A few questions. First, you actually want us to believe that Medicare pays less than the wholesale price for a drug? Really?
That's what he says.
Since I've seen other examples in durable medical goods I have no reason to doubt him.
Also, I am curious Fern.....how large is this oncologist's outpatient clinic that he obviously runs? Has to be done that way since you said the MD was purchasing the drugs then administering them to the patients. And since anti-cancer drugs are typically administered IV, this oncologist certainly isn't going to tie up all his exam rooms with patients receiving infusions of these meds....it'd be done via an outpatient clinic, usually...at least in the hospital/MD office situations I've either worked in or am aware of.
How large? I'm only a patient and haven't been all over his building, just one end. Additionally, I'm not confident in my ability to accurately estimate sq footage. There is a room I have been in one where IV's are administered. It's got between 12 and 18 'stations' (large leather chairs with equip etc). There are perhaps 8 small rooms for exams that I've seen. But again, I've not been through the entire building. I don't know what's on the other side.
So, he's losing $1M per year supplying IV meds to patients (and I doubt that)....how much are the patients being billed for outpatient clinic use, drug administration charges, equipment charges (both IV setups and monitoring equipment charges), etc.?
IDK those answers. I'm just patient; he's not a client of my accounting practice.
I'll say again I doubt he's losing $1M on Medicare patients via drug purchases unless the price being paid is lower than wholesale. I'm more willing to bet the MD was being hyperbolic.....and actually meant he's losing $1M relative to what he receives in payment via private insurance. That makes much more sense. But you never know....stranger things happen.
He was clear he's losing a $1M. IDK that he makes money off those drugs with private insurers. IIRC, he claimed that hospitals get a reduced price for the drug(s). He felt this pricing was done in an effort to get private practitioners drop their practice and join up with a hospital.
For instance, the wheelchair thing. Kinda makes sense in one way in that it seems the payment structure is encouraging renting vs. owning...conservation of resources if you care to look at it that way. Instead of someone using a chair for a few months/a year or so, then the family getting stuck with it after the reason for its use disappears, only to dispose of it at a yard sale or auction for $50, it gets put back into circulation. Should ultimately cost less, what with not having to buy new ones over and over.
But where's the industry growth with that attitude?
Frankly, we have to get health care out of the mentality of it being a for-profit industry first and foremost. And if the health care systems of countries like Canada, Australia, Great Britian, Germany, etc., are so horrible with compensation for everyone, why aren't all the MD's in those countries streaming into the U.S.? They're not....I don't see Canadian MD's abandoning their system to partake in ours in any numbers of significance; same with GB, Australia, etc. And it'd be dead easy for an MD from a 1st world western country to practice in the U.S.
I find your comment above odd, at least if they're directed to me. I haven't commented on compensation; I commented on gov price fixin g and were directed at a poster that claimed single payor would reduce costs by setting prices. No, just no. Costs are what they are, you can't control artificially control costs by mandating what is allowed to be charged. That's Venezuela, along with all the unintended consequences.
Additionally, physicians here seem worried the fed gov is going to drive them out of business. I don't know why a physician from Europe would want to come here. Why would they want to deal with our malpractice situation? Additionally, when I lived in Europe (Britain, Germany and France) I never met a single person who desired to move here.
But our problem isn't profits, it's rising costs without reason. And there's about only one way to at least temper that problem...examples abound around the world, like the system Trump praised in Australia.
HC in Europe has the same problem we do with rising costs.
I've read papers and remarks by Jonathan Gruber. The savings from a switch to single payor comes from a reduction in our 'over use' of HC. Gruber makes this clear. As in Europe, under single payor here there will be far fewer 'second opinions' and additional testing procedures, and the elderly may not be authorized for procedures such surgeries for hip and knee replacements. So, the savings result from
less medical procedures.
Fern
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