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ashling

(25,771 posts) Tue Jun 6, 2017, 10:03 AM Jun 2017

The Specialists Stranglehold on Medicine

https://www.nytimes.com/2017/06/03/opinion/sunday/the-specialists-stranglehold-on-medicine.html?smid=fb-nytimes&smtyp=cur

Republicans are trying to cut health care spending. But hacking away at Medicaid, weakening coverage requirements and replacing Obamacare’s subsidies with a convoluted tax credit will not deal with the real crisis in American health care.

The Affordable Care Act was misnamed; it should have been called the Access to Unaffordable Care Act. In 2015 health care spending reached $3.2 trillion — $10,000 for every man, woman and child in America. While our health care system is the most expensive in the world by far, on many measures of performance it ranked last out of 11 developed countries, according to a 2014 Commonwealth Fund Report.

But deregulation will not fix it. To the extent that we can call it a market at all, health care is not self-correcting. Instead, it is a colossal network of unaccountable profit centers, the pricing of which has been controlled by medical specialists since the mid-20th century. Neither Republicans nor Democrats have been willing to address this.

Most Americans mistakenly believe that they must see specialists for almost every medical problem. What people don’t know is that specialists essentially determine the services that are covered by insurance, and the prices that may be charged for them.

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The Specialists Stranglehold on Medicine (Original Post) ashling Jun 2017 OP

Most Americans DO NOT believe they must see specialists for almost every medical problem. In fact still_one Jun 2017 #1

still_one

(92,219 posts)

1. Most Americans DO NOT believe they must see specialists for almost every medical problem. In fact

Reply to ashling (Original post)

Tue Jun 6, 2017, 11:00 AM

Jun 2017

people see specialists when they are referred by their Primary Care Physician

This editorial also ignores the issues that the ACA went after. Three of the primary objectives were the following:

1. To provide health insurance coverage to those who were either unwilling or unable to qualify
2. To setup a series of standards whose focus was on preventive care.
3. To attempt to reduce the bureaucracy in the system, and improve efficiencies with mechanisms such as EDR, which could be shared between different medical facilities, and eliminate redundant tests and work-ups.

The article seems to be blaming all the problems for the high costs of medical care on unnecessary specialists, and that is flawed reasoning. It is a complex issue involving many components, including unnecessary middlemen, the high prices of drugs and diagnostics, unnecessary bureaucracies, unnecessary tests being ordered, many times to protect against potential lawsuits, and a whole plethora of other issues.

The ACA was an attempt to address some of these issues which had been ignored for so long. The ACA was far from perfect, but it was a first step. Single Payer, Medicare for all, or a public option did NOT have the votes to pass in Congress. The blue dog Democrats made it very clear they would not support those options. The ACA was the result. The republicans have been trying to undermine it ever since it became law. This included a majority of republican states unwilling to expand Medicaid, in spite of the fact that it would have saved those respective states significant money, and provided coverage for many of their citizens. They also refused to setup their own exchanges, and encouraged people in those respective states NOT to sign up for the ACA. To a large degree extent they have contributed to why premiums and healthcare costs have increased. They have generated an atmosphere of uncertainty, and continue to do so with their uncertain repeal and replace monstrosity, and have completely destabilized the market, which have also contributed to the higher costs

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