The Contented Cow Blog

Building Workplaces That Work

Monday I attended a lunch meeting at which a spokesperson for the American Medical Association was the speaker. It was good of him to come from Colorado to Florida to address our group, but it was, as we say in the speaking business, “a tough room”.

The speaker was there to rally support for the AMA’s positions on the growing health care crisis in the United States. Most of what he advocated didn’t go down any better with this group of business professionals (many business owners) than did the dry chicken on the buffet.

It’s a complex problem with no easy solutions. But here’s what I took from the speaker’s remarks, if I understood him correctly:

• Costs are out of control, and will only get worse.
• Physicians and hospitals are being reimbursed only a small fraction of what they’re billing. The rest is allocated between what’s negotiated with payers, and written off as bad debt. Oh, and they do a lot of pro-bono and charity work.
• Far too much of patients’ treatment is being determined by insurance companies, and not by patients and their doctors.
• A well-integrated nationwide system of electronic medical records is a long way off. The technology’s not the problem. It’s getting suppliers to cooperate, and governments to quit passing such restrictive legislation that’s getting in the way.
• Fear of litigation and extremely high court-awarded damages has led to unaffordable malpractice insurance, and the ordering of unnecessary “CYA” tests and treatment.
• The greatest share of pharmaceutical research and development is borne by American drug companies, and that’s why prescriptions are so expensive in the U.S., compared to other nations.
• Health insurance shouldn’t be tied to one’s employment.
• The best idea would be to eliminate the tax deduction that employers currently have for employees’ health insurance premiums, and use all the extra tax revenue collected to give back to individuals, who could then go out on the open market and buy a private health insurance policy. Our decisions about what kind of coverage to buy would be driven by our needs and what we could afford.

As you might imagine, that last idea wasn’t exactly embraced by the employers and business owners in the room.

I found myself agreeing with a few of the good doctor’s points. Not with others. But at no point did he suggest that there was anything physicians or hospitals could do to reduce costs or improve the quality of care.

He talked a lot about people taking responsibility for their lifestyles and their healthcare. But not much about any responsibility those in the medical profession might share. It all sounded a little one-sided to me.

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