Posts Tagged ‘Further discussion of the healthcare business’


By Paul Goldfinger, MD, Editor@Blogfinger

Last week we posted an article on Blogfinger that looked at the coercive effects of financial incentives in healthcare. We talked about ethics among doctors and we printed a letter to the editor from a physician who sent it to the New York Times.  That doctor bemoaned the compromise of traditional medical ethics while doctors get caught up in the pursuit of profits.  A Blogfinger Medical Commentary accompanies that post.   The link to that BF article is below.

Part 1 of BF healthcare business for doctors

Today the conversation in the Times continued as some physicians and others concluded that capitalism was not a good way to provide healthcare because of the profit incentives which ensue from  large corporations which have been taking over healthcare in this country.  In the process, many doctors have become employees and have to function according to the mandates of bottom-line-oriented executives.

Below is a link to today’s Times article, kindly provided by one of our FOB’s  (friends of Blogfinger) named Radar.

Medicine as a business NY Times Feb 9

Blogfinger Medical Commentary  Part II on this subject by Paul Goldfinger, MD, FACC:

I am frustrated, as are many doctors, by how the current economic system which drives healthcare creates  an environment for fraud, waste and abuse. To some physicians it seems that healthcare is a right which doesn’t lend itself to a capitalistic economic system.  (see today’s  NYT discussions linked above)

Our current healthcare is tarnished by out of control costs, corruptive fee- for-service reimbursement for doctors, and bottom-line oriented corporate management.   The costs are driven up by super expensive device manufacturers and pharmaceutical companies which have contributed to an unaffordable situation.

But I hasten to add that our current capitalistic system has produced the highest quality in providers, medical education, innovators, and creators of  extraordinary pharmaceuticals, high-tech diagnostic tests , and bioengineered/genetically driven advances of all sorts which promise a whole new future in medicine for this country and the world.

Other countries that have socialistic single payer  systems may be spending less, but they are not the innovators, and their quality and access cannot compare to ours. They look to America for the new advances.

Finally I am especially leary of Obamacare because, so far, it is overwhelmingly about cost and insurance, with little apparent concerns about quality.    As the ACA, with its mountains of regulations and restrictions , kicks in, Americans will, in my opinion,  become furious over access issues,  expensive premiums, and compromise of quality.

There is a chance that we will wind up with a single payer socialistic system.   Perhaps a compromise healthcare economy can be worked out over time with the government providing infrastructure, universal coverage, and regulation, but keeping physicians in charge of patient care.

In  Israel they have socialized medicine, but their medical care is excellent, and their high tech companies are world leaders and profitable. Similarly here there will have to be room for traditional American incentivization if we are to continue our successes while we fix the problems.

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