Who's cost? Identify your stake in the "COST" argument

(http://www.ama-assn.org/amednews/2008/06/02/gvsa0602.htm) is an article considering the Massachusetts legislative mandates for health insurance and whether the model is valuable for the nation as a whole. Naturally, the AMA (American Medical Association) has its own proposal for getting everyone insured.

For purposes here, the article confirms what we know in this age of finger-pointing and blaming...health insurers blame consumers (those pesky sick people) and doctors (whose COST to patients and insurers has steadily gone up), consumers blame...each other because that's easy to do and it keeps them from actually DOING anything, and doctors blame the COST of health insurance.

When reading any discussion of COST, assess whose interests in COST and what COST is being addressed.

Physicians are annoying because they pussy foot around...they play the "we care" card instead of confining their arguments regarding health insurance to their real stake which is support of affordable health insurance because health insurance is the most convenient way to make certain that they receive payment. While consumers respond with a predictable, who cares, as long as they're fighting against higher insurance payments, it's for the consumer to note that physician concerns have NOT resulted in improvements for consumers in health insurance costs, care, affordability of care or access to care. The proof is in the puddin' as the cliche goes. Physician lobbies and advocacy has not resulted in any improvements in consumer ACCESS to, AFFORDABILITY of or QUALITY of medical services in spite of the seeming similarity of goals of affordable health insurance because it's not about the consumer for physicians, it's about physician payment.

Physicians don't address the waste, the defensive medicine that amounts to excessive testing, and the pure greed that prevents them from addressing the COST of medical services. The COST of medical services is the purest part of the problem for the consumer because if COSTS of medical services were not astronomical then health insurance would not be necessary (you don't need help for paying for cancer care if it is within reason like the COST of other consumer services).

While the article above argues for legislative mandates for health insurance companies, which consumers should support because it places requirements of coverage on health insurers, consumers must also look for legislative mandates on the COSTS of medical services. The AMA will never support anything beyond that mythical ethic of self governance when it comes to themselves, and this is where the consumer and the AMA part ways.

So what should the poor doctors, whose salaries at the low end hover around $150K a year do? Well, they're doing it. They're looking for health insurers to cover the COST of medical services. They're seeking public monies to pay for their educations and they're threatening that there will be a "shortage" of physicians if we don't continue to accommodate their paychecks.

Perhaps, after the health insurers refuse to cover more (actually less is their mantra), there will be a new Medical Credit card so that those self-less healers can automatically bill their patients and leave the COLLECTION to credit card companies. Of course, currently, bankruptcy will discharge many of those debts. But, physicians are resourceful, maybe they'll require a co-signor for medical services.

Consumers must support COST controls within the medical services industry. The time for such action is not after diagnosis when people will do anything to get well, it is before. Is it possible? Of course. Doctors have organizations that take them abroad to treat sick individuals, hospitals that perform operations for free on "interesting" cases, but at home such "charity?" is not evident. Tax "credits" are available for all sorts of people, including physicians. The time and money saved through the use of technology and non-physician staff leaves time for a giving back to the society and its ills that have made them richer than many other Americans.

When it comes to controlling COST, doctor heal thyself.