This is why Mainstream medicine in the USA can be potentially dangerous

[Guest guest]

http://www.cnn.com/2010/POLITICS/02/10/health.care.costs/index.html?hpt=Mid

'Perverse incentive' in current health care system, says expert

By * Hyde *and* Drew *, CNN Special Investigations Unit

February 11, 2010 5:21 p.m. EST

[image: Dr. Jaview arrived in Mc 30 years ago and helped

create the county's first neonatal program.]

Dr. Jaview arrived in Mc 30 years ago and helped create the

county's first neonatal program.

*STORY HIGHLIGHTS*

- Most in U.S. health system paid for each service, regardless of the

results of service

- Creates " perverse incentive " for more medical services to create more

profit, expert says

- Expert: Excessive services drive up costs and do not improve patient

outcomes

- Docs must care for patients first, and then worry about profit, says

doc in Mc, Texas

*RELATED TOPICS*

- Health Care Reform <http://topics.cnn.com/topics/Health_Care_Reform>

- Barack Obama <http://topics.cnn.com/topics/Barack_Obama>

- Texas <http://topics.cnn.com/topics/Texas>

- Healthcare Issues <http://topics.cnn.com/topics/Healthcare_Issues>

*Mc, Texas (CNN)* -- Even as the health care debate turns to blood

sport in Washington, some analysts say the debate is ignoring one of the

leading causes of rising costs: the way health care providers are paid.

" They are rewarded for more services, not better services. They are rewarded

for more care, not better care, " said Dr. Elliott Fisher, a lead researcher

for the Dartmouth University Atlas of Health. " Most of the U.S. health

system is paid simply for each service, regardless of the results of that

service. "

The result is what Fisher calls a " perverse incentive " to order more medical

services. That may bring a doctor or hospital a healthier bottom line, but

it does not provide any better health for patients while driving up costs.

In Mc, health care spending is growing faster than anywhere else in the

country. When the researchers at the Dartmouth Atlas used Medicare's most

recent numbers to compare health care usage across the country, they found

that Mc spends almost twice as much per beneficiary as the national

average. Many providers use more of everything -- more tests, more hospital

stays, more procedures.

SIU Blog: Texas, Pelosi and the doctor

bills<http://siu.blogs.cnn.com/2010/02/11/texas-pelosi-and-the-doctor-bills/>

Mc is a small city on the Mexican border in one of the nation's poorest

counties, but the population is not exceptionally sick, according to

Dartmouth data. Nor does all that medicine make them healthier at the end of

the day.

" There's a whole array of services that are delivered in Mc that

patients in other communities are not receiving, " Fisher said. " And we have

no evidence that provision of those additional services yields any

particular benefit to those patients. "

In 1992, Medicare spending in Mc was under the national average. But,

since then, the business of medicine here has exploded, and Dr.

has seen the change firsthand.

arrived in Mc 30 years ago and helped to create this county's

first neonatal program. He believes many doctors here have lost their way.

" You have to care for patients first, and then worry about whether you're

going to make money. You cannot put money before patients, " he said.

said many in Mc's medical community are doing the opposite --

an assertion that put him on a collision course with one of the area's

newest, biggest hospitals, Doctors Hospital at Renaissance. is now

suing the hospital, accusing it of damaging his business and reputation.

Though he is one of its doctor-owners, he says he once was barred from

practicing there after complaining about the way the hospital does business.

" For a long time, there was a general staff meeting, there was kind of a

law: You have to refer [patients] to doctors that are part of the

partnership. This is your hospital, make it grow, " he said.

And that wasn't all, said. He said hospital staffers were ordering

tests and procedures he felt were unnecessary for his tiny patients.

" If you have a baby and it's born with a little elevated temperature or a

nurse hears a heart murmur, it immediately gets all these tests done, "

said. " It gets no assessment from the physician because they have

standing orders. So all of a sudden you're increasing the trauma to the

patient because you're doing tests on them -- some of them [tests] are

baseless, some of them are not. Also you increase the costs. "

It also increases the amount of money the hospital makes, since higher-cost

tests, procedures and facilities are reimbursed at higher rates by insurers.

