Category Archives: Medical Debt

Do No Harm

While channel surfing Tuesday night, I came upon the above documentary film, Do No Harm: Exposing the Hippocratic Myth, when I saw a scene of medical students graduating from Des Moines University. I wondered if this was the same school that my younger brother, who is a D.O. graduated from. It was, so I continued watching it to the end.

According to the documentary, physicians have the highest rate of suicide among the professions. And the toll on their friends and families is one of shock and despair that they never received any help for their depression and thoughts of suicide. The feeling of isolation overwhelms many of our young doctors, and the only way out is to commit suicide by whatever means is available.

At one point in the film when the producer interviewed him, the President/CEO of the Accreditation Council of Graduate Medical Education (ACGME), said they agreed with recommendations made to deal with this crisis, and then in the next sequence, the film states that hours were increased from 18 to 28 hours. However, in 2003 the ACGME set new rules limiting residents’ hours to 80 hours a week and to 16 hour shifts, so something is wrong here.

69 percent of doctors report having abused drugs. Medical errors are the third highest cause of death in the United States after Heart Disease and Cancer, with 251,000 deaths a year. Depressed residents cause 6.2 times more errors than their peers, and 1 out of 20 admit making an error that leads to the death of a patient.

The reason for this problem stems from the fact that residents are a cheap source of labor for hospitals. Residents are paid on average $40,000 a year, while Medicare pays the hospitals an average of $112,000 per resident. Hospital CEO’s annual salary range from $600,000 to $1 million, and with bonuses and incentives, it can go as high as $12 million or more.

Physician burnout among physicians, as the chart below shows, is highest among Emergency Medicine, followed by Ob/GYN, Family Medicine (as I can attest to with regard to my brother, who began his practice as one of six doctors, and is now the lone doctor in two offices. Needless to say, it has caused him some personal distress, but thankfully for my family, he is not a statistic).

Sixty percent of Emergency Medicine physicians experience burnout, OB/GYN physicians exhibit more than fifty percent burnout, and Family Medicine physicians exhibit roughly fifty-five percent burnout.

Until the medical profession comes clean and realizes that working physicians to death is not healthy for the body of American medicine, this abuse will continue. At one point, Pamela Wible says that this system is a violation of human rights according to the United Nations.

Please watch this very informative and eye-opening documentary, and if you have any power to end this crisis, please do.

How to Negotiate Down Your Hospital Bills – The Atlantic

Negotiate hospital bills? Why not negotiate drug costs, insurance premiums, co-pays, deductables, etc.?

Instead of playing this game, why not Improved Medicare for All. This way, no one will get sick paying for health care that is too damn expensive.

Read on.

Doctors’ bills play a role in 60 percent of personal-bankruptcy filings.

Source: How to Negotiate Down Your Hospital Bills – The Atlantic

Americans Forego Treatment Due to Debt: Where is Medical Travel?

A report from the Kauffman Family Foundation, as mentioned in last week’s The Atlantic, stated that more than a quarter of Americans indicated that someone in their family is struggling to pay medical debt.

Higher rates of individuals are found among low-income and uninsured people, and many are not suffering from chronic illnesses, but rather from sudden or one-time illnesses, according to Gillian B. White.

This isn’t surprising, Ms White writes, given the state of most Americans’ finances. She says that most people are ill-prepared to deal with any financial shock.

Another report cited in her article from the J. P. Morgan Chase Institute (hey, didn’t they cause some of the financial shock Americans are experiencing?), looks at how medical costs factor into household financial instability.

They looked at 250, 000 Chase checking accounts where they could categorize about 80 percent of the expenditures, and found that for a median-income household (around $57,000 a year), expenses fluctuated by an average of 29 percent, or $1,300 month to month.

The authors of the study examined extraordinary medical expenses: large (more than $400 and more than 1 percent of annual income) and unusual ( falling more than two standard deviations outside a normal household’s spending for a month).

40 percent of middle-class and older families faced an extraordinary expense of $1,500 or more due to a medical expense, and around 16 percent of middle-income households had one large expense during a one year period. The authors found that these expenses tended to show up when they experienced an uptick in income.

Ms. White concludes her article by debunking the idea that having Americans spend a significant amount of their own money up front will encourage them to shop around for better health care deals. The reality, she states, is that they will forego treatment if they cannot afford it.

So What Does This Mean For You?

Well, for those in the medical travel industry it means that you need to focus on getting those middle-class families to get their treatment abroad where the costs are lower, and to concentrate less on cosmetic, plastic, reconstructive and augmentation surgeries, fancy medical treatments of dubious value, and concentrate on offering the kinds of treatments Americans are foregoing.

Debating whether or not certifications are valid or worth the paper they are printed on, is a nice academic exercise, but real people are skipping vital medical care while you debate and hold conferences around the world.

I’ll say this again: the market will not come to you, you must go to the market.