Judgment Day

Supreme Court Health Care Decision Will Define The Future Of The American Health Care System!!!  That is the headline here in this Huffington Post article.  Man, have they over dramatized this enough?   I don’t like a lot of the aspects of the Affordable Health Care Act, as I have listed in previous blogs, but there have been some good pieces.  Heck, my son has my health insurance while in college and that is a good thing.  I just wish there was some people with cooler heads who could truly make this massive law even better.  Without specifics, they would need to strip it, simplify it, remove loop holes and create real competition.  But alas, they won’t and after the Supreme Court decides on the constitutionality of it, we will be in for a lot of chaos.  Get ready for the SKY IS FALLING pundits.  This is all you will hear for weeks or months.  But will it truly define our American Health Care System as the headline says?  I don’t think so.  I believe the doctors, nurses and other health care workers define our health care system.  The rest is just window dressing.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  10 comments for “Judgment Day

  1. Judy
    July 5, 2012 at 10:43 am

    fundamental issue: everyone involved needs a certain level of pay for services rendered. less pay, fewer workers, fewer services provided … only those that can pay can get services. altruism does not keep the lights or air conditioner on. that said, as a health care worker, i always try to keep other health care providers that i trust professionally in close relationship in case of dire need. after all, barter used to be a basic occurrence in the history of primary care. pay a tax vs pay a penalty…what difference does it make if you don’t have the funds to pay either way? ration, regulate, authorize…all synonyms for the same outcome, just a different perspective on ethics and legality in each choice. systems get what they pay for in the end.

  2. big picture doc
    July 4, 2012 at 6:57 pm

    Agree with the first two respondents that wussie physicians let the private sector screw us and our patients.

  3. July 4, 2012 at 1:07 pm

    Sigh. All this crap could have been avoided had we expanded Medicare/Medicaid to include everyone, like a civilized country. Of course, that would cause major unemployment/less profit within insurance, lobbying, officeholding, etc. It would also require us to think that a society should do its best to meet the healthcare needs of its members. Why is healthcare the equivalent of selling bananas or houses-why must it be a profit-oriented industry?

    • Pat
      July 7, 2012 at 3:20 pm

      So glad you mentioned houses – look what good federal involvement did the housing industry.

  4. JoAnne Fox
    July 4, 2012 at 12:25 pm

    Unfortunately, the “window dressing” needs paid for somehow, and gets called “healthcare”. The more people involved, the more the same outcome costs. Provider requests $20, paid out of receivers pocket costs $20.
    Same $20 service is provided, but provider requests payment of $25 to cover additional overhead of claim processed in office, submitted to a third party payer, who pays 2 or 3 people to try to not pay the claim, provider spends time & resources to try and get paid at all; provider eventually receives $14 but it cost $40. Without the bureaucracy, there would have been twice as much product, for the same cost. With the bureaucracy, value/quality of product provided will be reduced to $14 (or less, because overhead keeps increasing), rather than $20 (thus the 7.5 minutes max office visit).
    We as a society can only spend so much resource on “health care”. Lets try to get back to buying health care, rather than buying processing services and the accompanying dictates (e.g. how did your electronic health record improve quality in the massive power outages this week?).
    My suggestion is a return to insurance for catastrophes (as a contract between an individual and their choice of group), and individuals paying health care providers for “routine” services. Of course, this would create a lot of unemployment…

  5. Major Stu
    July 3, 2012 at 9:36 am

    This has been a misnomer since it started as Hillarycare. The Health Care system isn’t being remade as much as the Health Insurance system. True, health care delivery will be affected by the changes in the Insurance system, but the radical changes emerging will be in how people purchase (or choose not to purchase) insurance, and the inevitable rationing that occurs when the patient load increases but the delivery force is stable or in many cases being reduced. If you don’t believe that rationing will happen, go to a VA hospital and ask anyone there how happy they are with their treatment regimen. Pile on an army of bureaucrats to micromanage everything, and the IPAD aka “death panel” which will recommend bureaucratized one-size- fits-all solutions that anyone who has worked in health care knows that each patient is individual. Everyone needs to eat more broccoli may sound wonderful, but some of us can stand to eat it. The real reform would be to provide HSAs, voluntary pools, and portability separate from the workplace, the way insurance for everything else in this country works.

  6. steve
    June 28, 2012 at 6:06 pm

    I used to care but I’m now too tired. This country is going to get what it deserves by allowing this to happen. Listening to Obama and Pelosi makes me want to puke.

  7. Pat
    June 28, 2012 at 10:52 am

    Have to disagree K.O.M. Now the popular will, having long since commoditized the deliverers of health care, decide the future of medicine. How delightfully ironic that Obama’s centerpiece goal was upheld by a Bush appointee, continuing the latter family’s long tradition of growing federal power.

    • Theodore Bacharach
      June 28, 2012 at 12:25 pm

      Looking at things from the stand point of how does it affect me is certainly better than treading along in the footsteps of overreacting over inflation and criticizing on the basis of political furor. I have not heard anything constructive raised about how we can improve our patient’s care. Projecting the budgetary effects can be done and their accuracy in predicting is not great.
      If physicians want to take a stand get out of the sky high excursions and predictions and think about how we can improve the care our population receives.

      • Pat
        June 28, 2012 at 6:29 pm

        Ted, I quite agree with your first statement. My point is that I think it is no longer up to us to improve our patients’ care, except as the popular will allow and directs. The only stand left for a physician to take is whether or not to work, and for how long.

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