Sunday, May 17, 2015

Political Malpractice – A Matter of Opinion

In a crisply written 11 page working paper “A Physician’s Opinion Regarding Political Malpractice: The Origin of Medical Cost Inflation, HMO Rationing, and ObamaCare Cartel Controls,” Robert Geist, MD, a St. Paul, Minnesota, retired urologist and medical political activist, describes the evolution of modern health care “cartels”, which are replacing medical professionals as arbiters of health care.

Geist separates the transition from a professional to a commercial medical market place into 2 time periods.

One, 1973 -2010, when HMOs and other managed care entities took hold, matured, and sought to control the unrelenting cost inflation ushered in after Medicare was enacted in 1965.

Two, 2010 and thereafter when the federal government under ObamaCare and CMS transformed the health system into a series of cartels led by the managed care industry, insurers, hospitals, and Accountable Care Organizations.

A cartel is defined at an international combine to regulated and prices and output.

According to Geist, cartels were formed for three “evidence-free” reasons.

To remedy “poor quality care” (too much, too little, too varied”) brought on by greedy providers driven by the lure of lucrative fees-for-services.

To contain rising costs through corporate gatekeeping and through capitation and other payment reforms.

To reward physicians through cost sharing of savings and other rewards in the name of conserving society’s scarce resources.

From Geist’s perspective, this process, though well-intended by managed care executives and federal policymakers, has led to system failures , incessant reforms, higher costs, poorer quality, lesser access, and public turmoil, physician servitude, and power and merger mania among institutional leaders.

One Way Out

Geist concludes one way out of this government and managed care-induced turmoil is a decentralized medical market place though such mechanisms as health savings accounts, patients empowered choice, and free market health care.

Geist’s conclusion reads.

“It was political malpractice to ignore ordinary economic principles of supply and demand when the U.S. government wrote prescriptions for the nation’s medical sector that caused the abrupt onset of tax-subsidized demand inflation after 1965 and created the futile managed care rationing-of supply panaceas to control it.”

“Resolving public-corporate threats to patient care, clinic viability, and professional integrity would require political action to write a prescription for a new medical market place, where the consumer is king and money (instead of politics) is used to distribute goods and services.”

“Chances are that this new prescription would make medical care and its catastrophic care affordable to all Americans.”

A nice throught, but unfortunately, the chances of removing politics from the medical care cost equation, approach zero.

If you would like to read Doctor Geist’s paper in its entirety, contact me at Doctor., and I will forward it to you.

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