February 2012
51 posts
3 tags
Bastiat and Cancer
Everywhere you look people are tightening their belts. Unemployment is at levels probably equal to those during the depression if honest numbers are used. This is a tough economy. Not much spending going on. Well…except in certain sectors. Cameras on every stop light. Fast new race cars for our constables. Pet breeder licensing agencies. Local law enforcement using military drones! ...
2 tags
"Get Nurse Ratchet Away From My Patient!"
I was fortunate in my medical training to meet many bright, talented and dedicated physicians. One man that sticks out was a pulmonologist in private practice with whom I spent 2 months. His practice was the stuff legends are made of. The kind of medical practice that when described to younger physicians today, most don’t believe what they are hearing. This man was busy. He often had...
6 tags
Hans Hoppe and Unnecessary Surgery
I know of a hospital that recently went through the accreditation process only to be slapped down. The slap down was severe enough that the accrediting agency is coming back in a few months to determine whether the accreditation will be retracted, leaving this outfit..well…out of business.
Why is this important? This hospital used to be one of the best hospitals anywhere in this part of...
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Greedy Hospital Challenges
On another social media site, a hospital administrator posed the following question: ”What are your most challenging physician/hospital integration challenges?” Here is my response:
In Oklahoma City, big challenges include making employed physicians refer surgical business to other hospital employees, not the best surgeons. Also making physician employees order unnecessary lab work...
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V for Vendetta and Health Care
I have come to believe that disagreements and arguments between reasonable and rational people can be explained by the fact that the opposing sides subscribe not to different beliefs, but rather different facts. I am not including the chiselers and goons who want to rob you, those bandits who knowingly trap people in deals that are not mutually beneficial. I am thinking about folks who disagree...
9 tags
National Health Service, aka, Medicare
More and more articles are surfacing about the bankruptcy of the British National Health Service. As a government organization, they will never go bankrupt, of course, they will just stop offering certain services. This is called rationing. Ah…the advantages of a monopoly. The NHS is looking for 20 billion in cuts. This is not something they want to phase in. They are looking for it...
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Market Clearing Price
“Price controls cause shortages.” Ever heard this? This is actually not competely true. Price controls can cause surpluses if the price is set too high. Prices set too low will cause shortages.
What should be the price of anything? What determines the price? It is the presence or absence of surpluses or shortages that determine pricing. If products or services are flying off...
3 tags
Garthbrooksgate Aftermath
Ah. The damage control continues for Integris Health System. The smear of their skirmish with Garth Brooks and their attempts to deny him his donated money after a misunderstanding, must have them truly on their heels. The very expensive ads that Integris buys from local media in Oklahoma City have picked up. The very expensive ads they have bought for some time from local television stations...
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Not for profit gallows
The Sisters of Mercy (whose head nun, Sr. Patricia Talone, is paid $416,623) are so hell-bent to hurry up the “not making a profit” activities they are known for, have asked the City of Edmond for a waiver allowing them to place a temporary structure at their new facility/spa in Edmond, Oklahoma. This will allow them to not make a profit a lot quicker than otherwise, as their building...
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"Bankruptcy or Death," said the hospital nun.
Someone I know told me the other day that they were one heart attack away from bankruptcy. This individual has no insurance and has been denied insurance due to their past cardiac history. Some random thoughts.
What is your response to this? Do you think that the evil and rich insurance companies should be forced to provide insurance to this individual? Do you think that others should be...
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Connecting the dots
I just want to be sure that readers connect the dots between the salary paid to the nun running the Catholic Hospital Association and your hospital bill. Any Catholic hospital that belongs to this mafia-like organization (that would be virtually all of them) has to pay for membership. The money that they use to buy this membership came from…well…it came from you, if you were ever a...
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This Nun Wears Gucci
The head of the Catholic Hospital Association is a nun. She doesn’t look like a nun. She doesn’t act like a nun. And she sure isn’t paid like a nun. In this article, by George Neumayr, her salary and benefits package is revealed: $962,467. This amount is for 2010, however. If the raise she got from ‘09 to ‘10 is any indication, this gal will make over...
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Magnolia, Texas' William Wallace
Check out this website. Dr. Paul Dibble in Magnolia, Texas has jumped ship. He doesn’t deal with insurance companies. Period. He has listed his fees on his website. This is great stuff. He e-mailed me recently to make contact and let me know that a patient of his had actually had surgery at our facility, the prices at our facility being considerably lower than anything the patient...
