The Crisis in American Medicine: Limited and Costly

This morning my wife shared a letter just received from her former health care provider in Santa Fe, New Mexico. She writes that she’ll no longer bill insurance, with the exception of Medicare. To continue with her, she asks that you join her health community at $4100 annually. Medicare recipients must also join.

I ran into this same thing two years ago when I saw a specialist for a leg ailment. In the future, her clients would need to pay a $3700 annual retainer fee. That was two years ago. I’m reasonably sure with inflation her fee has increased.

I want to warn you that American medicine, formerly the finest in the world, is likely to become more expensive, limited and inequitable. Increasingly with the rise of corporate medicine, the emphasis is on quantity rather than quality. On average, you may need to wait several months before accessing your primary care physician, and even more to see a specialist, and when you do, it’s a physician’s assistant.

Concurrently, private insurance coverage is becoming more discriminating in what it pays for and how much. Medicare payout to physicians suffered a 4% cut this year, with an additional 4.5 anticipated cut for next year unless Congress intervenes before its adjournment next month.

Cuts like these result in reduced treatment, hiring of staff, and implementation of new technologies.

In response, doctors are increasingly resorting to concierge medicine, i.e., retainer fee medicine, now averaging $4000 annually per individual. Obviously, this will accelerate the already large number of Americans foregoing or delaying medical treatment, resulting in tardy diagnosis of mortality threatening illnesses.

As for hospitals, Mayo Clinic, accepts Medicare, but will bill you for the difference between original billing and Medicare payout. I fear this may become a growing trend.


Say it isn’t so: Fast foods in hospitals

Cleveland Clinic
Cleveland Clinic

A McDonald’s in a hospital cafeteria? Say it isn’t so!

According to McDonald’s, it has 27 franchises In hospitals.

One of them is in the world renowned Cleveland Clinic, in the top tier for treating heart disease and former home base of Dr. Caldwell Esselstyn (Prevent and Reverse Heart Disease).

This isn’t to say the Clinic hasn’t tried to rid itself of this glaring contradiction to its public embrace of lower fat and sodium foods. While it succeeded in shedding Pizza Hut, McDonald’s remains out of contractural obligations agreed to more than a decade ago.

The watchdog Physicians Committee for Responsible Medicine (PCRM) did a survey of 110 hospitals across the country and found that some of them feature as many as 5 fast food outlets:

The Five Worst Hospital Food Environments

St. Luke’s Episcopal Hospital/Texas Heart Institute/Texas Children’s Hospital Complex (Houston, Texas) 4 fast-food outlets and fried-chicken bar in the cafeteria

Medical University of South Carolina University Hospital Complex (Charleston, S.C.): 5 fast-food outlets and a cafeteria serving country-fried steak and other high-fat fare.

Naval Medical Center San Diego Hospital Facility Complex (San Diego, Calif.):3 fast-food outlets; patients order from menu featuring pork chops, meatball sandwiches, and other high-cholesterol fare.

Duke University Hospital Complex (Durham, N.C.): 3 fast-food outlets; patients order from cafeteria menu featuring spicy pork loin and other high-fat items.

Children’s Memorial Hospital Complex (Chicago, Ill.): 1 fast-food outlet; patients’ menu has chicken wings, quesadillas with bacon, and grilled hot dogs.

 McDonald’s says it offers a diversified menu that offers many options like salads.

Bull shit!

There are 14,000 McDonald’s in the U. S. Not one of them offers offers a veggie hamburger (unlike in Europe where it’s a government mandate)!   By the way, of all the fast food franchises in the U.S. and Canada, only Burger King offers a vegetarian burger, though it comes with a white flour bun.

Unfortunately, while some hospitals are trying to rid themselves of these outlets, others are adding still more, according to National Public Radio:

 Chick-fil-A recently set up shop in several facilities, including the Texas Medical Center’s St. Luke’s Episcopal Hospital and the Medical University of South Carolina University Hospital in Charleston, S.C. (Elana Gordon, April 2012).

 (We already know about Chick-fil-A’s strident anti-gay bias.)

Let’s face it: Fast foods are a money maker for some hospitals, quite willing to betray their ethics–forfeiting the well-being of their constituents along with it–for the wrong kind of green.

Perhaps we shouldn’t be all that shocked by such blatant hypocrisy, considering medicine’s Faustian trade off with Big Pharma. (See “Doctors And Hospitals Raking In Billions From Big Pharma, Huge Data Trove Reveals”:

But that’s another subject for another day.











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