Sep 16, 2014|
Garland talks with Dr. Paul Ruggieri author of the book 'The Cost of Cutting: a surgeon reveals the truth behind a multi-billion dollar industry.'
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Is an independent “select committee” necessary in the investigation of Russian hacking & possible collusion with Trump associates? This hours guest: Max Bergmann - Senior Fellow at Center for American Progress Steve Bucci - Director of the Allison Center for Foreign Policy Studies at the Heritage Foundation
Automatically Generated Transcript (may not be 100% accurate)
Sports leader -- create -- seventy WWL. WWL. And have them at 1053. -- show to climb inside Garland thing. 4260187. Or 66889. OH seventy. Here's Garland. Welcome back fill in the numbers -- -- reserve broad. Regarding Obama care. Well we have doctoral -- -- -- we could Britain -- operative p.s from the wall treat her little. -- -- doctors more -- more becoming very unhappy with their profession. Majority you know percentage. Since -- would not recommend. The industry to their children or prunes or young people going in school and commit unthinkable book. Called the cost of cutting the surgery reveals the truth behind a multi. Billion dollar industry. And and basically what I got a lot of good news. Almost longer offers surgeons or doctors. Gonna be able to afford to operate be able -- do what they do. Between Medicare Medicaid. Obamacare and changing the industry. It's kind of scary -- And we have the author doctor Paul Le rouge really how to do that pronunciation dollar. Contact our material up close those -- the date notice is it okay breathe pure. -- right does the person you want to do a wondered who helped me put my time management in there and won't get to what to do with. Jubilant cost of cutting and confessions of the surgeons and two books and your surgeon. Where do you find time to light another surgeon. And I need help. You know it's fun. It's like anything you want to put your mind is something. Clinton had to do it it's. A tidbit died when I came home. We can. My wife was very understanding the whole process -- both books particularly is passionately about a it's just it's like anything -- -- to -- -- -- it's -- -- -- I do as best you can. Do you have children. Well has stepped -- I get magnified just go for the first time I turn fifty. And the metal element of my -- and she had three -- -- to deprive them look. So it's very. The image boards and two books fuel or might he wrote -- -- about it all the tension. Fantastic woman is really completed my life but it's everywhere it's. Let's let's listen to what you Bernard surgeon for twenty years they. They must have bureau graduation forum -- young. I -- that might take a picture about food. Hello to your production in my living room the no genetic had to -- with my parents I think potentially it. All right and you were in the enormity endured an independent surgeon today. A -- -- -- just one sentence. The newsroom putrid and -- So primary Israel -- Bjorn going hospital -- wars and you talk about that -- did talk about the -- -- It was something called hi mark. Obama -- venture group. Had to endure a University of Pittsburgh Medical Center and say in the outcome they will serve as a test case on the impact to consolidation. In the health care industry. -- explain. But so it's going on everywhere and I don't think Pittsburgh it's the communities I practice. And Affordable Care Act this kind of hit the ground rules for the it was happening before that but it really accelerated the process of hospitals consolidating. Trying to preserve marketshare it's possible they are trying. Employment positions. Very faster than ever before in the past. And they're playing primary -- -- also important to urgent. But they can't -- -- team took a picture of hospitals -- keep their patients within the system they -- Get out every source of revenue from that patients. By the time into the hospital dumping them independently to hospitals that do -- have to employ the physicians. The kid take care of people. But it's going out nationwide. Hospitals. That kind of small hospitals to independent practitioners like myself. This feeling a lot of pressure for them. But I don't or use survivable. Don't turn into pension. I'm not. We can survive for a while. But in the end. We will have to work. Well and what what does that mean to August the patient. But what I think it means. I think it restricts your choice of doctor asserted. The system if your primary care employed by -- hospital system. They don't wanna do everything they tend to refer you to hospital system insurgent specialist. Then if there's an independent group across town that -- has better outcomes and there's certainly you'll never know that. I have more experience on particular operations. I don't know that it's going to be able to get to that surgeon recommended to have dual -- went up on my -- will pocket. But in reality it never go to -- victims. All right -- to break here when we come back quill will talk Bono live part of the book. If I remember correctly. 13 of positions though say they will not. Accept you Medicaid patients. 