Regarding the proposed Medicare physician fee schedule:
Hopefully this is the tipping point for healthcare reform, but dont hold your breath. There is just too much money and too many black-box schemes developed by unscrupulous politicians, insurersand yes, doctors, hospitals and retired state and federal officialsto evade transparency and accountability to the public. The Medicare score card now is: doctors down 15%; hospitals up 7%; nursing homes up 6.4%; and insurers and drug companies up 20% plus for increases in 2008 and 2009 Medicare payments. On top of this, the June 26, GAO study of the Advantage plans showed the insurers were keeping an extra $1.3 billion of profit each year from providers and extra benefits to patients that they had promised Congress. Ironically, this is about what one large insurer paid their rheumatologist/CEO in his final year of employment. It is America, and we all should have an opportunity to enrich ourselves, but professional ethics are wearing thin in the publics eye.
It is sure not the primary-care doctorshit hardest by the cuts in Medicarethat are driving the high cost of U.S. healthcare with their average compensation of $150,000 per year. In Britain where the per capita spent on healthcare is 40% of what is spent per capita in the U.S., primary-care doctors are paid between 80,000 and 120,000 pounds, or $159,000 to $239,000 as of June 30. The U.S. primary-care doctors will go even lower with the Medicare cuts of July 1 and Jan. 1. Our U.S. medical leaders may claim that Brits and Canadians have long waits for specialists and elective procedures, but we increasingly have long waits to see any doctor, and many hospitals now want to file liens on our homes. International studies show higher satisfaction among the public with healthcare in Britain and Canada.
There are plentiful opportunities to improve U.S. healthcare, but our politicians must focus steadfastly on the public need.
Donald SchottSchott HealthCare ConsultingCenterville, Ohio
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