WWL>Topics>>4-30-14 12:10pm Garland: on doctors' acceptance of insurance

4-30-14 12:10pm Garland: on doctors' acceptance of insurance

Apr 30, 2014|

Garland talks with pediatrician Dr. Floyd Buras and Sally Pipes, president/CEO of Pacific Research Institute, about whether doctors should stop accepting insurance in order to force changes to the system.

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Automatically Generated Transcript (may not be 100% accurate)

You're losing years in years ago my you may have been about 2000 years ago it was a moving. Called network. I don't know about a it television anchor that just could not take it anymore ended up. Screaming out of warned of -- into the spectrum sick and tired of all of this site and take it anymore. Yesterday Wall Street Journal. And dissimilar. Orthopedic surgeon -- -- send them or would California. Rotor opinion pieces on fire rule of the network. -- toward me three years of practicing position. And and he starts -- talking about idea we have from health care cost problems we have no -- try and do something about it. But he said there's also a problem when that individual position in the friendships. Does not to have the boards in the debate. And as being told. What to do and how ordered to. And he basically says. There on the mandates. And the requirement from the bureaucrat. Where do we stand up and say. We're not going to take it anymore and and that worked. With doctor borders with mr. talk about that pass roads in the Louisiana State medical society and practicing pediatrician doctor once again thank you for a given it some time. Does. The doctors. Letter Motorola. Medicine. Position. Industry -- the position that we're in this country. Now today that there's -- segment of positions to. Who who are that way that I belong to an organization called take back the profession. Which is you know try and make them do what -- plan. I also have some good friends that California is that these concierge practice where. They don't take any Medicare Medicaid private insurance it's strictly. Cash basis. And you know they'd have to deal -- any rules -- -- -- catch but the reality is is that most people. Are not independently wealthy and have to rely on insurance or Medicare. And that's where compassion can expand. The word down on market turned patients away because they don't have the money out just work with a client. And says it did the trick here is to have Madison has a house as a group. Influence what's going on and has a very good example of what happened. If you may remember a week ago or two weeks ago congress passed the law. Delaying the onset of the -- CD can -- converge. And then what is -- -- doctors and in the old -- and in a set of closed at one set of clothes for what you do. Called CPT -- so proxy and office is that at 992 wondering. He -- the patient was nearing its actions that and I CD we currently nine. Which is 382 point zero so when you're doing computer bill line. You don't type in all those words you type in on 913 for the visit treaty to point 00 for the diagnosis. And the computer knows what to do. Well the -- Matt in Washington secretary Stabile is mandated that effective October the first of this year. CD hand which is an app that means static. Now I PD nine has about 151000. Those I teach and has about 90000. So doctors would have to -- 90000. Close. To do their business and it's it's not realistic. And through the work that the AMA and some of the other professional organizations. Congress actually passed a law. Two weeks ago which was signed by the president postponing that conversion. And studying whether or not that's really necessary. So you know you could stand -- in I'm not gonna take it anymore. But she got to do the union organize. -- a simple way its agreement and tolerant you're so like that probably out Nevada. Saying you know I'm not gonna take it anymore but at the end of the day you've got to do it in an organized. And legal way and that's. What we do it positions that's what we have organizations. At the local level -- Spanish medical society at the state level. The Louisiana State medical society in the out right now does in in the legislature right now. And and the FDA -- -- the federal level and that's how he gets things done so you can cry in the wilderness but it's a lot better work. With an organization. And negotiate and you can -- get done what you want done. I'm fascinated this kind of in the weeds but the yeah. 90000 codes for a CD ten ICD nine -- codes were there for them. About 151000. The news is -- idea that -- memorize Adam a lot of my -- camera steady and everyday but it. Books and computer program to me -- you look it up in the books right. Like say I have an ear infection you look up in the book ear infection and it said the close to 82 point 00. And most doctors actually happens to Libya betterment of the doctor. And years in the opposite in Europe in Asia seem put a couple of checkbox on paper. But he -- check in the and and they're different -- specialty you know an orthopedist. Would have predicted that echoes from the pediatricians and obstetrician. And you know the ones that you -- but there -- booked there on you can look them up