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Medicare Cuts Scaled Back
Featured in: Healthy Living
Medicare helps device manufacturers by not cutting their fees. Dr. Rob states that this is what is wrong with our system.This is why we have problems with cost in healthcare...
WASHINGTON, Aug. 2 — Under intense pressure from health care
lobbyists and lawmakers, the Bush administration says it will scale
back and delay proposed changes in Medicare payments to hospitals that
would have created clear winners and losers.The proposals would have cut payments by 20 percent to 30 percent
for many complex treatments and new technologies. Hospitals will
instead see much smaller cuts or even small increases for many of those
procedures. Some of the changes will be phased in over three years.Doctors, hospitals, consumer groups and members of Congress had
said the proposed cuts would be devastating. Under the proposals, they
said, patients would have had less access to some services like cardiac
care.On Tuesday night, the Bush administration issued a final rule that
reaffirmed the overall goal of more accurate payments while backing
away from many of the proposed changes, including a sweeping revision
in the classification of patients intended to account for the severity
of their illnesses.The reaction from Wall Street analysts on Wednesday was positive.
“The final rule significantly moderates proposed cuts for cardiac
procedures,’’ Citigroup said in a note to investors. Lehman Brothers
described the final rule as “a win for cardiac and orthopedic device
companies, specialty hospitals and general acute care hospitals.’’ The
Prudential Equity Group said the final rule, which takes effect on Oct.
1, was “favorable for device manufacturers’’ like Boston Scientific,
Medtronic and St. Jude Medical.
To see the rest of the article, click here.
This really frustrates me. Stockholders are happy. Device manufacturers are happy. But yet they want to cut fees to primary care doctors. There is not enough money for P4P that would likely have a huge impact on quality. The problem is, we are not listed on the NYSE. There is little problem with financial solvency in the cardiac device realm. There is an exodous from primary care. See a problem?
I don't sound bitter, do I?
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Comments (6)
This also very relevant to my recent post about free markets http://www.healthvoices.com/blog/hgstern/2006/07/30/translucence_iii#comment-2396
Steve Beller, PhD
#3: AMA
Not too many years ago, the AMA was among the most respected (feared) lobbies, and among the most effective. What happened?
The day the AMA and FDA decided the insurance and drug industries needed more protection than U.S. medical consumers and taxpayers was the day medical research started catering to those who would benefit most from hoarding, manipulating and exploiting medical research. During the Reagan years of budget cuts including the failure to fund the FDA adequately federal agencies and medical academic researchers began to lean more and more on private funding. This resulted in drug approving FDA panel members having ties to drug companies and distorted research that did not really address the critical healthcare issues rationally or deal with the continuous problems associated with environmental pollution, drug and hormone exposures.
The first reported detection of a porphyria in a systemic lupus erythematosus patient occurred in 1952. Over the past fifty years the five dominantly inherited porphyrias (acute intermittent porphyria, porphyria cutanea tarda, hereditary coproporphyria, variegate porphyria and erythropoietic protoporphyria) have been detected repeatedly in systemic and discoid lupus patients, conditions that typically impact females more than males.
The question of coincidence or chance association has been brought up repeatedly with some researchers flat out stating the continuous damage occurring in active and not-so-latent "latent" porphyrias is illiciting autoantibody production. In some cases the antibodies are transient while in other cases the condition progresses to full blown lupus with all the nasty complications including seizures, psychosis, organic brain syndromes, cognitive dysfuncitoin, headache, intracranial hypertension, SIADH with hyponatremic encephalopathy, peripheral neuropathy, myalgia, photosensitivity, bullous lesions on the skin, alopecia, anemia of chronic disease, pericarditis/myocarditis, renal failure, abdominal pain with associated symptoms, liver damage, scleritis, sicca syndrome and pregnancy complications including preeclampsia.
All of these complications have been recorded with case reports of porphyrias.
Each time the theories of porphyrias or other possible defects in heme metabolism may be contributing to lupus (or other autoimmune disorders including rheumatoid arthritis, scleroderma, Sjogren's, CREST or Felty syndrome) are shot down by those claiming the porphyrias are the "little imitators" and physicians have the training, innate intuition and technological abilities to tell the difference. It is a load of crap and these patients are propping up egos with their lives.
It is no secret medical historians believe ignorance surrounding the symptoms of porphyrias led to folklore vampires and werewolves. The only difference between ignorance then and now is we do not burn these people to death. The caduceus is not representing compassion or even rational thought; it is representing an aversion to enlightenment.
#6: AMA
Is a specialist-dominated orgainization. They set the standards for reimbursement helping come up with the current payment structure. It made sense at the time but eventually created big inequities within healthcare. They did nothing to address the issue and the "rich got richer."
The AMA is still very strong, but does not represent the opinions of all physicians. Most primary care physicians stick with their own organizations for representation (AAP for pediatricians, ACP for internists, and AAFP for family practice).
Another problem is that the AMA acts very much like a labor union in that it advocates for the best interests of its members to the detriment of the entire industry (at least some labor unions have lost focus this way - I am not meaning to say that all labor unions are bad).
That's my gripe with them. But they have nothing to do with Porphyria.
Rob
Augusta, GA
New Websites:
Musings of a Distractible Mind
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A bright man told me that the medical device manufactorers and pharmacuetical companies hold the real power in heathcare, largely through their lobbying efforts. Providers and patients/consumers have very little clout in comparison. Non-healthcare businesses/employers, therefore, are the only ones who can offset this power through their influence on our government and insurers. And since employers can't stand the cost of health insurance (due in large part to the waste, ignorance, inefficiencies, mistakes, inappropriate care and greed plauging the healthcare industry), they must unite to demand significant change. The requisite tranformation must include rewarding providers for improving outcomes & controlling costs (e.g., P4P) and empowering the consumer through transparency of cost and effectiveness, while pressuring device manufactorers and pharmacuetical companies to cut costs. Stories like this support his contention.
See http://www.cphr.com/
Steve Beller, PhD
http://wellness.wikispaces.com