Physicians Drowned out by Politics and Punditry

The Tampa Bay Times, one of the nations’ largest newspapers, published an April 8, 2013, editorial by Richard Meyer, professor emeritus of the College of Business at the University of South Florida, entitled "How to put the brakes on rising medical costs." It not only misses the mark; it is naïve, exacerbating the beliefs of an already misinformed public.

I have felt compelled to respond to two opinion pieces in the past 40 years, and this is one of them.

Dr. Meyer proposes four solutions to stem rising costs:

• A national health card for medical records

• Funding for more medical residents

• Government bargaining with drug companies to lower costs

• One procedure, one price

Here is my response:

The true solution is founded in cutting waste, an estimated $750 billion per year according to the Institute of Medicine, a part of the National Academy of Sciences, not tweaking.

Nonetheless, Dr. Meyer suggests a national health card for medical records. Presently, with hundreds of different medical record systems and insurers, the lack of interoperability presents a formidable barrier. Cloud-based patient portals such as the one developed by MDClick are safe, secure, easily accessible, global and free to the patient.

Funding for more medical residents is not the solution. It wrongly presumes that physicians are service providers instead of health leaders. Training mid-level clinicians such as nurse practitioners and physician assistants who can handle 80 percent of the load with higher quality takes half the time. Physicians, with their advanced training, should be focused on complex conditions and managing the mid-level clinicians.

Bargaining with drug companies by government payers will only shift those savings as costs to the private sector, which already subsidizes public programs. Other countries can, not because they have single-payer systems, but because they have sensible tort laws and only pay for the drugs, not the liability, regulatory approval, or development. The American people shoulder the bulk of those costs.

One procedure, one price without addressing waste will kill the system. Why? Because, again, the private sector subsidizes Medicare and, especially, Medicaid. Medicare covers costs, barely, and Medicaid pays 60 percent less. Equalizing prices will force public payers to pay their fair share and dump hundreds of billions more onto the taxpayers' backs. I do agree, however, that price transparency is not only more practical, particularly in this time of rapidly increasing personal deductibles. It is common sense and in the public interest.

I have been on the front line of many sectors of healthcare for 40 years, mostly in leadership positions. It is massive and complex. There are solutions, and the Affordable Care Act is a step in the right direction, but it is insurance reform, not healthcare reform where the true solutions lie. Part of the problem is that healthcare professionals, who have real solutions, are drowned out by the din politics and punditry.