Tuesday, July 08, 2008

MN-01 : Dr. Davis offers a Prescription for Health Care

When I heard that there was going to be a doctor running to represent Minnesota’s First District in Congress, I wondered what type of doctor he would be?
No, not what his specialty would be … but would he be part of the growing majority of doctors who take a different view of the intertwining of health care and private insurance industries ?

A survey published in the journal Annals of Internal Medicine reported that 59 percent said they support legislation to establish a national health insurance program, while 32 percent said they opposed it, "Across the board, more physicians feel that our fragmented and for-profit insurance system is obstructing good patient care, and a majority now support national insurance as the remedy"

Yes, the health care system is facing challenges. It has been widely reported that there are 47 million Americans without health insurance, but that is just the start. Nearly all businesses with more than 200 employees offer coverage, but only 48 percent of the smallest firms do. While small businesses represent the majority of employers in this nation, it is clear they are having extreme difficulty in providing their employees with health care coverage. But even those that have insurance may not be seeking the care they should. Reuters reported : “About 20 percent of the U.S. population delayed or were unable to get access to medical care when they needed it in 2007, up from 14 percent four years earlier … For the insured, individuals said they were unable to get their health insurer to pay for treatment, or that a doctor or hospital would not accept their insurance. … medical costs - driven by drugs, hospital and doctor fees -- have risen at least twice the rate of inflation for several years, making it more expensive for those with insurance to afford care.”

The Brian Davis For Congress website has a very brief section on health care, including : “The cost of practicing medicine continues to escalate, partly because of an increase in malpractice awards which have risen at rapid rates. A government takeover of our health care system is not the answer. We should build a system that emphasizes preventive health care as well as continued progress in curative treatments. More competition in health care is part of the solution.

Not much there …. as it seems to be a retread of George Bush’s junk lawsuit campaign strategy that doctors "should be focused on fighting illnesses, not fighting lawsuits." It got Bush votes, but nothing got done … even with a Republican Doctor as the Senate Majority Leader and Republicans in control of the House and Senate. (NOTE : S. 354 HEALTH Act of 2005 was introduced in January 2005 and got six cosponsors. Norm Coleman was not one of them.) Putting caps on damages is at the heart of the legislation but there is a universal consensus that caps would do absolutely nothing to reduce medical errors or to compensate injured patients.

A candidate’s website being void of concrete solutions is not that unusual, but Dr. Davis was recently interviewed by the Austin Daily Herald and expanded upon his views :
In his long-time field — health care — Davis said a major step is ensuring more cost transparency, thus allowing consumers to shop for elective procedures, and teaching them the market value of their care.
“We have a third party system, so they don’t see the cost of care,” he said.
Davis also advocates for more uniformity nationwide in the health insurance sector, which he believes would allow companies more opportunity to operate across state lines, thus increasing competition and reducing cost.
“We have the best health care system in the world,” he said. “That doesn’t mean it’s perfect … but I think a free market works best.”
He also recommends more consistency in medical research funding for entities like the Hormel Institute, which can experience interruptions in research as grants periodically become smaller and less available.
“I know it’s a competitive market,” Davis said. “I think what I’d like to see with the government is that they keep a very steady funding amount as long as it yields results.”

So no mention of how to address the un-insured or the under-insured or preventative care.
But he does mention transparency … getting patients to shop around for the best deal.
Well, I suppose instead using Mayo Clinic’s Immanuel-St. Joseph’s Hospital in Mankato … a quick 12 mile jaunt, I could check the prices at the hospitals in New Ulm (25miles) or Madelia (40 miles) … I’m sure that my spouse wouldn’t mind the extra travel time, gas and unfamiliarity with the doctors and staff, etc..
Dr. Davis is suggesting something along the lines of checking the Internet for the cheapest gas … that may work since all gas is formulated similarly … but health care is dependent upon the expertise and equipment of the doctors and staff.
But this idea is being tried.
www.Carol.com is a for-profit Web site that is designed for high-deductible health care insurance plans by giving consumers the information they need to get good, cost-effective medical care. Most of the information is supplied directly by Carol's 30 tenants. These are hospitals, clinics and specialty groups that pay a fee to list their services and prices on the Web site. Carol CEO Tony Miller says a site like Carol can really only work in a metropolitan area where there's health care competition.
If Dr. Davis was running for MN-03 and it’s large metropolitian area, his idea may have some merit, but out in the vast rural area of MN-01, the idea is without merit.

If Dr. Davis wants to promote transparency, it should be the transparency in how well the doctor and staff perform. For example, sites like Health Grades can provide information about a doctor, but that information may be best used by the hospital administration than the layman.

Frankly, I am not sure how increasing competition will impact price. Dr. Davis salary in 2007 was $411,720 … and I thought most insurance payments are based on “usual and customary fees for the service and area” ? And in an earlier commentary, the American Medical Association warned that smaller paydays would give doctors an incentive to stop taking Medicare patients if the 10.6% fee cut was implemented.

One other aspect in Dr. Davis’ interview that is interesting. He mentions “consistency in medical research funding for entities like the Hormel Institute’. That funding is typically done through the “earmark” process in appropriations and I thought that Dr. Davis opposed earmarks.

From his website and this interview, Dr. Davis is not going to advance my interests if he is elected.
So who’s interests will he advance ?
Reviewing his most recent FEC filing of donations to his campaign reveals that 20% of his top contributors are in the medical field … donating 20% of the funds … and representing 17 states outside of Minnesota.

On the other hand, voters know where current First District Congressman Tim Walz stands on health care. His votes in support of SCHIP, Mental Health Parity, Veterans Care are well known … plus he has co-sponsored over 20 health care bills.

Dr. Davis’s prescription for health care is bad medicine.

1 comment:

Sally Jo said...

great post