40% say no -- Medicare. And not just and the doctors book called super cutting tell me do this -- we don't -- other shows on the same thing -- -- Go to W -- build -- -- good news shows and schedules -- a moment in Garland Robinson has. And we have doctor. Rouge a reason the book the cost of coding there. So you put that we're coming right back. The think tank with Garland Robinette -- WWL AM FM dot com. News talk in sports leader Michael Ford 26018704866889. -- seventy. We're pretty good about a book called the cost of -- is written by a surgeon -- insurgent group. Twenty years. Doctor poll real jury. Of neat yeah he's wheel loose at the -- and tell them -- built I read his book. I was also -- searching other things for a number of bullet -- shows and I'm doing. I hit this and Wall Street Journal. And -- -- doctors that talking about a total -- care organizations. And talking about. -- night mirrored assumed electronic medical rectory. And that the company that are literally coming -- being developed. Joseph stood harbor this morning from positions. Practice solution wind when we have to go through all of these. New requirements. And in your book -- -- talk about. Portable load. Health care. And you'll also bring -- -- accountable care organization. I do it and actually one and staple of -- portable character. But complicate your organizations. Or are. The large hospital systems. That employed physicians and the Cole is with Republican organizations or reduce costs and provide more efficient coordinated care now that's an admirable goal. And I think has some merit to -- But it has and I believe it I believe it has stimulated these turf for the we're going on the possible -- -- wanna get bigger. Promised system's been appointed different positions. Two points because that way they can. Garnish more Medicare money from the federal government can also have more clout with private -- were negotiating contracts. But it it is one of the staples of the Affordable Care Act -- I believe -- here to stay unfortunately. -- -- this is not in your book but I just tornadoes couldn't pay wholesome girl loved. Building a huge. University medical center here in New Orleans. And we've got competing hospitals auction Gergen. To -- and in Children's Hospital in that celebre elicited this thing is huge John I'm talking about millions. Of -- people. Tintin bad types that you wish and work on durable affordable health care and -- age if you've already got. -- -- -- -- major hospital. In. Talent of 34350000. In the small state may be four million people contend that being sustained under the current condition. But I believe so that describes. You describe exactly what's going on today. And boy hospitals -- feeding frenzy their spending money that's happening where I practice as well. Despite the fact there's there's there's there's plenty of political round. I care is being duplicated. I mean the mind is spending on that facility down there. They must have had a much where -- get it from -- -- -- mortgages and it'll go -- the -- house with if that's what's going on hospitals are wanting to be bigger and better. Put the whole time that can't when this all -- country of four years which really don't know how what's gonna pan out -- That they will be in a position to garnish. More federal money and they're negotiating power with the with payers if I see it where I practice your record stating what's going content. There is this survival with the finished. Yes I do believe it is their right that's a great way of putting it there will be survival of the fittest and unfortunately. So the independent physician practicing groups. -- -- a tough time surviving it and missed internally we just don't know really is nobody unanswered questions -- to portable character we believe hospitals like this system down there. Spending all the money. Three -- -- -- know what compensate you know we don't have it anymore we can't pay -- specialist. They have to fire darkness -- to talk Specter is go where the money Peter and I don't think people know the answer that -- Hugged -- polluted cushion -- a reason behind the -- as many years here in New Orleans a lot of prunes in hospitals a lot of doctor -- a lot of people learned management -- the hospital. And kind of gruesome month public figure figure for. Decades. And I had an illness that nobody could diagnose and is big should miss like -- -- five different times. Somebody said your book to Mayo and haven't checked. And I went up there and sure enough it was rare disease caller didn't time -- out. It was a very extensive plane ticket who's a very expensive couple weeks and then in the hotel. And and very expensive treatment. Or are we moving. To me a medical Linda shrimp. Two words you don't have the money you don't tip or you don't have the chance to get the best treatment. I great is I regret agreeing to a two tiered system this country. Eventually I think we're to get there. But we're gonna have people who can afford to do what you did and conceded -- specialists in the country. In Democrat people without insurance who just can't afford to do that. Some very -- call that a little bit. -- from the -- I -- we ball which -- always had that for you have suddenly living in rural Louisiana. That develops rare disease and -- shoot she's got that -- with the whole -- of those. Connection actually getting things done and are looking -- move back to Europe book. One of the -- you talk about sticker shock. Won't what kind of sticker shock or