Trying to get the thread tossed into the SPF?
Perhaps. However OP asked a very good question.
The greatest need in physician training today that is flat out ignored by medical schools, ACGME and hospital and program administrators, is teaching medical students, Residents and Fellows the business of medicine. It is a perfect example of caveat emptor. They buy into the medical profession without any idea of the medical business landscape. No one is teaching them what awaits them as this thread shows. However this is a very important topic that really should be dissected ruthlessly and aggressively by everyone just as if it were a board exam... literally.
Caveat lector.
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An American sickness : how healthcare became big business and how you can take it back / Elisabeth Rosenthal, MD, 2017. ISBN 9780698407183 (e-book)
“In 1993, before the Blues (BCBS) went for-profit, insurers spent 95 cents out of every dollar of premiums on medical care, which is called their “medical loss ratio.” To increase profits, all insurers, regardless of their tax status, have been spending less on care in recent years and more on activities like marketing, lobbying, administration, and the paying out of dividends. The average medical loss ratio is now (2017) closer to 80 percent. Some of the Blues were spending far less than that a decade into the new century. The medical loss ratio at the Texas Blues, where the whole concept of health insurance started, was just 64.4 percent in 2010. .....Medicare uses 98 percent of its funding for healthcare and only 2 percent for administration.”....
“They are methodical money takers, who take in premiums and pay claims according to contracts—that’s their job,” said Barry Cohen, who owns an Ohio-based employee benefits company. “They don’t care whether the claims go up or down twenty percent as long as they get their piece. They’re too big to care about you.” .....
“In fact, history shows that once a procedure is covered by insurance, its sticker price generally goes up because patients are largely insulated from the cost. (For example, when patients had to pay for physical therapy on their own, the cost was likely under $ 100 a session, significantly less than the $ 500 an insurer will approve today for a forty-five-minute treatment in a major metropolitan area.) .....
“Once acceptance of health insurance was widespread, a domino effect ensued: hospitals adapted to its financial incentives, which changed how doctors practiced medicine, which revolutionized the types of drugs and devices that manufacturers made and marketed. The money chase was on: no one was protecting the patients.”
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Mistreated : why we think we’re getting good health care and why we’re usually wrong / Robert Pearl, MD, 2017, ISBN 9781610397667 (ebook)
“When independent researchers crunch the numbers and compare nations, American health care ranks nowhere near the top of the list. In fact, among developed countries, the United States has the highest infant mortality rate, the lowest life expectancy, and the most preventable deaths per capita.....
“As a nation, we spend 50 percent more on medical care than any other country, and yet we rank seventieth globally in overall health and wellness...
“...our health care system functions in an environment unlike any other. There’s nothing comparable to it in American culture, society, or industry. The rules are different, the stakes are elevated, and the perceptions of everyone in it—from doctors to patients to US presidents—get radically distorted, leading to behaviors that prove hazardous to our health.”....
“Throughout my career, I’ve had the opportunity to observe American medicine from many different angles: as a physician and a health care CEO, as faculty at both the Stanford University School of Medicine and the Stanford Graduate School of Business, and as the son of a man who died too young from a series of medical errors. My conclusion is that the American health system is sick. We have excellent physicians who are burned out, unfulfilled, and in some cases, terribly depressed. We have a number of billion-dollar pharmaceutical companies raising drug prices upward of 5,000 percent, operating without fear of public backlash or legislative overhaul. We have already unaffordable health care costs that continue to rise at twice the rate of our nation’s ability to pay.”...
“In today’s health care system, ruled as it is by economics, there’s no “billing code” physicians can use for the time they spend comforting a family or holding a patient’s hand when death is inevitable. Doctors get paid for intervening, not for moments of compassion. Today, the insurance reimbursement system dictates how care is delivered. It has eroded personal relationships, devalued empathy and kindness, and undermined the very mission and commitment that led most doctors to practice medicine in the first place.”.....
OP, educate yourself asap on the business landscape of medicine.
GL
