Author Archive

Two Brothers on the March in D.C.

October 4, 2009
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A very interesting video about the increasing Moslem population.

October 4, 2009

Feds sued to keep out of states gun affairs.

October 4, 2009

Here is another outrageous article about the Fed attempting to pre-empt states rights.

August 31, 2009

This has not been mentioned or discussed anywhere that I have seen on the national media or in Congress.!

 

LET US LOOK AT THE COSTS OF MEDICAL CARE FROM A HISTORICAL AND PROJECTED BASIS

 

Most of the current cost of medical care has been driven by government i.e., Medicare mandated bureaucratic regulations that Medicaid and private insurers also adopt.

It has been estimated that these burdensome requirements account for at least 75% of every health care dollar today.

 

If we could get the government the hell out of our business, we could reduce the cost of medical care by at least 75% to 85% overnight!

 

Forty years ago in Oklahoma, an office call was $3.00, and a busy physician could have a large practice with just one full time nurse, and perhaps a part-time receptionist and bookkeeper.  Now a physician is hard pressed to run his office with at least 4-6 full time employees and several more part-time employees/consultants!  These employees have little to do with direct patient care and all of these people have salaries and benefits that must be paid.

 

As just one example of current mandated costs imposed on physicians and other health care providers, ask any practicing physician about the costs of “Prior Authorization” requirements in their offices today.  Then multiply this cost by the hundreds of thousands of physicians practicing in the United States today!

Let’s look more closely at an example of prior authorizations which are required whenever Medicare or other insurance does not want to pay for a particular medication or procedure that the doctor feels in the best interest of the patient.  We are required to call Medicare or the insurance company to beg for permission to prescribe the medication or get the test done. 

 

These phone calls can take an hour or more.  Let’s make it simple to follow by using multiples of ten:

One office employee spends one hour of phone time (mostly on hold!) at $10/hour = $10 of cost.

$10 x 10 prior authorizations/ day = $100 costs/day, for an employee to sit on their tush on hold.

Costs / 100,000 physicians in Oklahoma is:

$100 costs/day x 100,000 physicians = $10,000,000/day.

 

Yes, that is right: $10 million a day per 100,000 doctors that is being wasted to pay a medical office worker to waste time waiting on the phone doing nothing but eventually to, hopefully beg permission to use a medication that is in the best interest of the patient!

 

And this is just one example of the myriad of red tape, wasteful and aggravating bureaucratic headaches that doctors are forced to contend with daily.

 

Now let’s look at the effects of prior authorizations further: Suppose that the prior authorization is not granted for the high blood pressure pill that has controlled your Blood Pressure for years and you now have to change medications, because the insurance company doesn’t want to pay a few dollars more for the medication that has worked for you in the past!

 

Now you have to have several more visits (that cost money!) to the doctor to adjust the dose of the new medication, to control your blood pressure.  What if the new medication doesn’t work?  Not only are you at increased risk for heart attack, stroke, kidney failure, etc. and possible side effects from the change in medication, but each of these risks obviously means more cost to the system.  Not to speak of the dreadful complications that may occur to you as the patient! 

And this is only one small aspect as to why your medical costs are so high today!