Arthur “Tim” Garson Jr. wrote a piece for the USA Today explaining how to fix the healthcare system. The title was Half of America skimps to pay for health care. The only fix is to cut waste and it is quite an interesting conclusion. It starts out with:
In a new survey of 9,200 people across 15 states by my organization, the Texas Medical Center Health Policy Institute, 49% of respondents said they must cut other expenses to pay for health care. And they aren’t cutting back on frivolities like expensive electronics. Most often, they said, they had to cut back on their savings, as well as spending on food and clothing, to pay for health care.
The line that caught my eye is that people won’t give up on their expensive electronics. To me, that is MAJOR! He doesn’t even expand on the fact that people will do anything to keep their iPhones, Netflix, DirectTV, computers, laptops, and iPads. But Dr. Tim goes on:
But the real shock was just how little respondents said they could afford to spend on out-of-pocket health care expenses. Well over 50% of the uninsured put that number at just 2% of their income. We saw a similar trend with the insured population, too. Almost half of insured respondents earning more than $100,000 said they could only afford to spend 2% of their income on additional out-of-pocket costs. Across the spectrum, it seems 2% is the magic number.
Does this mean people just don’t want to pay for their healthcare? Maybe not. It could mean that they are paying so much on insurance (which most of us have now due to Obamacare) they just don’t want to pay any more. Dr. Tim ignores this and goes on:
Why does that matter? It sheds light on one of the most important provisions that the Affordable Care Act got so wrong. Obamacare defines “affordability” as 8.2% of income. Anyone who has access to a plan where premiums cost less than 8.2% of their income, and declines that insurance, must pay a tax penalty, known as the individual mandate. It’s a stunning disconnect. The government says affordability is more than four times what the people themselves consider affordable.
So, the public’s perception was never in line with Obamacare? There’s a surprise. Not. That was what Obama’s administration was banking on. Remember this?
“Lack of transparency is a huge political advantage,” the adviser, MIT health economist Jonathan Gruber, declared in newly unearthed video from an academic conference at the University of Pennsylvania in 2013.
“And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical for the thing to pass,” he added.
So what is Dr. Tim’s big fix now? Cut the waste, which he believes is due to doctors being greedy. Well, that’s interesting and an unbelievable reach. Dr. Tim feels all doctors should be on salary and that will fix it all. In fact, he thinks “payers such as Medicare and major insurers could offer bonuses to health systems that put physicians on salary.” Wow, that sounds great. Let’s give the hospitals and administrators the bonuses they save on doctors’ backs.
Arthur “Tim” Garson Jr. is a pediatric cardiologist, former medical school dean and director of the Health Policy Institute at the Texas Medical Center in Houston. He is elderly and made his money, and a lot of it, a long time ago. I just love when people who become wealthy decide that later on that they need to fix the same system that got them wealthy. Hey, Dr. Tim, why don’t you give some of your money back?
Secondly, putting all physicians on salary means all physicians are owned by hospitals. That is exactly what I am opposed to. I have lived it. The marriage between a hospital and doctor is an unholy one and is filled with conflicts of interest.
Third, saying that the cause of such waste is due to physician incomes has been proven false over and over again. Don’t get me wrong, I do think the disparity in the income between some specialties is problematic but who do you think would be the first group salaried or cut in Dr. Tim’s plan? Yup, the primary care folks. They would find reasons NOT to touch the income of super-specialists like Dr. Tim was. The administrators would make up a term like “outliers” or something like that and those docs need to be left alone as the hospital would be afraid they would leave. Been there. Seen that. Over and over again.
So, in conclusion, people won’t give up their gadgets. They pay too much for insurance and have little left for out-of-pocket costs. And Obamacare missed the mark badly. Therefore, according to Dr. Tim. let’s cut doctors income by making them hospital employees and putting them on salary. Oh, and by every doctor what it really means is every primary care doctor.
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