would you see uses sticker shock unequivocal. Is that the lies and maintain. Or resume. Good to build that we get in any -- I guess sticker shock to the country that we start as a health care costs that are going to be climbing it's. And expected to approach 20% of GDP. -- by 2012 straight. To open it obamacare has apologized for the problems. Sort. The sticker -- it is interesting because. Most patients a lot of surgeons have no idea what. The cost of what they're putting in people joint replacement hernia mesh -- -- really most of us don't have any idea what these things cost of patients themselves have been shielded from things for the majority of the health care for years because under crazy system we have. Hospitals afford what they want to charge. Without any transparency without any competitive forces protecting those charges its insurance companies pay them whatever they paid him I give an example of -- hernia repair and but I did a patient received just Bill -- itemized deduction of a hernia repair itself was over 171000 -- charge by the hospital about three hours of work. The Medicare and -- paying out hospital about third and I had our life he was about 340 dollar some of that operation. And I mean insurgencies are a whole another our conversation piece. Two sticker shock I think your country is beginning to see -- to deter kids. Because more patients have a higher deductible plans and obtain more out of their pocket and that's and that they're gonna start to realize. My there's better places out there but what else can we do -- pregnant crosstown. Yeah. Or are doctors. And yeah I don't know or -- of this Sunni majority of doctors couldn't be able to continue. To see Medicare and Medicaid patients. That's a good question special what's happening with Affordable Care Act as a Medicaid population -- country is increasing. Rapidly under the Affordable Care Act and actually that's good and bad in a way that's the patients -- covered but they're covered by insurance that is contrary. Appealing to positions -- insurgents. I mean I get paid. Tony cent to five cents on the dollar for what I charge for Medicaid patient we take all comers or group we're going to have to. But he can't he can't run a business -- Medicaid patients they cannot and that is one reason why. Private practices are actually putting ourselves up and failed to be bought out by hospital systems -- they just can't afford to run a practice an important. How much did you say you were making 29 -- -- I get paid for a procedure for Medicaid patient point nine cents on the dollar. My private -- -- teeny anywhere from sixty to seventy cents on the dollar Medicaid is higher than that. -- -- in the middle may be even lower but. These are numbers that are not new they've been like this for years. And began increasing Medicaid population coming under the Affordable Care Act is gonna create some problems. There we got 101000 -- -- turning 6 o'clock and for an alleged thirteen years. Well it's in the Medicare population. Positions options are they're there for the Medicare patients who did not kicking your Medicare patients. Two patients have to go to travel farther. Maybe he's somebody -- familiar with it's unfortunate it really is the. Who attended notes -- site from one of the doctrines -- being interviewed in the past. And you're sitting here are -- to avoid the financial dilution Medicare. He would do that -- shrewd political -- pull -- -- news -- -- electronic record -- he spent ninety. Minutes -- two hours. Day. Just collecting that. Well -- electronic health records concept is being very good and noble concept. It may have some merit went all sorts out but -- more than is the majority of physicians. 85% of them hate it didn't because it takes away from patient care. Particular ways from the time they have to stand on patients there. The most in this announcement at least an hour. Up -- -- torched that burning electronic health records also -- the private practice like myself. I want electronic health record I have to pay for this computer software unless some part of our hospital system and when I don't have to pay. But it's saddening to see that the majority of physicians survey after survey despite. A good break for news connected duper Mildred ten minutes of the capital are where your oral on the regular doctor polled -- jury. -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- -- Doctor. More importantly portions of those over the -- well -- -- digress. Added doctor Roland and I asked him. While -- stood the bells and medical. System in the world. And he referred me to a book the big claim to. French was number one. And then they'll they're close to that was Switzerland. Singapore. Wrong shrimp you Canada. It's seven -- but as I looked at each war and in did more reading. Bridge as a thirteen billion dollar deficit. And they're cutting back constantly. -- and what they do. England. The same exact thing. And it in your book wounded chapters zoo's marketing money in medical devices. Is is that why we can't seem to get the cost under control. It's one reason -- growing that. Good to kick your point that you made I personally we have prepared to -- in this country and may not be the most cost efficient. When you look at other systems out there. Anderson opened in the England international public health