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Bastiat and Community Benefit
If I didn’t have my hands full I would like to open a surgery center across the street from the not for profit hospital in Tulsa that has bestowed such large amounts of “community benefit” on local residents. I would display prices called “community benefit pricing” on a large neon sign out front. I might even run weekly specials.
We would include in our medical...
"You should thank me for robbing you," says...
In this last Sunday’s Tulsa World, page A5 is a full page ad for St. Francis Health System. Basically, the CEO, Jake Henry, has taken out this ad to let the people of Tulsa know how lucky they are to have St. Francis Health System. A shadow box showing that the 2011 “Community Benefit” amount was almost 70 million dollars. The total for a ten year period beginning in 2001 was...
7 tags
"30,000 doctors. Not 29,845." No way.
Ezra Klein of the Washington Post recently wrote the biggest threat to The Unaffordable Care Act and health care reform was a shortage of 30,000 primary care doctors. I find this very interesting for a number of reasons.
If it is true that a shortage of 30,000 primary doctors exists or will exist shortly, why is that? There aren’t shortages of plumbers or tomatoes. What’s up?...
6 tags
Electronic Medical Records and George Orwell
Have you noticed how many cameras have been installed on stoplights? And not just at busy intersections. Everywhere. The intersection without a spy camera is the exception, it seems. What are these cameras for? Are we supposed to feel better because “big brother is watching?” Are these cameras there for our safety? Fans of the police state would say “there’s no harm...
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Hospital Pulls a Knife in a Gun Fight
A physician with a high deductible health care plan recently tried to obtain a price for his son’s upcoming surgery (an outpatient procedure). Read his blog about it here. The local hospital quoted him $37,000. A local ambulatory surgery center later quoted him $1500…and you thought I might be exaggerating the price differences out there! It seems that the hospital needs a whole lot more money...
4 tags
PPO "Repricing"
PPO’s were set up ostensibly to help with the escalating price of health care, the idea being that if you include only the highest quality physicians and facilities in “a network,” effectively eliminating the unethical or incompetent players, you could theoretically curtail complications and minimize unecessary surgeries/care. Physicians and facilites would then theoretically provide discounts in...
6 tags
HMO Bait and Switch
Ok. This is really important so let’s go over this again. Health maintenance organizations are organizations designed to make money by denying you health care. I decided to write this blog after seeing an editorial in our local paper pushing people to consider HMO’s as a way to decrease ”out-of-pocket” costs. These organizations have come and gone through the years but not before causing great...
6 tags
FEMA, Bankruptcy and Syphillis
You are a banker. You loan money to people and charge them interest. If they don’t pay you back you have collateral but still are probably going to lose money. You figure out that it doesn’t matter anymore whether the borrowers can or will pay you back. If they can’t pay you back the taxpayers will pay you back. Are you now more likely to make risky loans?
You want to build a house on the...
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Entitlement
I witnessed Dr. Tom Coburn at a town hall meeting not long ago. One of his “questioners” was a recently retired air force officer who displayed a sense of entitlement that I haven’t seen since I was a resident working in the obstetrics unit at an indigent hospital. Dr. Coburn was straightforward with him. Then he was firm. Then he made an example of him. This was all very interesting to...
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Austerity: For Some
Times are hard. Everyone is cutting back. Well, not everyone. I see government spending money like never before. Police with fancy new race cars, surveillance cameras at every intersection, new or renovated offices for federal employees..you get the idea. The other sector that appears to be thriving is the hospital sector. New hospitals, new rehab units, new facilities and acquisitions...
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Ivory Tower Meetings and the Deaths They Will...
This article is worth reading. Now I’ll tell you why. Notice what is not there. Got it? No? Market competition. Transparency. Less government intervention. Addressing uncompensated care. Abuses by not-for-profit hospitals. Sending the management of these Ponzi schemes back to the states where they can be dismantled. Didn’t see those did you? I’ve been in meetings like...
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Surgery Center of Oklahoma and Facebook
Today the Surgery Center of Oklahoma launched its Facebook page. Being semi-new to the social media world, I find myself having difficultly wrapping my mind around the power of social media and its significance, mainly because of its limitless and expandable nature. I can honestly say, though, that I am more excited than ever about the possibilities that this move will bring.
Many more...
