The book offers a unique perspective from a practicing physician who gives an inside view on how and why the healthcare system became broken and discusses solutions on how to fix it.
"There is no question among doctors that limiting healthcare access will become the future. Adding 30 million more people enrolled in government-paid Medicaid into a system now shackled by reduced resources makes it impossible to avoid limiting access. Perhaps those members of congress who passed this nightmare didn't care since they made sure that it wouldn't apply to them." Writes Dr. George.
In "Big Medicine" Dr. George explores these five reasons why the current healthcare system is unsustainable and why The Affordable Care Act will be unable to help as many Americans as it promised. They include:
• Not enough doctors to deliver care. • Not enough hospitals to care for the 30 million more people who allegedly will access the system. • Mandates which lock individuals into a system that strips away their choice while making them pay for the privilege. • Bureaucratic panels which micro-manage the entire healthcare system while establishing a plethora of regulations that demand compliance in the face of penalties for those who dare to buck the system, or who make mistakes • Penalties for those who dare to buck the system, or who make mistakes. • Prohibitive costs, finally admitted to, that are the outgrowth of the oversight needed to police this draconian system. "An unintended consequence of the Affordable Care Act is the sacrifice of the doctor patient relationship enshrined in the Hippocratic Oath. The pressure for doctors to practice medicine driven by government mandated cost control measures will ultimately affect an individual's right to determine the course of their own healthcare," Writes Dr. George. "Those physicians that choose to practice individualized care in consultation with their patients and refuse to succumb to interoperable EMR's will be fined for not being "meaningful users of the system over time." The threat of fines, penalties, and possible confinement has many severe effects on physicians and patients. Forced to conform to federal edicts, the physician will no longer be able to practice medicine as he or she believes is in the best interest of the patient". In Chapter 12, Dr. George addresses how the United States government could hold Google or any other Big data company to a different standard from that which it holds a physician. "Since Big data companies are not limited by the strict confidentiality requirements of the doctor-patient relationship, they might be able to share health data for the right price. If a doctor discloses private medical information, he or she could be fined up to $250,000 and potentially be imprisoned up to 10 years." "More than 220,000 doctors already refuse to accept ObamaCare's new Medicaid enrollees, a number that is growing. Doctors want to care for people, but because Medicaid reimbursements are so low they can't do so and keep their practices open. Furthermore, doctors, who believe in the Hippocratic Oath, have declined to accept new ObamaCare enrollees because they refuse to work against the best interest of their patients." Writes Dr. George. In addition to thoroughly discussing the current trajectory of the US healthcare system. Dr. George offers several solutions of reform and strategies that doctors and patients can use to take the power of healthcare back for the good of the doctor patient relationship which is essence of good medicine. They include: • Change the tax code to allow private physicians to write off bad debt.. Allow physicians to write off delinquent patient bills as bad debt. • Change medical malpractice laws through tort reform. • Allow Medicare and Medicaid access to cheaper drugs from other countries. • Require insurance companies to honor the pre-certification process require that if an insurance company pre-certifies (approves) a procedure then they have to pay for it. They cannot deny it after the fact and leave the patient on the hook for paying the bill. • Refuse to mandate, as a matter of licensure, that physicians must accept Medicare, Medicaid or ObamaCare health insurance plans. • Reform EMTLA (the emergency medical treatment and labor act) • Reform medical insurance so that funds paid for medical expenses that did not reach the deductible amounts would rollover to the next year so that they could be used as a credit that would limit out-of-pocket expenses for patients. • Offer physicians a credit for their yearly malpractice premiums in exchange for caring for indigent patients • Physicians move to an insurance free model. eg, Direct pay model, offering sliding scale, subscription based models, barter • Physicians and patients use medical cost sharing (a non insurance model allowed under the Affordable Care Act - (e.g. Libertyoncall.org) • Add supplemental policies such as Aflac which pay a prescribed amount for medical occurrences (cancer, MI) and hospitalization
About Dr. Elaina George Dr Elaina George (http://www.drelainageorge.com) is a Board Certified Otolaryngologist. She graduated from Princeton University with a degree in Biology. She received her Masters degree in Medical Microbiology from Long Island University, and received her medical degree from Mount Sinai School of Medicine in New York. Dr George completed her residency at Manhattan, Eye Ear & Throat Hospital. She is on the advisory council of Project 21 black leadership network, an initiative of The National Center for Public Policy Research. Dr George hosts her own radio show, "Medicine On Call" and she is also a keynote speaker many organizations. As a solo practitioner in private practice who is also a small business owner, she has a unique perspective on the problems of health care delivery, the true costs of healthcare and viable solutions.
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