Diary

Medical Tyranny

The WSJ article Medicare Plans to Cut Specialists’ Payments points out the reality of a government improperly involved in business. Government Administrators get to decide the value of a service.

Payments to cardiologists would be trimmed by 11% overall, but certain procedures they perform would see steeper reductions. Alfred Bove, president of the American College of Cardiology, figured that cardiologists would receive 42% less for an echocardiogram and 24% less for a cardiac catheterization.

So…one magic wand later…stuff is cheeper. Huh?!? So what’s a rationale behind this?

Ted Epperly, president of the American Academy of Family Physicians, said the Medicare proposal would help reduce the income gap among doctors — specialists make two to five times as much as primary-care physicians — and attract more medical students to primary care. He called the change “long overdue.”

Funny, I thought that some procedures required more expertise, that supply/demand drove price, that markets infulenced price…guess I was wrong. I guess I need to adjust my thinking so we all make the same wage…forget universal minimum wage…let’s go right to a single wage for everyone!

Seriously, the real gold in the article is the comments. Check out the message from Grant Lynde. His opening quote: “This plan is at least Earth shaking to the medical industry, and is potentially disastrous and is built on fallacious arguments:”…to which he lays out 7 points. Here’s one that points out that even current government intervention is handcuffing him.

6) Capital expenses… look at the degree of the cuts. 20%, or more… in one swoop. Imagine any other business. You paid some capital expenses to upgrade your factory. Your customer then unilaterally tells you that you are going to earn 20% less per widget? Yes, in this economic downturn, a lot of other industries are feeling the same pinch (airlines, hotels, newspapers, you name it). But in health care, as a provider, I don’t have the opportunity to make up for this lost 20%. I simply cannot work more. Nor am I legally allowed to invest in complimentary businesses that could buffer me from this. On the other hand, my investors/banks/family members who have loaned me money expect to be paid. How?

Emphasis mine. He addresses salary, malpractice, school, hours, oncall support, etc. He loves his job and is thrilled by the “tough save”.

How is this guy now a source of funds, an ATM for a guy who didn’t work as hard or make the same sacrifices? I want the incentive for my doctor to be passion for the job. If the job pays well, or if that’s a motivation, that’s irrelevant to me. I do not want some person who is punching the clock, cause it’s the only job he could get, doing surgery. And yet, that’s the structure getting built. Where does passion get rewarded in a government beuracracy? I think the answer is that it’s “rewarded” primarily when you have a passion for power.