I recently read a book titled “Two Days That Ruined Your Healthcare.” In its 96 easy-to-read pages, Dr. Waters explains the start of our healthcare problem and the fallacy of false economics that is promoting it. I couldn’t have said it better and I congratulate him on his precise book. One particular excerpt from chapter 8 titled: Gresham’s Law Strikes Health Care poignantly supports the comments I made in the guest opinion piece I penned earlier this year.
He states “Gresham’s Law holds that bad money drives the good out of circulation. It appears that the law is now at work in U.S. medicine… Confusing ambivalence aside, equal pricing in our society will surely sooner or later lead to equal services. True, the physicians with embedded patterns of excellence may live out their time because they can’t bring themselves to jettison superior habit patterns in favor of the new order. Some stalwart hospitals will also naively refuse change-until they declare bankruptcy or are purchased by a larger, more “economically enlightened” system. Patients affiliated with these “vestigial remnant” doctors and institutions be well advised to stick with them as long as they last. They are after all the venerable coin of the realm. Indeed, it might be postulated that the healthcare standards in the U. S. dangle even now by these fragile threads… the “mediocrity lag phase”- the gap between outmoded excellence on the one hand and the practical economics on the other.”
What the above information is saying is that because our system has set the prices for services (the bad money), we can eventually expect the differences in quality to go away and we will get what we pay for. The idea of excellence (the good money/currency of high quality services) will be eventually brought down to the common denominator that is determined by the fixed price. We are witnessing this happen as we speak – I stated before that the system doesn’t distinguish between a specialist, physician, board certification, or PA for physician (supervised) services- in the eyes of Medicare (and also the insurance payers) it is all paid equally. This is why your specialist and physicians are placing extenders in their place. Sooner or later even the old dinosaurs like myself who have been holding out will have to either fall to the wayside or provide the same equal product that the fixed prices are creating. I have been becoming painfully aware of these forces coming to bear especially in the past few years.
I highly recommend you read Dr. Water’s book and get a much more clear understanding as to why all the rhetoric about equating health care to health insurance is missing the point. Health care starts with competent physicians, nurses, hospitals and extended care facilities, not a health insurance policy. That is the fallacious starting premise that our politicians make and the public is being duped into believing. We need free market forces in health care. It works for all other services and it will work for health care as well.