Physicians

PHARMA/PHYSICIANS/HOSPITALS/QUALITY: Busy busy busy

My correspondents have sent me lots of articles today. All worth a read—

When Is a Pain Doctor a Drug Pusher? Basically never as far as I can tell but in the DEA’s view any time the DEA feels that its livelihood is threatened. What a disgusting scumbag organization (and I include the US and State DA’s in their ecosystem), and I’m beyond disgusted that as a taxpayer I’m paying for this insanity. The DEA needs to abolished and anyone who’s

Report Rates Hospitals on Their Heart Treatment. The “report” is from CMS using Medicare data and it names names. I spent the last two days with lots of hospitals. They don’t think this type of hospital ranking matters yet, and they’re right. But it will matter increasingly as patients figure this out (more from me on this next week).

 

3 drug makers busted and fined for drug reimbursement scam in cancer drugs. Not exactly a surprise:

The plaintiffs argued that the drug makers had sold medications to doctors at steep discounts to the “average wholesale price” that Medicare and pension funds paid, while secretly encouraging them to claim full reimbursement from insurers.

There is nothing rational about allowing doctors to profit from selling drugs. But then again there’s nothing rational in our payment system as a whole. This is, though, one abuse that should be ended quickly.

Finally from the WSJ, yet again showing that it’s a socialist rag, How many doctors does it treat to see a patient? (Behind sub wall I’m afraid), but let me give you the first few lines:

In the mid-1990s I worked weekend shifts as a “moonlighting” doctor in a suburban Chicago hospital. When I would show up on Friday evenings, the other doctors would always say: “Peter, remember, no roundtrips on weekends.” Translated, that meant no patients admitted over the weekend should go home before Monday afternoon at the earliest. I soon understood the genesis of the “no roundtrip” rule. At the crack of dawn on Monday mornings, before their regular office hours, the doctors would go from room to room, providing consultations and filling out billing cards.

The villain is of course fee-for-service medicine. The author wants it eliminated and he’s right. But note the interesting screw-up in the current incentives. The doctors wanted to see their patients on the Monday so they could bill FFS and make more money. But the hospital was getting a fixed DRG payment for most of those patients. It was in their interests to get them out of the hospital as soon as possible, as every moment they stayed they were making less money because they were filling a bed that could be filled with a new admission. Both of them are crazy incentives for the overall health care systems, but more than a decade later we still do not have hospitals and doctors on the same set of incentives—even irrational ones!

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DanAnonmyousSwapnaGregory D. PawelskiAnnR Recent comment authors
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Dan
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Dan

When Competition Does Not Benefit Consumers “But corruption is neither need based or greed based. It’s simply opportunity based.” —– Billy Tauzin, president and C.E.O. of PhRMA, the pharmaceutical industry’s most powerful lobbying group, as Mr. Tauzin stated in Boston recently. It has been said by others that the pharmaceutical industry should not have government regulation or interference from our government because that would drastically limit if not eliminate innovation as well as our health care choices, both from the perspective of the doctor and the patient, so the public has been told often. So, the public’s health would be… Read more »

Anonmyous
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Anonmyous

We need to dispatch WHO teams to
Vietnam
Bangladesh
Germany
France
Iran
Mexico
Indonesia
Korea
Congo
Madagaskar
Pakistan
Niger
Columbia

Gregory D. Pawelski
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Gregory D. Pawelski

Like the Energizer bunny, it keeps on……… “results are egregious….The most severe culprit being Bristol-Meyers Squibb with an 1131% markup on its drug Vepesid. Other companies mark ups range from 28% to almost 700%.” 3 Drug Makers Are Convicted in Reimbursement Overcharges By BLOOMBERG NEWS A federal judge ruled yesterday that AstraZeneca, Bristol-Myers Squibb and Schering-Plough must pay damages for overcharging on certain drugs paid for by Medicare, pension funds, insurers and patients. Judge Patti B. Saris of United States District Court in Boston found the companies liable in a nationwide class-action lawsuit over drugs administered by doctors. She dismissed… Read more »

Swapna
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Swapna

Government doctors are now thinking of money because of the paltry payments they recieve. If the hospitals paid their docs sufficiently, there would be no need to resort to such activities.
Again it boils down to how the hospital is performing ecenomically. If the management goes for prudent policies like effective management, outsourced medical transcription services and better infrastructure, surely there would be no dearth of funds to pay for the doctors. I speak of this as someone who has closely watched this sector for many years now.

Gregory D. Pawelski
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Gregory D. Pawelski

What does it take to support Medicare reimbursement for a cancer therapy? Typically the oncologist has to produce one or two papers showing that yes, taxol + carboplatin has been used in ovarian cancers. In oncology literature, there is rarely a situation in which there is only one form of therapy which has proven effective for any first-line treatment. The NCI publishes on its “state-of-the-art” website, you can find multiple different forms of therapy. So you could flip a coin and be equally well off or equally supported by the literature in choosing therapy. So you have a choice of… Read more »

AnnR
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AnnR

I find the hospital ratings site to be usable but I’m not sure it’s relevant to me as an individual. First of all, nobody I know has much choice about what hospital they go to — and I live in a major metropolitan area with at least 10 hospitals within 20 miles! Maybe if you have no insurance you get to pick your hospital – since you won’t be paying anyway? Second – are you supposed to arrive at the hospital you didn’t choose with a checklist of things they should do? What about my MIL who is 89 and… Read more »