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Free Markets in Medicine: Why?
Why am I such a fan of free markets? Why are most people in the health care business not big fans? Why are most people in any business not free marketeers? I think the answer is complicated and simple all at the same time. I mean by this that there are many reasons, each of which is fairly easy to explain. Many businessmen start off as free marketeers only to succumb to the help that the...
4 tags
9.2 million dollars
This is what a Tampa hospital billed the estate of a deceased patient. Now, in defense of the hospital, the patient was there for 5 years. For those of you that are following this blog you know that I’m wondering how the whole “uncompensated care” thing factors into this. Well, it turns out that the hospital expects to collect no more than 1 million of this incredible charge…ok…maybe 2...
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Fighter Jets and Medicare
I stopped taking federal money in 1994. I realized that government was huge and out of control and thought that anyone taking federal money was on the dole. It finally dawned on me that I too was on the dole as a physician accepting Medicare money. This money, after all, ultimately comes from a taxpayer stick-up by Uncle Sam. But to be frank, the federal government made it easy for me....
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The Fraud of "Uncompensated Care"
What in the world is this? This is fraud, that’s what it is. This is a number that hospitals come up with at the end of the year. It’s a number that supposedly represents the amount of charitable care delivered for which they were not paid. The hospitals report this number to the feds. Then….ready?….they get car dealer like rebates from….ready?….YOU! Yes, that’s right.
“But wait,” you...
"Not for profit" tent city
Mercy Health Systems, in their rush to not make any more profits, plans to ask Edmond, Oklahoma planning commissioners to approve the placement of a temporary structure meant to house their employed doctors until their permanent, 88 million dollar complex is built. You see, they need to generate revenue sooner than they thought they would need to in order to not make any more profits.
If you...
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Time Preference and Medicare
One of my partners told me today of an aggressive move by a hospital (where he does some surgery) to “buy” his practice. Valuing his independence and understanding what this purchase would really mean, he continues to reject their advances. Typically, hospitals buy a doctor, put him on salary, get him to sign a very wordy, complicated contract and monitor his every move. Payment of...
3 tags
Lawrence Huntoon, M.D.: Medicare's Nightmare
Indefatigable. Merriam-Webster’s dictionary defines this as “incapable of being fatigued, untiring.” Synonyms are: tireless, inexhaustible, unflagging, weariless. No adjective describes Dr. Lawrence Huntoon better in my opinion. Dr. Huntoon is a practicing neurologist as well as the editor-in-chief of the Journal of American Physicians and Surgeons. This journal, formerly...
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Nurse gives her gynecologist the "pink slip."
A nurse I know just fired her gynecologist. He had been practicing independently but recently “sold out” to one of our “not for profit”-seeking hospital friends. If you think that this hospital bought his practice because they are not interested in profiting from this move, you need to follow this blog more closely.
Back to the nurse I know. Since her last visit to...
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Oh Canada, Part Deux
Two more patients from Canada are having surgery at our facility this week. One is a woman suffering from a horribly painful gynecological condition that, once again, is curable (not treatable, but curable) with a routine outpatient procedure. She was looking at 18 months best case scenario to receive treatment in her home town. That this is the situation in Canada is remarkable. That she...
4 tags
Opt-Out?
Sen. Coburn and Rep. Lankford have proposed that states be allowed to opt out of the federal highway programs/system and keep the huge tax levied at the gas pump to do with as they see fit, not fight to get it back from the feds.
The significance of this concept was probably lost on the journalist that included this blurb in our local paper or they would not have included it in our local paper. ...
8 tags
National Health Insurance
In a recent edition of our local paper, a letter was printed by a person advocating national health care. She said, “…… a single-payer system is the only plan guaranteed to stop skyrocketing health care costs by taking the profit margin out of health care. It would reduce costs, guarantee choice and ensure that all Americans have quality, affordable health care. It would give Americans far...
14 tags
Static Analysis vs. Dynamic Analysis
Economists from the “Austrian” school of thought (this includes brilliant men like Hayek, Mises, Rothbard, Hoppe, Salerno, Higgs, Herbener, and many, many others) reject the idea of economic modeling, as human actors have different ideas of value. This is called, I think, the subjective theory of value….that a painting or a bottle of wine or a mansion might be worth different amounts to different...
