be (at least in my state, I emphasize the “supposed to be”). We can do better, so let’s do better for physicians and patients.
Primary care pay will go up, specialists will see drops in income. Specialists: As with so many businesses, industries and professions, enjoy the high times, but always know that they won’t last forever, so plan for the decline of the life cycle of specialist physicians. It’s an old marketing and business concept – the product life cycle.
Physicians will be less lone wolf, and more reliance on current knowledge. People seek out major medical centers and younger physicians because they want the ones who are most current. Wide variations in care, from outcomes to life expectancy to cost, are not going to continue to be tolerated.
After President Obama’s speech to the AMA today, AMA President Nancy Nielsen and incoming president J. James Rohack held this discussion for the press, as reported by the Wall Street Journal.