January 9, 2020

Today in Becker’s Hospital Review, two articles regarding health care financial abuses should create much reflection and discussion among health care leaders. One article comes from the Lown Institute and their 3rd Annual Shkreli Awards. They name their top ten list of the “worst examples of profiteering and dysfunction in health care.” The second comes from the Washington Post’s reporter Heather Long who reports on research conducted by Princeton University economists Anne Case and Angus Deaton. The point made by these researchers is that “A few people are getting very rich at the expense of the rest of us.”

The interesting thing to me is that the Lown Institute focuses on the big picture and Case and Deaton touch on the accepted notion that the big players are to blame; however, local abuses are also an important contributor to health care costs in America. One of the main points in Case and Deaton’s research is that physicians in America are paid enormous amounts of money as compared to the rest of the world. They further state that “Physicians are a giant rent-seeking conspiracy that’s taking money away from the rest of us, and yet everybody loves physicians. You can’t touch them.”

I urge all health care leaders to access this information and give it some serious thought. How many times have you heard a community member say “Pay them whatever they want, we need them.” “Pay her what she wants, she saved my life.” Has a Board member ever said “Pay him what he wants, he generates a lot of money.” I could go on, but I think I made my point. Further, do you know or have you heard of any CEO’s that have tried to change this dynamic and ended up being a target of not only physicians, but also their patients because “everybody loves physicians?” Have you as a health care leader looked the other way in these situations, or done everything possible to maximize the dollars flowing to the medical staff while placing legalities and ethics on the back burner? Based on DOJ law suits and settlements, some Boards and CEO’s are guilty of the above!

It is my belief that the vast majority of physicians and hospital Boards/CEO’s want to do what is best for their patients and communities. I also believe that physicians are valuable and that we should treat them with respect! After all, I and my family members are patients as well, and we value our physician relationships. However, I believe that a non-board certified FP/OB should not be paid in excess of $1,000,000.00 per year or see 70 patients per day! Is this fiscally or clinically appropriate? Further, is this the only physician in America paid at this level or beyond?

In closing, I would like you to consider the following from Case and Deaton. The U.S. health-care system is “like a tribute to a foreign power, but we’re doing it to ourselves.”