Author: Bring Free Market into Healthcare System

Thursday, 25 Apr 2013 10:25 PM

By Greg Richter and John Bachman

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Transparency in healthcare not only can drive down costs, it can also lead to better treatment, Dr. Martin Makary tells Newsmax TV.

Makary recently testified before Congress about the lack of accountability at hospitals and health care entitlements and is author of the New York Times best-seller "Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care."

Medical mistakes and preventable infections are the third leading cause of death in the United States, behind cardiovascular disease and cancer, Makary points out, arguing that it is time to spend as much on the third leading cause as is spent on the first two.

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“I have seen patients harmed because of bad incentives in healthcare, profit motives, incompetence,” he said. “And, no, I’m not alone. Every physician out there has a story.”

People are just beginning to recognize the epidemic of medical mistakes and overtreatment in the United States, Makary said. The Choosing Wisely campaign and others have begun to address the issue, he said.

“Patients are getting crushed out there right now with co-pays, and their insurance premiums are going up,” he said. “We need some fresh ideas.”

National registries and information on Medicare and patient outcomes at hospitals are among the information already can be collected, but isn’t available to the public, said Makary, a surgeon and faculty member at the Johns Hopkins University School of Medicine and School of Public Health.

“We’d have a functional free market,” Makary tells Newsmax. “People could actually make rational health decisions.”

Makary doesn’t buy the argument that federal HIPAA rules, requiring patient privacy, prevent the ideas he’s put forth. Information that identifies patients can be removed from data, he said, allowing for comparisons for good- and bad-performing medical treatment.

Data might show that some hospitals have a 50 percent C-section rate and others an eight percent rate. Restrictions on the data, however, don’t allow the public two know which hospitals are which.

“If that information were available to women seeking a place to have a baby, it would probably drive the free market and it would probably address the 30 percent of healthcare expenditures that may be totally unnecessary.”

Makary doesn’t see any hospitals as purposely trying to hide data, but he believes the current data-collection methods reward medical facilities that decline to take on patients with complex issues and punishes those that do. Several groups are collecting better data, he said, and he thinks the public has the right to see it.

Patients have no idea how much their medical care costs, Makary said, and doctors are frustrated as well. “Docs are getting crushed out there right now,” he said. They are seing Medicare payments cut, and malpractice premiums and overhead increased.

All the while, the focus is on how to finance the “broken system,” he said.

“We don’t need to find different ways of financing the broken system. We need to fix the broken system.”

The Affordable Care Act, or Obamacare, has had one positive, Makary said: increased coverage. But, he added, it hasn’t addressed the cost issue.

“Your co-pays are now going to be $100, $150, $200 for everything that you encounter,” he said. “You’re essentially paying for all of healthcare out of pocket now, unless it’s catastrophic or a large bill.”

People might benefit from health exchanges, he said, “but if we think that we can control healthcare costs with the recent law, we’re really fooling ourselves.

“I’ve got patients that tell me they choose their hospital based on who’s got the best parking,” he said. “We cannot have one-fifth of U.S. economy competing over parking. They’ve got to be competing over patient outcomes, performance, infections, complication rates, re-admissions, things that are important and really signify value for our dollars in healthcare.”

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