" The way we pay now, some services are rewarded more than others, " Fisher

said. " And so, hospitals tend to emphasize those kinds of services where

they can be sure they'll make a profit. "

Because of privacy laws, it is hard to determine if all of those babies Dr.

talks about actually needed the tests or not. In court documents,

the Doctors Hospital at Renaissance denies all of 's allegations.

The hospital will not speak on the record about the case. But the

hospital's chief financial officer, Turley, insists that it is patient

care, not profit-making procedures, that is the secret of the hospital's

success.

" You keep your employees happy, they want to work here and the finances

follow. And that's exactly what we do here, " she said. The hospital doesn't

bill any more than any other hospital in the region, Turley said.

Doctor's Hospital at Renaissance has brought cutting edge technology and

world-class services to South Texas, including robotic surgery,

state-of-the-art radiology, 45 medical specialties and 17 facilities, she

said. What's hard to imagine is that they've been able to finance all of

this growth and expansion when, according to Turley, 75 percent of their

patients are on Medicare or Medicaid.

Turley says the hospital thrives on reinvestment and efficiencies. But,

according to Fisher, hospitals in areas that have the highest health care

costs are also thriving from the nation's health care system -- a pattern he

says ultimately can have catastrophic results.

" Health care will not be affordable for the middle class in another 10 years

if costs keep growing as they are now, " Fisher said.

" It doesn't need to be that way. "

" We can have much better care at much lower costs, " he said, but reaching

that goal will require a new way of thinking.

" We are not rewarding what we really want, " he said. " We're rewarding people

for doing stuff that's paid well. What we want to do is pay them well to do

the right thing. "

This is my contribution

Think before taking advice from a mainstream doctor. Our children's health

have been under too many interventions at a very young age that no wonder

why so many children are sick in different ways ( neurologically, physically

( cancer), etc ) I realize that this is hard to chew when this is the only

thing you know, I am a native from other country, things are different out

of the USA. Well...food is a problem here as well...no the lack of, but the

quality. Same with medicine, they do too much (unnecessarily) and the only

purpose is profit. Think about mammograms, thermograms I heard are safer,

but there is a big industry behind mammograms and this procedure is pushed

very hard. I am happy CNN publish these news, but you would think they would

have the same objectivity about vaccines and the over use of them. You only

read about the dangers of in the web, from parents who are telling their

stories...this shows how powerful is the industry of the vaccine making.

Billions, billions....Have you ever questioned why they keep pushing for

more and more? At this rate they are going to recommend a daily vaccine (an

apple a day) .

Another observation, I do not know if you connected the dots, but in the

last two weeks has been a big propaganda of the H1V1 vaccine, and it was all

over the news in that sequence.

- First Bill Gates said he would donate billions to the vaccine research

(now this make me think this guy is investing in biotechnology).

- Second they discredited Dr Wakefield even more (particularly I am thankful

he funded the Thoughtful House, they helped heal the gastrointestinal

problems my son had - the mainstream pediatrics practice now is

acknowledging many children with autism present gastro intestinal problems

that could be the cause or important part of this illness) Which is

Wakefield point of view and he lead us in that direction.

My experience in mainstream medicine: ignore the symptoms, other did a

endoscopy /colonoscopy, they did not find anything and no recommendation was

given, although my child had persistently bad stools and definitely

absorption problems (I guess they found something because they did not want

to talk to me after, or this procedure was unnecessary and they saw me as

big dollars).

http://www.generationrescue.org/wakefield_statement2.html

- Few days later the CDC announced the Influenza virus is still a danger and

they recommended the vaccine again. I guess someone is this institution is

in big trouble for spending too much money in a vaccine few people want

and/or the vaccine makers over produced it and now and they have too much

in stock. I read they plan to add this to the next year's influenza

vaccine. When you think in any vaccine think about the Gillian Barry

syndrome, think if a particular vaccine is worth the risk. Particularly I

think the Influenza vaccine is unnecessary and very unsafe. The Flu kills

people with weak immune systems, probably victims of previous years

influenza vaccines. Never put a vaccine when a person is remotely sick.

Research on how to improve your Immune system, you are not going to get this

information for any doctor, many of them have very little training on it.

It has a lot to do with good nutrition, good habits, good sleep, stress

management and fitness level

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