on the computer I mean it's been not a secret. He is that he used the -- that's the way bill has done. Was it a computerized system the probably ICD ten. And Andy's story is Iran the TV union at a solid time. For example. If -- attacked by Turkey. There's a code now that your tactic by Turkey. If you bitten by -- Turkey. If -- scratch by the Turkey or the Turkey just run in the obnoxious over each one of those under -- -- has it that the will widen. You know why that might -- -- And I think got elections around the country on this there's actually a code. For accidental drowning after following up -- water skis for reasons the water skis are on fire there's account for that. This is broader than Comedy Central. Iraq I get a credit doctor this doctor. Probably auto industry didn't sound better. The bill the big break your income. I get more questions about. What -- doctors go through because on one day and we're constantly talking about we're -- reduce the cost of health care. On the and it seems like we're putting things in place that makes it. Intricately more typical for you and ways to reduce health care. When you're pulling -- 151000 codes or 90000 codes. Just to do basic methods and -- Where triggered bug barrier been preaching Wall Street Journal for the years of -- from the cool or attributes are important as 23 years. Ropes giving letters same sick and tired of via bureaucrat Simpson these requirements. And he's -- -- and observer elegant figure anymore there's even. Pretty specific -- said to the perfection would put up with what we put up with the scrutiny. And the coercion from outside forces legal position and do with the media wouldn't do it. The labor union wouldn't put with the adhesive we -- doctors can change the paradigm could as a group elect not to take in the insurance. Not to -- at Medicare. Many doctors or -- taken these steps -- and better understand this week called a doctor Doug -- purist. As resolute Louisiana State medical society. Practicing pediatrician doctor -- to do. Correctly. This doctor. Probably broke presents a minority. In and what he's saying -- enters. The minority. And and that fidelity yeah advocating is what stopped and called concierge medicine. And and narrated them some practices here in laws that are like that basically the philosophy is you every January pay a membership fee. You know he's -- around 15100 dollars and let that get you -- that sense is that doctors personal email home phone number. -- media contact priority booking. He and you paper in the opposite it's out of pocket. And and that's great I mean I am pediatrician and I deal with you know young families with kids in the many young families with babies. Have 15100 dollars is lying around to sign up for. A concierge service. That's not realistic I've got to work list the patient. And the patience. Sources of financing if they get their insurance to workers there on Medicaid. Cool or whatever insurance I mean realistically. I can't ask the patient to come up with that kind of cash. We've got about children and all that diapers formula and clothes and you know you don't have that kind of money land around so compassion. Trumps the day. You know liking being -- -- Ali rules and I don't like me either if you wanna talk fury -- talk to doctors had to show right now. They went live this week with their federally mandated. Electronic medical record to get them meaningful use reimbursement from Medicaid. And you sit in the -- -- -- thereof furious. But you know is is if you don't take Medicare. Then what he would do it senior citizens in the put them out on the street. So you'd -- you do you take care but at the thing with any industry. You know he use you you run a -- strategies. You get inspected by the Health Department to make sure that the food is welcome. You have such rules and regulations and I'd rather not have to deal with it. But it the end of the day. An aspect of public safety comes into play. So when -- media by the patient. Compassion is gonna trump today. And you know those guys to use that concierge. -- -- there exclusive client Allan good for them. But the average primary care working class stock is vehemently that others working class people who don't have that kind of money do cost here has -- Consumers -- and I've Myron -- we go let's go back to ICD ten code. Whoever gives the proposed this has -- at least some modicum of education concerning the health care industry. Who in the right mind would say years ago -- -- do that replace 151000 coach -- 90000. Codes and isn't there's some. Positions. Organization. That consider that the government. Let's stop the insanity side -- this have nothing else. We get stopped and that's what the AMA did. And the -- post bound by. So we got it stopped. And -- out of work on getting it turned back the other way and that's a question lobbied congress. But you know the problem Washington got out the bureaucrats -- -- and I didn't make -- rules. And we figure out we comply you know all -- now what they do. Well they -- ball rolls -- mean that's -- job to make rules so but somebody has to do is reduce the size of government and. Not just Madison. But industry yeah. Good luck -- -- -- now. Little -- you've gore and a little bit different direction here. Moved when we to have at least one dollar -- number of doctors are seeing enough and they're doing the coast to use services. Was under the impression that by -- Medicare and Medicaid in those states expanding Medicaid. And Obama here and changes in insurance companies. The virtually everybody was getting some insurance somewhere. I have been -- keep people on yesterday organizational wouldn't even aware of -- 53000. People with health insurance and clinics. Here in New Orleans and regional area. They -- nine million dollars is still in business by August of was are closing their doors that -- 3000 go and I'm looking at Biotech stocks. Or the last two years have gone up a 120%. And it's making drugs like so boldly. New hepatitis C drug thousand dollars a pill. Where where's all this going all week. Reducing on one side in editing on the job. Well -- after the drug questions you know companies are allowed to recruit their research and development costs. And that that's that's not true of drugs is true of any patented service that would if you come up with a a new invention -- patented. For seven years or you can stand that the fourteenth. You have exclusive rights to it. And what that what the government reasonably does is allow you recruit pew research and development cost. And at the end of the patent. You know it runs out and it goes generic and the price will come down. That's why this country leads that the world in research and development of new drugs. Because we allow companies to invest the money and recoup their investment. -- income we have poured and understand the reasons why I am crashed in the region. Why it is that waited for the -- that like saying that. I'd love to have a home for my hopes and it and I just don't have the money for it -- guys should be allowed to do it I don't get how that works. But what we have to do is constructed system that takes research and development cost in -- consideration. And of course that the government. With the reality and -- -- -- in the cheapest possible way. And it feels adage you know he's on a flying an airplane. Built by the littlest bit. You know there's always ways to cut costs. But I think what what we have to do is recognize that we run a capitalistic. Economy in this country and that. Cost of investment and research and development. After being included in the budget. For healthcare and any other technology that comes along. And what people are saying in Washington is will we don't have the money needed actually want to exclude that. What they're trying to do is socialize. A capitalistic economy and that's where the struggle -- right. -- revealed that. One of the -- question totally off the subject in your pediatrician. You may not have been me. Desired responded this at all or have the knowledge about respond. Well we've we keep talking about these drugs don't work 44 death row inmates from weird thing I think it was in the Oklahoma last night where there. Tried to kill wounded -- married to and he won't cooperate in the middle of it and died of heart attack forty minutes later and there's a big bro -- what kind of drugs we can get and should use. And it's the same time our legislatures. Telling us in the world's telling us that her once killing their rebutted that uses its. Could herald wouldn't it be used in in these. -- -- That error that it is very great drug CD's I mean it's just start with something simple like potassium chloride. You know if if you want euthanize. They've got a dog he's really thinking taken -- -- In value sedate him -- -- in the big injection potassium chloride it's cheap it's convey. And they lose sleep and then go to sleep in and stopped on. The problem comes in where where bleeding heart sin and and socialistic people say. We all week we want you to kill them but likely kill them and compassionate way. -- -- -- -- -- -- -- You know he needed particularly in. You know obviously going to be shouted Dahmer on his camera. Yeah I killed somebody kill it and gotten. Well I've I've had more between noon and they say -- when news along the same lines. When they -- with a smile on their pitch intrigued. Well I rarely get together aside I mean you know that stately old adage about anesthesia in general it's controlled poisoning. And has the skill of the anesthesiologists. That they want to point you to that point. Where you're almost did but not dead and then they bring you back. Well they have the skills to take you beyond the point where they can bring you back. But then that people who were against the death penalty say that's cruel and unusual punishment. Well you know that's a different argument than that the mechanics. Are people trying to come up with. Not cool ways to kill people love that that doesn't exit. Doctor always learn laugh when I talked to you know European nutrition have limited time. Always grateful when you talk to office. Have a good doctor floored Burris past president -- state medical society and practicing pediatrician. We'll talk to a presidency you or search institute. I'm always fascinated by the induced at all from time to will have one -- or was born in Hartford then with the other. And they would have totally different opinions that would see how it goes in the next power -- -- Doctor -- California. -- -- -- Ballmer to be exact orthopedic surgeon. Broderbund entries from Walter journal -- -- and pretty much spiral we're in particular in the medical community. Reminds me of all -- above -- network where television anchor and got that up with -- everything from producer of wind and so sick and tired of taking this thing anymore. And became accountable. Byword did that everybody for a reason revolving used during that time. In this opinion -- -- city's been practicing. 