Fixes for the ‘perfect storm’ roiling health care
I hate to be the doomsdayer, but the crash is here and going to get much worse. The Virginian-Pilot and Daily Press have published numerous columns and letters about deteriorating medical care. It is the worst care I’ve seen in 40 years, with some appointments taking as long as a year. The numerous problems plaguing American medicine are not receiving attention or action.
I wrote guest columns in November 2022 (“Lack of residencies for new doctors is unconscionable — and fixable”) and November 2023 (“The doctor residency shortage continues to cost lives”) explaining the serious lack of specialists and primary care physicians. Unfortunately, nothing significant has been done to correct this abominable situation.
I read a recent piece calling for an increase in Medicaid reimbursement. That’s a good start but the reimbursements need to be increased across the board. And if we don’t have enough physicians, it won’t help patients, who will still suffer.
What are the ingredients of this perfect storm? Among them are a lack of medical providers, despicable reimbursements to providers and politicians paying little attention to the whole medical environment.
A primary care physician may get an insurance reimbursement as little as $15 for an electrocardiogram. A complete blood count is reimbursed at $7.70. The equipment required for these tests costs thousands and thousands of dollars. There is no control of insurance company reimbursements, which are well below the cost for the doctors providing them.
Why should you care? Independent practices are going extinct. Primary care physicians can’t pay off their student loans so few follow that path.
Have you ever wondered why a procedure done at the hospital is much more expensive than one at a private practice? The public knows this when they see the reimbursements that the providers get. Politicians need to pay attention to their constituents’ suffering. They also need to pay attention to the middle class which is being squeezed to death.
Insurance companies need to be monitored and their reimbursements made public. They need to be held liable for denying
necessary tests and procedures. Many providers don’t even offer the tests anymore as they lose money. This is dangerous and it is bad medicine.
Ironically, we should have the best medicine, given current scientific advances. But technology means nothing if it’s not available to you. What can one do?
Write letters, like myself, and call your local and national representatives. Push the national media to report on this critical shortage. Politicians need to do their job. We can’t pass laws, but they can. They really need to look at what is critical and important to the people they serve, rather than other numerous, and sometimes wasteful expenditures.
Can you imagine the politicians can save a life? Well, they can.
The federal government needs to fund 10,000-15,000 more residencies to produce thousands of additional primary care physicians and specialists. The state can allow qualified associate doctors who have an M.D. degree and have passed their boards to practice with another M.D. while waiting for a residency position to open. Several states have done this already, but not Virginia.
In addition, if corporations or people want to limit or control your health care, then they should accept the same liability that the physicians do. Some coverage decisions about your medications and diagnostic tests (such as stress tests or CAT scans) are made with impunity. If an outside authority can deny you good medical care without even seeing you, then they need to have liability. Wake up and smell the betadine.