Which Tail is Wagging the Healthcare Dog? By Mark Tumblin

The single most important part of health and therefore healthcare is the patient. As a patient, when was the last time you felt you had the most influence over your healthcare delivery? We spend more household income on healthcare than on cars and gasoline combined. Healthcare spending is 4.3 times higher than what we spend on the national defense. Health insurance expenses are the fastest growing cost component for employers. Unless something changes dramatically, health insurance costs will overtake profits by 2008. We spend 80% of every healthcare dollar on chronic diseases such as diabetes, hypertension, obesity and emphysema. We must reform healthcare beginning with the patient or have the "chronic disease tail" wag the healthcare dog. Many commercial insurers use Medicare's fee schedule in developing their own fees. The centers for Medicare and Medicaid Services proposed a 5% decrease in payments to physicians in 2007 with more to follow in the following nine years. In fact, projected cuts would equal 37% in that period while the increase in the cost to treat a patient will increase 22%. Pay scales established by private insurance companies will then be expected to follow suit and the patient will feel the "physician influenced tail" wag the dog. [more...]