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Health Care - The Elephant in the Room

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By Ben Cohen

A reader writes in:

I am a psychologist whose primary reimbursement is from Medicare and Medicaid because I provide services in nursing homes. In that capacity, I am reimbursed at 50% of the Medicare allowable; physicians (except psychiatrists, because they are mental health providers) are reimbursed at 80% of the allowable. Because I am a single parent with school aged children, my work day is truncated, but taking that into account the rate of my average earnings the past four years is about $80,000. Now, I spent 11 years in school, with two years of post-doc to become a licensed psychologist. That would be a 13-year investment in education and training. About the same as a plastic surgeon or anesthesiologist. Yet, they earn four to five times what I do. And, that is the elephant in the room no one wants to talk about;
physicians expect to make far too much money, especially those in specialties. My son recently had his four wisdon teeth removed. The aggregate of time the dentist spent with him was less than sixty minutes. The bill? $1800. Almost two thousand dollars for almost an hour's work. Not a bad gig if you can get it. If I, as a health care provider, can generate that much in a week of providing services to the elderly, I have had a good week.Of course, you hear physicians wail about the risk they take, that patient's lives are in their hands, and so on. Well, the fact is, very few patients die from physician's doing procedures, including bypass surgery.Medicare has the lowest overhead of any insurance program; and you would find the elderly and their families are quite appreciative of it. Does that mean there are not abuses? Certainly not.The worst thing that happened to medicine is when they hired MBA's to manage their practices. I think you would find that the overwhelming proportion of physician group practices are managed by an MBA. So, lets see, you want the gatekeeper to be a government bureaucrat seeking to minimize cost, or do you want an MBA seeking to maximize profits as the director of medical services? That is the decision currently out there.