service but it is over the country. I don't have a private insurance. There was nobody can get a private positions and get a privacy urgent picking the operational parameters that that private system is growing -- -- And upon what the government there that they have to put more money into that happens to live to relieve the backlog of the public system. And that's. Rick -- couldn't overcome the deficits. But this country if not the most cost efficient way of delivering -- I believe the best health care. And you know that the device industries it -- it turned -- industry and for good reason. Yeah I mean you -- while Nokia devices like personally a lot of cash to competitive not orthopedic surgeons used joint. Q are expensive route marked up and sort of speak. Other insurgents use other devices or about a minute medical technology issues and company. And it is hard to the level. That really shouldn't be of just getting to realize that's who. OK and you broke drugs do quote on your current -- When -- -- urology colleagues put it. Why should listen to real strong take up approach Sigler and threw for insurance. -- risk of complications. What I can Google as soon or the bigger incision much more confidence I get paid the same amount. And my patients who Joseph well -- veteran -- -- and you were talking about robot I actually. The -- it is. It's very controversial topic today that it can't believe that. They've given attitudes about ten advantages of robotic surgery and nobody will deny that it costs these studies out there. In the short term mission and -- -- operation didn't Barkley compared to traditional laparoscopic surgery which I do there's at least several thousand dollars more. The outcomes of the -- typically stoic spinach. Too robotic -- over traditional laparoscopic surgery. Right now. And the company that produced the robot. There's billions. And juniors in the market implants and they have marketed these robots to hospitals to petition with a two way. They've gone directly to that position and directly to the consumer. Typically don't it's about robots. Once you kind of delve into that a little bit robotic surgery it's a -- technology and -- I'm sure there's going to be advantages when it was sort out specific companies -- every sentence should be doing robotic surgery that's. 11 in my opinion. The other is that there are certain operations for many operations that I do get inserted. And the cops don't justify an independent they just don't. This change from drugs we were talking about breach and slowly out of -- your words today. There was no room reply -- period more than 34000. Surgical appears shortages were analyzed. To see what the current surge through cool complications. Had a in the hospital revenues says some in the authors concluded. Complications. Pay and handsomely. Explain. But the do. Complications after surgery. The affect what will happen. Where it's gonna continues to occur tradition of the competition to be readmitted to the hospitals and costs money and hospitals charge so that. And then did they they get reimbursed for that right now. That's changes hospitals are now becoming more confident. In particular care more accountable for something. Some of their outcomes to it is the United Kingdom they're not getting paid now from the Medicare standpoint and -- certain. Events that happened in the hospital after surgery. That's finally coming around but today complication is that there. Just charge that bit and then determine the company's business. So if something's being done about it does that mean something. -- have been done about it before. Is obamacare and a regular. Eliminating that -- minimizing. Right that -- obamacare is pension portability within the character had its worst it's. Hospitals can look at their quality outcomes just hold them accountable for the outcome I just preparing them for the future. The complications. And that's one of the continue to profit from the character. All right little intrigue and so move our listeners we have John in memory pure rumor doctor Paul. -- -- -- you Carlos second -- ordinance on two question. It's just maybe a little bit on a different -- -- like in an opinion about it and I had scored racial abuse should always hear the government talk about how much -- waste and abuse here is. In what they pay a medical approach. Well number one if they know how much it has -- much know where it is and it's they know where -- is why are they doing something about it. It says there's Broadway producer every profession including the medical profession -- the insurance industry. It is. And it'd been again been transparent and not a consistent in this industry to the public. But the medical industry the insurance industry industry. The embarrassment at the plant in Cuba from the public and the public knows what they're paying for. Just dictating to try to understand how much thought we can reduce that list. If it happens every major complication that we have in this country that included an eloquent and attention to the. -- -- -- -- -- Well you know. How much it is and it released big numbers out and an -- you know. How much is. Much know what it. So I didn't say never understand if you know assumptions Scotland on and you know where it is why don't you do something about it. Good point and just camp out and