Balls and Walnuts
more than you ever wanted to know
LOLPREZ
Did you catch Bama’s presser tonight? I found out something interesting. Absolutely laugh-out-fricking-loud fascinating.
Turns out we’ve been making tons of money on tonsillectomies. I must be a millionaire many times over by now, and the money is, oh, I don’t know . . . Hey, Karen, what did you do with all the millions I made on tonsillectomies?
“Squirreled away in overseas accounts,” she says.
No, no, it's way too easy.
I was hanging out in B-field Memorial’s doctor’s lounge waiting for their Medical Executive Committee to call for me. I’m applying for privileges, along with three other new docs, and the MEC here likes to meet and greet each new doc individually. We hung out together watching Bama’s presser, making cat-calls at the TV. Now, folks, you know I voted for Obama, but when it comes to health care this guy is laughable. His example of cutting out waste from the system? All those instances where docs order the same test on a patient because each doesn’t know what the other has ordered.
Oh, that’s going to save us a ton of money.
But it was his crack about doctors choosing to perform tonsillectomies because they reimbursed so well that made me laugh out loud.
Yes, there was a time when “general practitioners” took out tonsils and made lots of money doing so. Perhaps $100, perhaps less, but that was in the day when someone like my dad could fill the cart with a weeks’ worth of groceries for less than $20. But that was then, and while we may make a bit more on a tonsillectomy than we did in the 1960s, that money doesn’t stretch nearly as far. Given the time spent on doing pre-ops and post-ops (which are not reimbursed, but rather, are considered part of the ‘global package’) and time on the phone counseling the parents or patients, tonsillectomy simply doesn’t pay. From a purely greed-centric point of view, we would make better use of our time seeing patients than removing tonsils.
We do it, nowadays, because it’s medically indicated, i.e., the right thing to do. The idea that some docs might do it with dollar signs in their eyes is, well, LOLZ.
An interesting bit I discovered while feeding my rage over Obama’s tonsillectomy crack:
The Health Insurance Institute estimates that “getting sick and getting well†will cost the average American $105 in 1960. This sum will be distributed about as follows: $34 for the hospital, $26 for the doctor, $28 for medicines, $11.50 for the dentist, and $5.50 for other costs. The average United States family in 1957-1958 spent a little over $300 for medical care.
From The Atlantic, September 1960
D.
Medicare will only cover PAP smears every other ear. If I want to get one every year, like is recommended, I will have to pay out of pocket. Yet I can see my nephrolgist every month, even thought it’s not recomennded. Obvuiously they’re not talking to the people who deal in this stuff.
Funny thing is, the government pays hundreds of thousands, perhaps millions, to fund work groups who put forwarded treatment recommendations based on a review of the medical literature. Practicing docs take years to conform to these recommendations, and of course most never do, even though the recs are usually quite logical and fair-minded. But God forbid we get in the way of a doctor’s judgment with such things as facts and medical evidence!
I still say the whole idea of our government – the big, sprawling money-grubbing entity that can’t seem to do anything right – running our health care is laughable and a recipe for disaster. It’ll be like Medicaid and Medicare, only for EVERYONE. Docs will turn patients away because they’re losing money waiting for the gov’t to pony up their price-controlled payments on the patients they’re stuck with, the allotted hospital beds for covered patients will always be full creating horrid wait times, and scalper companies will be running ads on TV for ‘supplemental insurance’.
While ‘Universal Healthcare’ sounds warm, fuzzy, and promising, remember who’s running the show and making the decisions. The US Government. They screw everything up.
Bear in mind, though, that for millions of people without any health insurance, what you’re describing sounds perfectly acceptable. Also, Medicare is administered well — in private practice, I never had to wait more than a few weeks for reimbursement. I don’t even have complaints about Medicaid, except for the fact that the reimbursements are so dreadful — aside from that, it was a hassle-free experience for me & my staff.
I think the government can do it right, but I don’t think they WILL do it right.