I began my career in health care working as an accountant for a nonprofit hospital. One of our senior finance executives did a case study of how much the heath care system saved compared to a for-profit system that had to pay taxes. I don’t recall all the details, but it was in the neighborhood of $100 million dollars in 1990. About that same time the accounting managers were told we could no longer write off bad debts to charity care. Charity care had to be granted to deserving patients; we weren’t allowed to decide after not getting paid that care must have been charity.
Category: Direct Primary Care
Universal Coverage Will Not Cure Health Inequity
The United States spends about twice as much per capita on health care as other high-income countries. Yet our health outcomes are not as good, on average. It’s not that all Americans are in poor health, it’s that some Americans are in poor health and pulling down the average. As I’ve said before, health is correlated with wealth and education. Wealthier is healthier.
Should Medicare Pay for Cancer Screening in Healthy People? No but Seniors May Want to
A while back I wrote about Galleri, the holy grail of cancer screening tests, saying:
Cancer is usually treatable if caught early. The cancers that are the deadliest (such as pancreatic cancer) are lethal because they are difficult to catch early. Many deadly cancers have no symptoms until they’ve spread. About 90% of cancer deaths are due to metastatic cancer, that is cancer that has spread beyond the original location. In theory most cancer could be treatable if only it could be caught sooner, before it has a chance to spread.
Physicians’ Practices Vary: Some are Good, Some are Bad
I am (generally) a big fan of doctors experimenting with different forms of medical practices. Some doctors are sole proprietors and work mostly alone in their office. Years ago, I went to a doctor who did not accept insurance and would not make appointments. His office was small since he didn’t require a billing staff and was very efficient. His prices were transparent and quite low ($35 office call in 1993).
Another physician, this one from Northern Virginia, pioneered primary care consultations by telephone. Doctalker Family Medicine would do house calls, in-office visits and consultations by phone. Each service came with a different price tag. He did not accept insurance, but his office would help patients fill out an insurance claim form for a modest fee. Most of his consultations were by phone.