43 years. In said the problem is when the individual positions in the trenches don't have the boards in the body. And being told what to do and how to do -- Said mixes say damn the mandates and requirements -- bureaucrats from stand up and say. Where are gonna take anymore you've been mixed this suggestion. We -- you meaning position we could change the paradigm. Recruit as a group elect. Not to take any insurance not to accept Medicare. Many doctors are already taking these steps are real sure what that means other than. Sometimes -- policy nerves medicine when. You get to doctors that's -- for you and is limited to bill patients. But to veteran -- that's where bestselling pipes and Jordan's. Presidency Euro Pacific research institute contributing writer Forbes dot com selling book from the -- or appreciate the time again. Oh well thank you and aren't greater so what you can do is doctor -- we will rule does he -- -- elect a lot of positions. Well I think he does and I think you know it's in my mind it was a bit unfortunate that a lot of the -- didn't work. And got you know two obamacare -- -- -- became the law and equipment debate when the president -- 59 speeches about what obamacare. You know with gonna do why he want to reform the health care system adopted. Sat back and I think now the chickens are coming home to Britain and they're upset and it really angrily. Delighted that someone like that -- -- until it is willing to stand up and say it's really what mattered that the doctor patient relationship and how. You know empowering doctors and patients that's how we're going to reduce cost. In health care and get. Reduce the number of uninsured but instead. We have under Obama care assistance that is not empowering doctors and patients it empowering the federal government. And it's you know. Through increased legal mandate and insurance companies tax increases subsidies controls on insurance companies and you know the president. -- -- a 78 million Americans -- have in -- in the exchange with a much greater than that number they had projected at seven million. But when you break that down. You know 20% of the people. You know had not even paid their premium and doctors are finding -- not the patient coming in you know that. They don't even know kinda coverage there they're their patients have whether they paid their premium in it's it's really becoming an. Dot -- and onion unraveling situation it very very very painful and many tearful moment but I think I hope that doc. -- to get out and speak we've gotten very important mid term elections as you know coming November. Did this selector in particular his tone electronic health records. So -- penalized with the warm reversed some reimbursement superior don't spend at least two hours today. Dictating and documenting via electronics. Of it. And it's a broad -- and a -- -- it's a waste of precious time but it makes it sound like this has been. A problem prolong time -- gesturing obamacare. Well part of obamacare was. The fact the federal government was you know mandating that that talks you know and sign up for electronic health record. And it's very expensive it cost about 40000 dollars to enroll and it's. The government is controlling it you know we have tremendous. Software developing development -- companies in this country knew what they're you know happening all the time it shouldn't be to mandate from the federal government this -- happen. You know automatically. As younger doctors in particular you know -- more. Familiar with the computers and using computer and I hardly ever -- ever go to that. The teller at the bank can do everything electronically but by Andy is very spent a lot of older doctors. Didn't wanna do it and then in order to get a subsidy. To set up their electronic health records they have all of the meaningful use. Only meaningful use wolf you have to apply and it's it's a complete. Disaster doctors. Like him and other specialists. You know and and primary care -- well should be focusing on their patients taking care and not you know having to do all of this expansive than. Am costly in terms of time paperwork that is becoming more and more part of medicine. -- -- gophers forgive me just joined those. -- finger rebuttal -- opinion piece in the Wall Street Journal yesterday from a bone doctors in California. Basically suing doctors and sick and tired -- configure anymore talking about the rock person in the mandates coming -- Washington. In appearing with -- the page treatment of patients. You got column that you got portions of its call -- 60170. Told for anywhere in the country did six fixated on injury