Op/Ed: The Courage to Trust Medical Care to Patients and Physicians

AddThis Social Bookmark Button

The days of trusting legislators to focus on a constituencies best interests are in the rear view as the main interest is parroting the necessary buzzwords for election and then consumed with banking lobbying money.

Our legislators have become spectators who wait for the perfect moment to pounce on their political "enemy" and then go on cable news shows to boast about it.

The "us against them" attitude, punctuated by hyperbolic, apocalyptic rhetoric closes the door to finding solutions. Our interests would be better served by having town hall meetings where voters could state their concerns, air their differences, and learn what legislators are doing about their issues. Caution: meetings at 9 a.m. on Wednesday when paid activists are guaranteed to outflank the working general public are prohibited.


Op/Ed: A Health Savings Account Could Save Your Life


There are strong differences of opinion on how to attain a healthy citizenry. Educating potential patients about what drives up medical care expenditures can start the conversation. Well-informed patients would demand solutions based not on corporate interests or government or political agendas, but on a fair, competitive market that maximizes choices and achieves lower costs.

Eight years of the Affordable Care Act have borne out Congressional Budget Office predictions that abandoning basic principles of insurance—which compensates only for events beyond the insured's control and is priced according to the degree of risk—would lead to higher and higher premiums, fewer participating insurers, and unsustainable government expenditures to subsidize insurance premiums. The data in three recent Centers for Medicare and Medicaid reports on ACA exchanges show "individual market erosion and increasing taxpayer liability." The average monthly premium for coverage purchased through the exchanges rose 27 percent in 2018, and federal premium subsidies increased 39 percent from 2017 to 2018.

A less frequently discussed cost driver is the disturbing trend of private doctors' offices being scooped up by hospitals, health insurance companies, and venture capital groups. Prices tend to rise when health systems merge, because of decreased competition. And not only do hospitals and health systems generally charge more than private physicians' offices, the government compounds this problem by paying more to hospitals than independent offices for the same service.

review of 2015 Medicare payments showed that Medicare paid $1.6 billion more for basic visits at hospital outpatient clinics than for visits to private offices. Patients are the biggest losers: they paid $400 million more out of pocket and had their tax dollars wasted. The study also found hospital-employed physicians' practice patterns in cardiology, orthopedic, and gastroenterology services led to a 27 percent increase in Medicare costs. This translated to a 21 percent increase in out-of-pocket costs for patients.

Similarly, a U.C. Berkeley School of Public Health study of consolidation of California's hospital, physician, and insurance markets from 2010 to 2016 concluded "highly concentrated markets are associated with higher prices for a number of hospital and physician services and Affordable Care Act (ACA) premiums." In consolidated markets (defined by the Federal Trade Commission's Horizontal Merger Guidelines), prices for inpatient procedures were 79 percent higher and outpatient physician prices ranged from 35 percent to 63 percent higher (depending on the physician specialty) than less concentrated markets.


Op/Ed: Create Your Own Healthcare "System"


Big medicine and third-party financing are taking the cost curve in the wrong direction. This speaks to the urgency of encouraging cash friendly practices that bypass insurance and direct primary care (DPC) practices. With DPC, all primary care services and access to low-priced commonly used medications are included in an affordable upfront price. Importantly, DPC's time-intensive and individualized management of chronic diseases decreases hospital admissions, paring down Medicare's $17 billion spent on avoidable readmissions.

Why corporations want to marginalize private practice seems clear; the government's motive is open to debate. Surveys consistently find that patients overwhelmingly want "personalized provider interactions." Thus, herding patients into government-directed programs is not the solution. One core problem with government systems is their reliance on the goodwill of politicians. As President Ford said, "a government big enough to give you everything you want is a government big enough to take everything you have."

It's time for Congress to scrutinize anti-competitive health system mergers. It's time to bring to the floor over a dozen bills to expand and improve Health Savings Accounts (HSAs) to give patients more control over all facets of their medical care.

Congress, the clock is ticking on this legislative session. Stand up for patients. Or did the dog eat your courage?

 

Bio: Dr. Singleton is a board-certified anesthesiologist. She is also a Board-of-Directors member and President-elect of the Association of American Physicians and Surgeons (AAPS). She graduated from Stanford and earned her MD at UCSF Medical School.  Dr. Singleton completed 2 years of Surgery residency at UCSF, then her Anesthesia residency at Harvard's Beth Israel Hospital. While still working in the operating room, she attended UC Berkeley Law School, focusing on constitutional law and administrative law.  She interned at the National Health Law Project and practiced insurance and health law.  She teaches classes in the recognition of elder abuse and constitutional law for non-lawyers.

Haute Tease

  • Sarah Janks, Australian Bridal Designer, Offers Five Tips in Planning Destination Weddings

    AddThis Social Bookmark Button

    Proposal season is officially in height and many new brides-to-be will be jumping to start the wedding planning process in 2016! With more and more brides choosing destination weddings, we have the best tips for travel, dress shopping and ultimately planning the perfect destination wedding.

