The other day I was talking to a patient of ours about the promises of Medicare for all Americans according to the recent political debates. It seems that our politicians, who know nothing about what healthcare is all about, have determined that good health is just a commodity- something that you bargain for to get lowest price. Well, dear readers, this is not the case. When I explained to this patient that what they would end up getting is some poor, overworked doctor who really does not care about their health, and only cares about getting that co-pay or whatever compensation they can get, she did not like to hear my words.
I gave her an example. When I make a sleep appliance for a patient, the cost to that patient is around $5000. Currently, Medicare would only pay me $1100 for that appliance if I was a provider. To be honest, that $1100 does not even cover my costs to make this device. So what happened? What’s wrong with this picture? I called my lab one day and actually asked if I could somehow make a super cheap appliance and was told yes, it can be done. When I saw the device I told the lab guy it looks like a piece of junk and I would never allow a patient of mine to wear such a crappy device. He agreed, but said this is what dentists with Medicare provide- a piece of junk. Our government has boiled health care down to a commodity- i.e. provide the cheapest of the cheap and ignore the quality.
And now, this will reflect with the kind of doctors you see. If I was such a provider of Medicare services, then doing work at nearly a 75% discount would mean I could not provide quality service and high quality treatment- that is just the way it would have to be. My patients know that I travel frequently to train in physical therapy and osteopathy and now sleep medicine training. I am able to help so many, many people get better because I am highly trained in the field of craniofacial pain. If I was to participate in Medicare or other discount plans, then you as the patient would suffer.
Heck, I know everyone wants a good deal, but healthcare is no place to cut corners. The numbers just do not make sense and the politicians who think they can promise free health care to everyone are not making sense either. To have the government tell us what they are willing to pay for a procedure forces the doctors to bid themselves downward to the point where they not only do not make enough money to survive, but now they are forced to cut corners and do the LEAST (Least Expensive Acceptable Standard of Treatment). To me, this really is NOT acceptable in any way at all. This approach demeans the quality of care in this country.
Currently, the US is no longer one of the top 10 for quality healthcare in the world. We are not even in the top 20 any longer. I attribute this to the fact that healthcare has become a low quality business in this country where ‘cheap’ is the ruling factor, not quality. Do you folks remember that East German car- the Yugo? Well, that’s what we now have in the US- it’s still healthcare, well, sort of, but instead of pride, prestige, and quality we are now more like that Yugo. Low quality and run by a bunch of mechanics (politicians) who could care less about value.