What Is Driving Our Health Care?

Katie Jennings recently wrote in Politico Magazine of the American Medical Association’s role in American health care policy, particularly concerning pricing for services (see “The Secret Committee Behind Our Soaring Health Care Costs”).   Since the 1990s, an AMA committee has been in charge of determining the value of services provided by physicians, including determining Medicare prices.  Jennings points out that the committee serves as “a de facto federal advisory committee” but is not subject to the transparency requirements of the 1972 Federal Advisory Committee Act.

Discussion of unfair pricing within American medicine is nothing new.  The New York Times reported in 2013 on the unreasonable costs of hospital care highlighting more murky arrangements concerning medical care pricing:

”It is no secret that medical care in the United States is overpriced.  But as the tale of the humble IV bag shows all too clearly, it is secrecy that helps keep prices high: hidden in the underbrush of transactions among multiple buyers and sellers, and in the hieroglyphics of hospital bills.”

Many people complain about how a simple stay in a hospital is a risky financial venture, especially when bags of saline can run into the hundreds of dollars.  This is far removed from the Christian origins of the hospital and its role as a place of respite and refuge for the stranger or the poor.  However, I think Jennings’s article is particularly important because it seeks to get at the root of the problem and expose the misguided philosophy behind it.

In the article, Jennings states that while over half of physicians in most industrialized nations are primary care practitioners, only 30% of doctors in the United States work in primary care.  Dr. Nancy Snyderman of NBC reported this week on Walmart’s foray into medical consumer clinics, which are designed to provide a cheap alternative to visiting a physician’s practice for minor ailments.  It looks like we are continuing the trend away from family practitioners, with on one end the million-dollar specialist and on the other end the physician assistants and nurse practitioners serving up retail medicine.  One thing is for sure:  The idea of a physician being first and foremost a person’s caregiver fostering a relationship over time is pushed out of the American medical equation.

In many areas of American society we suffer from a lack of a sense of fairness.  Words like “dysfunctional” are used to describe our leaders in Washington, but a simple development of one’s character so as to be able to see something other than one’s own self-interest would go a long way toward addressing our problems.

For Further Study

Jennings, Katie, “The Secret Committee Behind Our Soaring Health Care Costs,” Politico Magazine, August 2014.

Bernstein, Nina, “How to Charge $546 for Six Liters of Saltwater,” New York Times, August 25, 2013.

Snyderman, Nancy, “What You Need to Know About Walmart’s Walk-In Health Clinics,” NBC Nightly News,  August 29, 2014.








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