12 tags
Self Insured
What does this mean? This means that a company is willing to take the risk of the expense of providing health care to its employees. Rather than pay gigantic amounts of health insurance premiums, the company actually pays the bills.
We are self insured here at the Surgery Center of Oklahoma. Our employees have a health savings account. That means that the company gives them a certain amount...
5 tags
Your Right to Health Care
This is an easy one. You don’t have a right to health care. Maybe I should end the blog right now.
Oh well, I’ll see if I can explain it for those who aren’t laughing out loud right now. You see, it all depends on how you define “right.” If by exercising a “right” you violate the “rights” of another….well….then you don’t have the original “right” you thought you had.
If you think you have a...
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Fear and Entitlement
Imagine for a moment that you are poor…really poor. You read in the paper that the gang in Washington is going to cut Medicare benefits and make you pay more…money you don’t have. What is your reaction? Fear would be understandable. Possibly even anger.
Imagine for a moment that you live in the most affluent neighborhood in your town. You are really rich. Seriously rich. You read in the...
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Hugo Chavez: Medical Tourist
Hugo Chavez, the socialist dictator of Venezuela, went to Cuba to have his cancer operation recently. I figure this makes him a medical tourist. His trip to Cuba for medical treatment raises many questions, too.
First, why not have his treatment/surgery in his own country? Maybe because the care there is…well…awful. Yes, I said it. Check outthis article on health care in Venezuela. “But the...
5 tags
Government-Funded Medical Research
Should taxpayers be forced to fund medical research? Should taxpayers be forced to fund any research at all? The academic researcher would say (and has said), “if government doesn’t fund this who will?” As more and more people are “looking behind the curtain” and finding that national bankruptcy is actually possible and budget cuts are unavoidable, brace yourself for the whining and gnashing of...
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American Board of Medical Specialties: Parasite
Years ago I flew to Washington D.C. for a meeting. I redeemed some points on a credit card and upgraded to first class. Woo hoo! On the return trip I sat next to a professional looking woman and asked her what she did for a living. She responded that she owned and operated a consulting business that helped manufacturers comply with new consumer product safety rules and regulations. ”Wow,” I...
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AMA
What are people in this country supposed to think when the AMA endorses a single payor government health care scheme? Doesn’t that mean that the physicians are by and large in favor of it? Or is it possible that the AMA is not on the same page as the physicians? But if the AMA is charting a course that is not consistent with the wishes of the physicians, wouldn’t that affect their membership...
8 tags
Medicare
What is free market health care? Free market health care means no-government health care. To the extent that the government is involved in any market, that market ceases to be free. Government is force, pure and simple. The brilliant Austrian economist Murray Rothbard defined government as “…a monopoly on violence.” Any time that government funds are involved in any market, there are strings...
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HMO's
How do HMO’s work? Physicians are paid a “capitated rate.” That means that for every patient (capitated means “head”) the physician receives a set amount of money….regardless of the care rendered to the patient. Typically at the end of the year, the extent to which the physician has been successful in limiting the patient’s health costs results in a bonus…to the physician that denied them care!...
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Electronic Medical Records
The federal government is paying physicians and facilities to convert all of their medical records to an electronic/digital format. And like any federal program there’s always an “or else!” If facilities or physicians don’t make this transition, then future Medicare payments will be reduced (there’s always an “or else” clause in any law, federal or otherwise). A recent article in the local...
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Frederic Bastiat and Knee Surgery
Not long ago we operated on both knees of an uninsured man at the same time. He had been quoted $20,000 by a local hospital for the facility fee. Well, not exactly. They actually told him that he would need to put $20,000 down as a deposit with the balance of the charges due at the conclusion of his surgery, depending on what supplies were needed. This did not include the charges from the...
Thomas Sowell and Surgical Pricing
I always get a kick out of the process of formulating a price for surgical services. Many times physicians have no idea what a fair price is for their professional fees! The fees at our surgery center are a function of time and materials. Operating room time is expensive and the supplies that are needed for completion of a surgery are expensive and have to be accounted for. The anesthesia...
7 tags
Snatching Defeat from the Jaws of Victory
Check out this article from the Fraser Institute. More and more articles like this are surfacing, pointing out that economic central planning (a concept long ago devastated by Bastiat, Hayek, Mises, Rothbard and others) in health care as in any other industry, is simply a disaster. The Canadian health care system is bankrupt, so they are eliminating services in order to stay afloat.
The...
