November 15, 2018- by Steven E. Greer, MD
I have cut the cord and no longer get cable TV. However, the free content posted on apps lets me occasionally see what is happening inside the bubble of old media.
As I predicted, as soon as the midterm elections were over, the 2020 presidential candidates have started to make Medicare-for-All, or single-payer, their campaign platform. In an effort to pander to the Republican corporate base, which has traditionally included the hospitals, insurance companies, and doctors, Fox and Friends produced one of their typical “TV quack doctor” segments opposing changes to the current broken system.
The doctor this time was Nicole Saphier, MD, of Memorial Sloan Kettering cancer hospital, a radiologist. She proceeded to warn about how single-payer systems result in rationing and long-waits to see the doctor. She claimed that a Medicare-for-All system would break the bank and cost $33 Trillion over 10-years.
However, what she failed to mention is that the current fee-for-service model that dominates the American medical system is the root of the problem. And within that problem, radiologists like herself are some of the biggest offenders. CT-scans, mammograms, nuclear imaging studies, etc. are vastly overperformed because they are the biggest revenue source for hospitals.
To make matters worse, she works for an oncology hospital. Cancer treatments are the worst of the worst when it comes to bilking the system with fee-for-service. In fact, it is legal to have a system that rewards oncologists for using the most expensive cancer drug possible. They get a percentage of the drug cost as payment.
To specifically address some of Dr. Saphier’s comments, she states that a Medicare-for-All system would cost $33 Trillion over 10-years. She is correct. If Medicare started to pay for all of the American healthcare costs, which are more than $3 Trillion a year now, that is what it would cost. But that is not what would happen. Medicare spends a fraction of what private insurance spends per patient. Medicare also has pilot programs to bundle the costs for large-ticket disease categories, such as cardiology and orthopedic implants. Medicare does not have CEO’s making hundreds of millions of dollars in salary. Medicare is not a for-profit entity tasked with the primary fiduciary responsibility of please shareholders.
Dr. Saphier is also correct to point out that most hospitals would have to make dramatic cuts if they lost private insurance payments. Good riddance. Tertiary care hospitals are dinosaurs doing more harm to patients than good, in many cases. They employ ten-times the people they really need because they have grown into pseudo-government jobs-creation projects.
That is why this Fox and Friends tabloid-TV segment is accidentally the best discussion on the topic that I have seen. It has it all: the hypocritical fee-for-service doctor, who works for an oncology hospital, bashing alternatives ways to pay for healthcare, the propagandist TV bubble bimbos supporting her message, and completely misleading statements about the costs.
Bravo, Fox News. You deserve an Emmy for “Best Accidental Journalism”
(Editor’s Note: I recently had a meeting with senior executives for the biggest hospitals in Central Ohio. I was stunned at how oblivious they seem. They are still actively constructing new buildings to their tertiary care hospital not realizing that they need to be cutting back and doing the opposite. I sent an email to them warning “Winter is coming”)