Highlights of the PCDC Primary Care Summit: My notes from the discussion between Dr. Mitchell Katz, new CEO of NYC Health + Hospitals, and Dr. Elizabeth Rosenthal, author of An American Sickness.
Pedigree or mutt? That was the question we faced a few years back when we went looking for a family dog. As far as I can tell, mutts and pedigrees are pretty similar – both kinds of dogs spend their waking hours persuading their humans to give them treats!
We ended up with Selkie, a Heinz 57 kind of mutt. Besides being totally wonderful, choosing Selkie over a pedigree saved us hundreds of dollars.
Healthcare costs: Pedigree or mutt?
Which brings us to the panelists at the Primary Care Summit. They pointed out that much like choosing a pedigree dog, we can pay a premium for unneeded specialized care, hospitals that feel like hotels, and name brand pharmaceuticals. But in today’s fragmented healthcare system, perhaps that’s not what we all need. Maybe choosing a mutt would be just fine.
Highlights of the PCDC Primary Care Summit
As usual, these are from my own point of view, in the audience, and may not be what the panelists intended.
Healthcare costs: Profit vs. care
- Middle-class pain: Because of high-deductible health plans, healthcare costs are now a middle class issue
- Escalation of billing: Simple exams, such as colonoscopies, are now billed as surgical procedures as hospitals seek to maximize revenue
- Market consolidation: When hospitals consolidate markets and acquire doctor groups or practices, they raise prices across the board
Patient expectations grow
- Luxury or necessity? Patients now expect branded and luxurious facilities, even though this drives cost. In Europe, hospitals feel “like junior high schools” not hotels
- Patients expect action: Patients also don’t like doctors to recommend “watchful waiting” for their symptoms, even though that’s often the best course. Thanks to decades of pharma marketing, they expect action, which encourages a “do something” culture among doctors
Primary care vs. specialists
- Too many specialists: The US system is overloaded with specialists. Specialists tend to recommend more aggressive and expensive treatment
- Health plans drop the ball: Insurance companies are abdicating the role of cost control and patient advocate. It’s just not worth it to them to battle providers over individual bills