Few spared in consultant's review of healthcare scene

Politicians, radiologists and dentists were a few of the targets hit by Marc Sauve during his talk on healthcare reform "Truth, Lies & Painfully Simple Solutions" at the 24th annual Healthcare Facilities Symposium & Expo in Chicago this week.

Sauve, a senior healthcare strategist with Nashville-based Gresham Smith & Partners, began by explaining that the Patient Protection and Affordable Care Act is not going to lead to a "government takeover" of the healthcare system, but it will lead to a “major overhaul.” He added that a major overhaul is needed.

As he does every year, Sauve backed up his words with a truckload of doom-and-gloom statistics, mixed with sarcasm and wisecracks. Sometimes he gave stories behind the statistics, such as why so many births are paid for by Medicaid. (Lowering the Medicaid eligibility thresholds for prenatal care is cheaper in the long run because babies with low-income parents are born healthier and have fewer medical needs, according to studies Sauvé cited.)

Though he didn't like the name of the program, Sauve praised the CMS' move toward value-based purchasing, saying, "You're going to be rewarded for your performance—that's groundbreaking."

Sauve also said he likes the move toward patients having access to and more control over their own medical records, and he even praised Newt Gingrich's Center for Healthcare Transformation for summarizing the massive healthcare reform bill in a one-page chart, noting how it illustrates that Kathleen Sebelius has "the biggest to-do list ever."

But he slammed former New York Lt. Gov. Betsy McCaughey over her remarks about a healthcare reform proposal to reimburse providers who offer end-of-life counseling, which led to the "death panels" criticism. He did the same for presidential candidate Rep. Michele Bachmann (R-Minn.) for her claims that the HPV vaccine causes mental retardation and for others who discourage childhood vaccination. "We've got to move on from the 'round the campfire stuff' from the 1200s," he said.

Doctors did not escape his barbs, and Sauve lampooned a survey of physicians in which 40% said they would not choose the same profession because of the administrative headaches. "What were they going to do instead? Become professional basketball players?" he asked. "Give me a break."

He then cited a survey by physician recruiter Merritt Hawkins that showed healthy starting salary gains for many specialties. "I don't know what kind of pressure they're feeling, but they should be doing OK," Sauve said.

To reduce skyrocketing medical costs, Sauve suggested moves similar to ones in Canada, where dental hygienists can now work independently.

"What is this going to change?" he asked. "The dentist won't come in, slap you on the leg, ask you about the family and charge you an extra $50."

Sauve noted that computers can now analyze diagnostic imaging better than radiologists who are being paid $400,000 to do so.

"If you're going to shoot me to the moon, I don't want a guy with a telescope lining it up," Sauve said, adding that he wants a computer to track the course.

Follow Andis Robeznieks on Twitter: @MHARobeznieks.



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