     
  • The Academy Of Motion Picture Arts and Sciences Announces Major Gifts From Jeffrey Katzenberg and Steven Spielberg

    AddThis Social Bookmark Button

    Beverly Hills, CA – The Academy of Motion Picture Arts and Sciences received separate $10 million gifts from Jeffrey Katzenberg and Steven Spielberg for the Academy Museum of Motion Pictures.

     
  • Marco Polo Review – Intoxicating, Passionate, An Epic Masterpiece

    AddThis Social Bookmark Button

    "Marco Polo," the newest miniseries produced by The Weinstein Company and Netflix debuts in its entirety, immediately captures and seduces with the ancient lands of China, the Kublai Khan dynasty its imagery, mystery, exotic arts and allure.

     
  • Utah Woman Charged in Six Newborn Deaths

    AddThis Social Bookmark Button

    Megan Huntsman, 39, was arraigned on murder charges stemming from the serial slaying of six of her seven newborns who were found stuffed in boxes in the garage of her Pleasant Grove, Utah home.

     
  • Maestro Victor Vener And His California Philharmonic Return To Walt Disney Concert Hall For An Awe-Inspiring 11th Season

    AddThis Social Bookmark Button

    Los Angeles  - This is the time of year when the heart of downtown Los Angeles beats a little faster with anticipation of another unforgettable summer season with Maestro Victor Vener and his California Philharmonic at Walt Disney Concert Hall. 

     
  • A Bigger Splash Review – Four Stars, A Must See Sex, Drugs and Rock and Roll Thrill Ride

    AddThis Social Bookmark Button

    A Bigger Splash, from Fox Searchlight Pictures and StudioCanal, presents a high drama, rock and roll ride as lives, past, present and future slingshot at breakneck bullet speed hurling on an intense altering collision course toward an inevitable cataclysmic ending.

     
  • A Star Is Born Review – Bradley Cooper and Lady Gaga Shine In this Modernized Remake

    AddThis Social Bookmark Button

    A Star is Born, from Warner Bros Pictures and Live Nation Entertainment, brings to the screen an unlikely story of love as mega rock star on a bender meets singer with the golden pipes in a drag bar.

     
  • Academy Award® And Emmy® Award Winner Nicole Kidman To Star In Karyn Kusama’s Destroyer

    AddThis Social Bookmark Button

    Academy Award® and Emmy® Award Winner Nicole Kidman will star in Destroyer, a modern Los Angeles crime thriller to be directed by Karyn Kusama from an original screenplay by Phil Hay and Matt Manfredi.

     
  • Cannes Film Festival to Pay Tribute to Robert De Niro with a Hands of Stone Special Screening

    AddThis Social Bookmark Button

    Hands of Stone, from The Weinstein Company, presents Robert De Niro in a role that already has insiders buzzing about the possibility of a golden season for one of the most revered and legendary actors in film history.  

  • Beltway Insider: Boston Bombing Suspect Moved; President, Senator Targeted in Bio-Terror Scare; CISPA Killed in Senate; Fertilizer Plant Victim’s Mourned

    AddThis Social Bookmark Button

    President Obama, with the Boston Marathon bombing suspect in custody, attended a memorial service at Baylor University in Waco for those who died in the West, Texas fertilizer plant explosion.

     
  • Beltway Insider: Obama/Putin; ISIL/Syria/Russia; Turkey; SC Flooding; Dem’s Debate; Pot Sales Brisk

    AddThis Social Bookmark Button

    President Obama and former ostracized Russian President Vladimir Putin have apparently put their differences behind them as the two have teamed together in the common purpose of riding Syria of Islamic State Fighters and Syria's political transition.

     
  • World News: Pompeo Plans Impromptu Meet with Israel’s Unity Government Leaders (Q&A)

    AddThis Social Bookmark Button

    Secretary of State Mike Pompeo, in the middle of the coronavirus crisis and no foreign travel on his agenda, is scheduled to arrive in Israel on Wednesday for meetings with Prime Minister Benjamin Netanyahu and Defense Minister Benny Gantz.

     
  • Europe Tightens Border Control Amid Refugee Crisis

    AddThis Social Bookmark Button

    Syrian refugees continue to seek asylum in Western Europe before countries in the EU institute border controls to manage the flow of thousands of migrants. The refugee crisis has presented a challenge to the continent's open border policies that have been in place for decades.

     
  • The UK’s Jamie Porter Band Strikes All The Right Cords; Drops Sonic Smile November

    AddThis Social Bookmark Button

    Jamie Porter, playing in bands since high school, has cited his inspiration range from Johnny Cash to Bruce Springsteen and now with the Jamie Porter Band he has found his place mixing Country and Classic Rock.

     
  • CNBC: Rural Retail Chain Owner Stage Stores Prepares for Bankruptcy

    AddThis Social Bookmark Button

    Stage Stores, which operates department store brands in predominantly rural areas and small and mid-sized markets, is preparing for a bankruptcy filing that could come as soon as next week, people familiar with the situation tell CNBC.