Viewpoint

Through a Glass Darkly

Congress, today, overrode President Bush’s veto and passed H.R. 6331, a bill originally designed to delay a scheduled decrease in Medicare reimbursements that became so packed with Congressional fodder it was guaranteed to be vetoed by the administration. Doctors now anticipate a reimbursement increase instead of a sizable decrease. Competitive bidding on durable equipment contracts has been limited, or removed, stalling market forces. The political power grab is obvious and benefits anyone in favor of big government and national healthcare. Setting aside the political loss to the White House, which is a non-issue, some claim the big losers are insurance companies that participated in Medicare Advantage, a program that enabled recipients to choose among various health plans based on price versus coverage, and introduced market forces to Medicare. Generally, recipients received expanded coverage at reduced rates, so it’s hard to figure why Congress should want it removed; nevertheless, millions of recipients will now see their coverage go down and premiums go up without Medicare Advantage.

 

Lowered Expectations

It’s been a long time since I expected anything other than glossed over, sound bite journalism from the mainstream media, so Good Morning America’s sophomoric May 28 "report" titled "Does Telemedicine Work?" really shouldn’t distress me, but it does.

 

The Circle of Non-Reality

Axioms can be illuminating. Take, for example, the project manager’s credo: "Fast, good or cheap — choose any two. You cannot have all three." This is sometimes referred to as the Circle of Reality, though in some circles, reality is optional.

   

Full Circle

Not long ago, doctors made house calls. How nice it must have been to be treated by one’s doctor in one’s own bed, with family about and chicken soup on the boil. No lying in tiled hallways, clinging to cold metal tables waiting on overworked ED staff. Physicians had time to bond with patients and build relationships. Could that era come again? Possibly.

 

A Nation at Risk

With the recent opening of the "Hospital Compare" Web site (www.hospitalcompare.hhs.gov), the Centers for Medicare & Medicaid Services (CMS) and the U.S. Department of Health and Human Services (HHS) may be leading the race to transparency in healthcare and, consequently, to consumerism.

   

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