seven. Rob of that book that we call -- the pink. We started -- this -- -- -- about a that the doctor's opinion piece yesterday in the field Wall Street Journal. -- -- are -- -- surgeon out of Santa Barbara. And basically says doctors are fed up again taken anymore with the current system and I assume he's talking about obamacare. Is Tuesday in the mandates and requirements from the bureaucrat food and stand up and -- Oregon take it anymore. And he suggests the doctors could change the paradigm that could as a group. Elect not to take in the insurance not to accept Medicare. And when our -- that we would call selling -- presidency you'll Pacific research institute. And Sally. What does that mean if if they didn't take insurance didn't take any Medicare. What would doctors do how does that work. Well I mean there's the number of things that can can began back you know I think what is contracting it. -- an increasing number of doctors -- not taking Medicare patients and I want to increase in Medicare eligible for our seniors. Are finding it hard to get a doctor because they are reimbursed about 20% below what they get retreating private patients. That puts -- this huge expansion of Medicaid program for low income American. -- -- -- Doctors they reimbursed between 3842%. Below what they get -- -- -- critiquing Medicaid patients. And so increasingly we've seen in Massachusetts which attempt case because. Romney care is now eight years old that that we're on Medicaid can't get doctors -- if they do their long waiting list so. One of -- -- one of the -- think it's that doctors are going to stopped seeking people who are on programs that are funded by the government the second is that. As antisense -- and had a why take any insurance and concierge medicine which is. Private matter from where. Patients lined up with a with a doctor for concierge service about 4500 doctors. In this country today are offering concierge service that takes the middleman. Out of the equation and becoming increasingly. Popular so that's important I think also that the numbers that came out of the Deloitte consulting study. I'm late last year when they did this survey. Six in ten doctors -- reported but after the survey questions said. That they're can seriously considering getting out of that they're quitting medicine in the next one to three years and it because. Up Obama care. Don't -- showed Obama -- aside as second because mourners took a little bit broader. Students warrior earlier in the 11 o'clock show. On new hepatitis C drug. This -- miraculous suitable got 3.2 million people with his deadly disease. This -- cures people three to six months very very minor side effects everybody wants it singled notes. Thousand dollars to build -- ground eighty grand per person. Or twelve weeks of treatment. I have read more books and I can count on health care all over the world. They halted the top health care in the world this -- Parental as some looked. At 34 billion dollar -- was that as does every other -- here in the world. And they're cutting back on services cutting back on doctors' fees cutting back on elderly today. The fact of the matter -- that in the world today there's no system. -- works without a very big deficit. And Morgan have to get used to the to have having the best medicine and have not just them they do. Well you know you're absolutely right and number of people you know. Will say you know compared you know that Bernie Sanders and his. Senate help committee testimony hearing which I kept by at. About a month ago he had someone on speaking about bracket someone from. Ben market coming from Taiwan that you know all of these assistant. Are expensive and in particular in France which has gotten very serious fiscal problem. They're finding that because of the deficit in healthcare they're having to clamp down. On the service -- that part they're providing into more and more people are being pushed into a an HMO. Our situation in France. -- -- the American people in the nineties. Rebel against the health maintenance organizations. On concept and so. They -- successful because that the whole idea the incentive for HMO or completely reversed. And the American people didn't like you know having to go through gatekeepers -- -- -- that it's it's really I think you know what. Doctor -- -- I was talking about it. He really should be thinking how do you empower doctors and patients and health savings accounts. Eight just days which about fifteen million Americans now have that tell you put doctors and patients in charge and you cut costs. And and reduce the number of uninsured. So in portal will run out of time thank you so much for the call is usual -- have a good day. All right. Double bill bigger celebrity profile of the reopened men like coach says Rica one doctor in the percent or -- ago to this position. Does not -- present. A lot of doctors. And then we the president of search institute to helped search institute. Saying we have -- If it's complicated world out there and leisure how we find out the facts WP. And Julio covenant that's going to be talking about childhood obesity should abuse streetcar line down north rampart street and in new amnesty program. All animal or come.