Most docs know the history of medical finance and the creep of health care payments with tax dollars. We know that the costs of chronic, much less catastrophic, health care are high. Nevertheless, most doctors look at history and know that changes in government health policies will likely mean that we will be burdened with regulations and that any talk about “savings,” means a cut in pay for what we do, on top of increased regulations.
At least as often as I hear complaints about payment for our services, docs express urgent concern that aren’t able to care for our patients due to limitations on services, requirements for prior authorizations with limited, sometime under qualified, personnel approving necessary treatments, limitations on numbers of prescriptions per month, and the inability to find sub-specialists when patients need them. And that it is only going to get harder. In my opinion, the “hassle factors” introduced by bean-counters and government bureaucrats are responsible at least as much for the increase in costs as increased definitions of health and improved technology.
A well-known cliché’ about of the cost of regulations is the ridiculous bill for an aspirin in the hospital. My own experience with regulations is another example. In 2003, when HIPAA came into force, requiring compliance, the vendor for my billing software wouldn’t support my old Linux software. They demanded that I buy the new Windows program, requiring all new computers, with the resulting cost of installation, training and the inevitable lag (and error) in billing. At least for some of us, there comes a point when the hassles aren’t worth borrowing the money to keep the office open.
Extrapolate these cascades of costs across the entire system and add in the regulations we know about, much less the ones we don’t know about – yet. Who can calculate the true cost of the Federalization of medical care?