Internal Medicine Of Southwest Florida
June 22nd, 2011




Some of my friends and family have suggested I write a book about the health care industry situation.  The things I have observed and would say have already been said in Dr. William C Waters III, MD., MACP's book published in 2008. Since then it has only gotten worse. Read the following letter and feel free to forward the message-let's make this viral! If you or your friends wish to sign up for our newsletter have them follow the link.
The Numbers Don't Add Up- The Health Care Problem is Economic and the Problem Can Be Solved The Same Way.
Family's are spending 17-22 thousand dollars a year in insurance premiums- before they even call on a doctor. This is just plain nuts. The math doesn't add up at all. How long are we as consumers going to stand for this?!?? If every family in this country could save half of this "wasted money" annually,  can you imagine how much money the parents would have stored for their personal retirement (300 hundred thousand in principle over a 30 year work career). This is an atrocity of magnificent proportions!  


In 2 Days That Ruined Your Health Care (And How You Can Provide the Cure),  Dr. Waters explains in 96 easily read pages the start of the problem and the fallacy of false economics that is promoting this.  I couldn't have said it better and I congratulate him on his precise book. One particular excerpt from chapter 8 titled: Gresham's Law Strikes Health Care poignantly supports the comments I made in the guest opinion piece  I penned earlier this year.  He stated "Gresham's Law holds that bad money drives the good out of circulation. It appears that the law is now at work in U.S. medicine... Confusing ambivalence aside, equal pricing in our society will surely sooner or later lead to equal services. True, the physicians with embedded patterns of excellence may live out their time because they can't bring themselves to jettison superior habit patterns in favor of the new order. Some stalwart hospitals will also naively refuse change-until they declare bankruptcy or are purchased by a larger, more "economically enlightened" system. Patients affiliated with these "vestigial remnant" doctors and institutions be well advised to stick with them as long as they last. They are after all the venerable coin of the realm. Indeed, it might be postulated that the healthcare standards in the U. S. dangle even now by these fragile threads... the "mediocrity lag phase"- the gap between outmoded excellence on the one hand and the practical economics on the other."


What the above information is saying is that because our system has set the prices for services (the bad money), we can eventually expect the differences in quality to go away and we will get what we pay for.  The idea of excellence (the good money/currency of high quality services) will be eventually brought down to the common denominator that is determined by the fixed price.  We are witnessing this happen as we speak - I stated before that  the system doesn't distinguish between a specialist, physician, board certification, PA for physician (supervised) services- in the eyes of Medicare (and also the insurance payers) it is all paid equally.  This is why your specialist and physicians are placing extenders in their place. Sooner or later even the old dinosaurs like myself who have been holding out will have to either fall to the wayside or provide the same equal product that the fixed prices are creating.  I have been becoming painfully aware of these forces coming to bear especially in the past few years. 


If any of our email newsletter patrons would be interested in discussing the Health Care system, Dr. Water's book and potential solutions to our plight, please fill out a service request form. Depending upon the response, I will work on finding an appropriate venue/space to have that discussion.  I would be interested in knowing how patients are feeling and what they are willing to do to continue getting access to their physicians regardless of what the "system" has in store for us.
I highly recommend you read Dr. Water's book and get a much more clear understanding as to why all the rhetoric about equating health care to health insurance is missing the point.  Health care starts with competent physicians, nurses, hospitals and extended care facilities, not a health insurance policy. That is the fallacious starting premise that our politicians make and the public is being duped into believing.  Dr. Water's solution starts with health savings accounts and I do agree this is a very good starting point.  The problem with the current HSA programs is they still mandate people buy insurance (which the price fixing monopoly of the current health insurance industry controls).  We need free market forces in health care. It works for all other services and it will work for health care as well.  Please visit IMSWF's blog site to leave comments and to read other information.


Raymond Kordonowy MD
Internal Medicine Of Southwest Florida