goes back. Right any bad people in place. -- would have the will to change and they're not affected. By outside political and economic government forces and didn't happen we'd get a critical mass. Until something happened in unfortunately. Wanted to play debates partisans. That in many ways and we are terrifying. There is a Broadway in a different -- surgery did this really. A lot of them out of London it couldn't be done out there for a variety of reasons and confident that the money. Boarded some of those reasons. Wanted to principally -- a lot of defensive medicine practiced out there. It there -- a lot of position for the almost certainly Paramount practiced defensive about it for fear of -- to root for the ordering tests. During operation spirit to prove a negative it's just that this study. Over 50% of physicians surveyed in this study. If they know attempted unnecessary and not suited for the Pentagon that the -- It didn't happen to be changed over the whole legal employment and it's that it's. Senator percent of them impacted by a position to go down. Probably another reason it hasn't been there was some sort of infection in my position just like any profession just didn't think it was a problem. It's all about. People and attention to try to people that I have been directly with I don't like them but they couldn't make the headlines and that's another reason there's other reasons why this bill but I don't think -- retreating. It's such as certain cancers for instance -- deal between. -- -- But there there was a lot of saving -- intended to identify where indicated it's easy to have the will to do it. Doctors got to take one more break we'll come back you'll five more minutes you tell them talking to -- Dog to a whole jury. The cost of cutting -- than -- moved his -- he's a surgeon and revealed she truly find a multi. Billion dollar into. -- We're better Rangers soon are quickly changing medical cures -- slugger before it's the cost of. Doctor poll gave -- Jerry. Good doctor the road there's also road confessions of surgeon. Bug doctor what do you think when you talk bug you talked about incidental findings. And you mentioned Doug cat scans are immoral and should children. Yes I mean I don't more than ever we -- doing more imaging studies on people. Cat scans MRI ultrasound. Bit technology and advanced to a point where we can really. Look at or attention and -- for -- and an anomaly and ordered him during that that's an airport source finding. Things such as. Small matters is that we will never find before. And most of these are usually incidental and benign and a big don't contribute to a patient's. Due out later on in life. But promise refining these things now more than ever and and coupled with that order which the defensive medicine and positions practiced today in the back of their -- They can't ignore these things so they send him to specialists like myself for a certain there -- certain to be analyzed to leave it to be operate on. -- -- pools there -- nothing bad I mean that this data Chavez. Most of these are -- But all of this and not only physical and emotional pain patients complete -- procedures. But also -- content system. And Hudson and Benson didn't lose your drew a breath and general losing audience. Girl with the doctor reassuring them. Thank you Garland very important subject I guess my short comment is you -- -- and need guys who. Who went to medical school and graduate and have all the years of direct -- How is this middle -- person. With virtually no expect he's. Our expertise. Our king proper in the cost the -- thing. There's just no way. Most of us can do that in which is why we get -- have a more universal health from them. Even what obamacare is proposing. Is Bristol -- -- that you can point to is -- right and the public. It's really I don't want to understand. What. Things cause they can start by actually asking calling up their hostile -- in their insurance company. -- -- have an upcoming operation once it's gonna cost me or -- gonna crush you but there's gonna cost my deductible. That's where they can start and it -- get some answers. But he's right in essential -- public terrific disadvantage not only would cost or -- experience of position to insurgent. Hundreds upon the public really know I experience there's certain. And and we're -- and government have put Pink Floyd can book that -- -- do you want to ask you talk about the robot should very expensive very sophisticated. They can't carry no good calling does sit in the corner doctors have to use them. And you even mentioned doctors that. Heroin smuggling get a gallbladder. Just to getting there and soon at all so the use some of the robot lecturer. Traders finger studies have shown us for a new technology comes sort of happened before I discovered surgery a leader eighties and early -- While some instance of gallbladder surgery for instance there was not a it is about a 2030% increase in the number of golf -- being performed so you wonder. We're just -- -- hard core reasons there's something in changing the doctor Jill very close to where they didn't get the cost of content. Get anywhere. Barnes & Noble Amazon.com. My web site and the dividend every couple Richard our company bookstore will have to support. Really introducing the all appreciate -- I'm good -- yeah. -- -- -- --