Simple Ways to Reduce Health Care Costs for HMOs and Medicare

As the presidential campaign in the United States moves toward the various delegate conventions, it becomes clear that massive changes to health care delivery might once again be considered. Whether that only occurs in the Democratic Party or also among republicans, the success of Michael Moore’s recent documentary, Sicko, makes some kind of reform likely.

This nation is in the midst of a financial crisis that all of the candidates seem to be ignoring, so the purpose of this book is to make suggestions about actions that might be taken by medical doctors and administrators to bring down those costs now. To that end, we will look first at all of the fraud by medical doctors pertaining to Medicare and the Health Care Maintenance Organizations (HMO’s.)

The first step that can be implemented right away, without any oversight legislation is for doctors to voluntarily stop charging insurance companies their full hourly rate even though they usually only see each patient for ten to twelve minutes per visit. That’s a neat way to avoid salary controls and to also evade taxes, isn’t it? And Medicare and the HMOs must know this since they all have medical personnel on their staff to try to find ways to avoid paying for necessary procedures.

If that could happen, I think legislation should be proposed stating that no HMO administrator above middle management shall take a salary in excess of one hundred and fifty times that of any registered nurse, with no further college specialty. No one is worth the kind of salaries most of them are paid. It is to sooth their egos when they compare their employment to that of comparable positions in private industry. But HMOs were created in an attempt to get health care costs under control in the first place, so their purpose makes it impossible to compare their responsibilities with that of any other upper level business position. We must now ask ourselves to what extent does the profit motive belong in the health care industry.

Taking these three steps immediately would cause an instant decrease in costs of common surgeries and preventive care. Its hard to estimate how quickly costs would drop, but an immediate change would be dramatic. Such common procedures as seeing five patients per hour and not pro-rating charges are but one example. Later on we’ll also talk about how much a band aid costs in the Medicare system.

Another way in which doctors routinely pad the accounts is sending a medical student in for a visit twice a day or more when a patient is recovering from some serious surgery. The doctor then charges Medicare and/or HMOs the full doctor fee for each visit by medical students. They don’t earn a penny for providing interim care. In fact, they pay tuition.

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