“We have so much available that we can’t afford to give it to everyone,” William Plested, president-elect of the American Medical Association, said about our nation’s health care system. Plested (in photo), a California surgeon who graduated from Wichita East High School in 1954, told The Eagle editorial board Wednesday that at some point, society and legislatures will need to decide what medical services to provide to patients who can’t afford to pay for their own care. We must find a balance, he said, between not providing any care and providing anything they want.
Posted by Phillip Brownlee
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11 Comments
Since we have limited resources on healthcare, how much of it goes to illegal aliens?
hmmmm…
This would be a novel idea, how about if it is need to continue life or maintain a worthy standard of living…give it to them! Transplant, cancer surgery, that is a rather simple criteria Of course we could always follow Scrooge’s idea about tiny Tim, “rid the world of the excise human beings”. That would be well and go for society …Unless you were tiny Tim’s dad! But then he could just eat cake!
How much is a human life really worth? That is the real Question, who get to decide if you should live or die. (Back to Terry Shivo huh?) How much say YOU have in that decision seem to be how much money you are worth.
I don’t think it has anything to do with money, but maybe everything to do with it. *Confusing myself*
Some people would question giving a liver transplant to an 88 year old patient. Terry Shivo is a good example of how much care is warrented to somebody who will not recover. What about people who would like to end their lives? Should they be able to?
Would cosmetic surgery be a part of free care because the person needs to feel better about themselves as part of a healthy life. Breast augmentation, sex reassignment, penis enlargement, and etc.
I read somewhere that 90% of the total cost a person spends on healthcare (either themselves, by government care, or through insurance) comes in the last 6 months of life.
Routine care is not really expensive. Believe it or not, its cheaper than getting health insurrance through co-pays and premiums even by a large employer with good insurrance.
I’ve always wondered (and never crunched my personal numbers like I should) if I would be better off if I had a catastrophic insurance plan with a really high deductible and just paid for regular visits out of pocket. The “catch” is that probable $10,000 deductible under that scenario, and what to do if you have say, an emergency room visit or something similar that racks up a few thousand in bills, and you haven’t had time yet to mount up a strong health savings account.
I agree, Joe, there are possibilities out there that maybe just aren’t being explored. Is it because the pharmy companies and insurance providers know they have a pretty good racket going on?
Huh? Dr. Plested would make a great federal bureaucrat. Well, if there is so much medical care available then there is absolutely no reason to limit it. Except when it cuts into profits?
What he said makes absolutely no sense unless one reads into it that hospitals and the AMA would like to limit medical service to get a bigger piece of the pie when when patients overstay their insurance coverage and hospital can’t kick them out and begin to lose money. It would also allow physicians, and perhaps therefore hospitals, to just choose patients whose cases would be profitable, something of which the small specialty hospitals have been accused by Wesley and Via Christi.
I mean, if that is what Dr. Plested is talking about in his roundabout way.
Hey, Mr. Brownlee, do ya got a link to that?
I searched some sites on the Web. Dr Plested is pushing physician autonomy in decision making as to who should or shouldn’t receive care. But that’s why we have ethics boards at hospitals and state advance directives (such as Texas) determined by a GROUP of people, not by one doctor as with Dr. Kevorkian.
Dr. Pleasted advocates “physicians’ autonomy to make medical judgments based on clinical evidence, in partnership with patients, and without undue interference from government or insurers.” [quote is the site's author, not Dr Plested] It sounds like Dr Plested is altruisitic—that he is not interested in cost cutting matters.http://www.spfldcol.edu/homepage/dept.nsf/0/a2331e6ce5211916852570fa004fd553?OpenDocument
But here we get to the heart of the matter: “While Medicare’s expenditure target system artificially caps spending on medical services, this type of system inherently cannot cap the amount of medical services that are needed to adequately treat sick patients. When patient need for and utilization of medical services is greater than the target, payment rates for individual physicians are reduced.” Dr. Plested before the House Ways & Means Committeehttp://waysandmeans.house.gov/hearings.asp?formmode=view&id=127
There is Dr Plested’s long statement to the House Way & Means Committee on behalf of the AMA in support of Congress not extending the moratorium on physician referrals to specialty hospitals in which they have an ownership interest. In making those referrals, as the EAGLE has reported in the past, specialty hospitals have been accused of choosing only the least sick patients in order to achieve higher revenues so that the sickest, more-costly patients go to general hospitals.http://waysandmeans.house.gov/hearings.asp?formmode=view&id=2531
There are also numerous web sites concerning Dr Plested’s push on behalf of the AMA to have Congress cap malpractice suits, which was successful.
The question is, in allowing physicians to decide who should or should not get care, and how far that care should be taken, how much of that decision-making would be based on the bottom line. Frankly Dr Plested, in his statements on behalf of the AMA, seems primarily occupied with cost factors rather in good medical care itself.
With the price of healthcare rising exponentially in relation to incomes, as it has for the last fifty years, most of us will not be able to afford health insurance before long.Fifty years ago, an office visit to your doctor cost about $5, and a normal delivery was $25-50, depending on the hospital. Medical insurance wasn’t necessary; you could pay for most procedures out of pocket or from a modest savings account. Yes, we have new and improved tools and techniques today, but do they warrant a $150 office visit and a $2500 normal delivery?Fifty years ago, my family physician had one employee, a nurse that doubled as receptionist, and did the books on Saturday. Today, a doctor will have at least twenty employees, many of whom are involved with keeping records and filing forms for insurance companies.With the advent of personal computers, and miniaturized lab equipment, it might be possible to return to the days of doctors with one or two employees, cutting costs to the point of eliminating the need for insurance companies except for catastrophic healthcare. I would sure like to see some studies on such ways to cut healthcare costs. I’m sure the insurance companies wouldn’t!
Has anybody ever seen a hospital bill? My friend requested a full break down of all cost that was charge to his insurance for his wife’s baby delivery.
The hospital charged the insurance company for every little thing and they were inflated as well. Such as $10 for a box of tissue (If you use it or not). $5 a roll of toliet paper. $5 for each pair of latex glove used. $400 for sheets and pillows.
It was unbelievable. I know the hospitals charge that to the government for medicade and medicare patients and to the health insurance companies, because I’ve seen the invoice with my own eyes.
Kind of reminds you of defense contractors. Gouging at it’s finest and we all pay the bill, either through higher taxes or health premiums.
Joe,When my wife was hospitalized after a severe stroke (in 1983), I asked for an itemized bill, and was told that it would be impossible since it would demand too much computer time. The abbreviated version was for almost half a million dollars.
Dear Mr. Brownlee:
If you are still reading replies to your blog, in regard to your Saturday editorial regarding Dr Plasted’s statements about Medicare, if the AMA exaggerated the claims about malpractice insurance in order to get Congress to cap jury awards (see letter to Dr. Plasted at http://www.centerjd.org/GAOAMAltr.pdf) then do you suppose the AMA might exaggerate claims about Medicare repayments being insufficient? There are many physicians and dentists who seem to center their practices around Medicare (and Medicaid, too). I know of one physician, for example (just as you presented the statements of only one physician in your editorial), whose primary clientele is in geriatrics–his life blood IS Medicare.
Have you crossed the line between reporting and editorializing–or is it the AMA who purchased the EAGLE?