Doctors in Scott Walker's Wisconsin have a plan for Obamacare

The medical society representing Barron, Burnett and Washburn counties — with 75 dues-paying members — says America’s health-care system requires radical surgery.

Tri-County Medical Society Resolution on the High Cost of Medical Care in America

 WHEREAS, Healthcare costs in the U.S. are exceedingly high compared to other countries, and,

WHEREAS, Measurement of quality of care, such as longevity or infant mortality have been documented to be not as good as in other leading countries, and,

WHEREAS, The current plan (Affordable Care Act) is complex and expensive and does not appear to adequately address cost containment, which is the area of our special interest, and,

WHEREAS, The leading organizations of providers, insurance companies and governmental entities have not addressed the cause of these high costs, and,

WHEREAS, The leading organization of physicians has remained silent on these costs and has quietly worked to increase them, and,

WHEREAS, The high costs of care are often hidden or difficult to understand or obtain information about.  

THEN, BE IT RESOLVED BY THE TRI-COUNTY MEDICAL SOCIETY:

 1. That, National tort reform is the cornerstone of cost containment. The amount of money to be saved by not ordering unnecessary tests and procedures to protect doctors from frivolous lawsuits is widely underestimated. Thanks to the long and hard work of the Wisconsin State Medical Society, Wisconsin is a model for other states for tort reform. Our premiums are lower (the patients ultimately pay these) and fewer unnecessary tests are ordered by physicians fearing malpractice suits. This level of tort reform, and perhaps even more, should be extended to all of America by federal law.

2. That, Transparency in medical pricing is of paramount importance in reducing cost. The difficulty in obtaining the cost or price of medical care should end (re: Time Magazine article March 4, 2013). These should be very easy to obtain. Doctors are as ignorant as patients as to these prices and hospitals should teach doctors and patients these prices, not hide them. This transparency should be mandated by law. We feel that the harsh light of public scrutiny may shame providers into reducing the most egregious prices (like $130/minute for operating room time?)

3. That health insurance should be available on a “shop” or compare basis that is easy and consumer friendly. This should not only be ”mandated by law”, but actually happen in all 50 states. To date, this information has not been easily available to consumers. Indeed, in many rural Wisconsin counties, under the new Accountable Care Act, there is only one company offering policies, which is totally unacceptable.

4. That the health insurance industry should be mandated to pay out 85 cents on every dollar of premium. (currently, under the Affordable Care Act, that number is 80 cents, and this requirement is starting to drive down the cost of insurance) This number should be ratcheted up until it ideally gets to 95 cents, which is where Medicare is. This should be mandated by law and reviewed by a “public services commission”, like the utilities are.

5. It is a painful thought, but overbuilt hospitals and other facilities should be allowed to fail, with some consideration to the distances and access in rural America. This should be mandated by law. Who pays for empty beds? We all do!

6. Not-for-profit health care facilities should be not-for profit. Period. These organizations currently hide large profits in excessive executive compensation, excessive lavish building projects, bloated foundations, and other “shell games”. This should be reviewed by a “public services commission”, like the utilities are.

7. Physicians should be prohibited from owning medical care facilities of any nature that they could potentially refer patients to. Examples include surgicenters, laboratories, imaging equipment, etc. This is clearly conflict of interest and should be illegal. This include physician owned clinics that own their own surgicenters, laboratories, imaging equipment, etc.

8. The public, as patients need to take ownership, to become responsible enough to shop for value in health care. We recommend that deductibles be made a percentage of total bill and not a fixed dollar figure. That way, the patient has incentive to shop the purchase of health care and take advantage of less expensive care closer to home. The patient needs ownership and needs to be involved in shopping for savings.

 When all of the above are in place, and transparency allows competition, these costs will stabilize or drop, the insurance industry should be able to meet the “80 cent” rule, and start working on the “85 cent” rule, aiming at Medicare’s “95 cent” example. To encourage all this progress, Congress should introduce and debate single payer legislation as a threat if those industries do not meet cost reduction expectations. This single payer concept could easily be accomplished by a stepwise extension of Medicare downward 10 years every January first, giving these industries 6 years to adjust their business models. Holding this threat over these industries, there will either be compliance with cost reduction by regulation or by single payer at Medicare reimbursement rates. These industries may choose. On the other hand, these industries could be offered to have some restrictions above (2,3,4, and 6) lifted if they accept the single payer concept. Eliminating the ubiquitous “non-compete clause” for doctors would reverse the growth of mega-systems and increase competition, reducing prices further. Such competition would also ensure quality care as well

 We agree with Steven Brill, Time Magazine author(March 4, 2013) in that we take no official “stance” on single payer, but strenuously point out that single payer would solve the problem of the high cost of medical care in America To quote Dr. Robinson, Berkeley Health economist, in the Dec 3rd New York Times:

“The only way to pay less for health care---is to pay less for health care!”