Health Care Reform Without the Smoke and Mirrors. Alieta Eck, MD

7/31/2019 Health Care Reform Without the Smoke and Mirrors. Alieta Eck, MD

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Heal t h Ca r e Refo r mW i t h o u t t h e

Sm o k e an d Mi r r o r s

A sso ci a t i o n o f A m e r i c anPh y si ci a n s & Su r g e o n s

Al ie t a Eck , MD, Pr es iden t


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Un e q u a l Pa y m e n t s f o r Sa m eSer v ice in Sam e Locat ion

W h e nH o s p i t a l

Bi l ls :

W h e nPhys ic ian

Bil ls :

Off i c e Vi si t : $ 1 2 4 $ 7 0

E c h o c a r d i o g r a m : $ 1 6 0 5 $ 3 7 3


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St a t e Me d i ca i d Bu d g e t s

Medica id To t a l St a t eB u d g e t

N ew Je r s ey $ 1 0 .7 B $ 3 3 B

Ca l i fo rn ia $ 4 2 B $ 9 2 B


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Cos t t o Pr ov ide Ch ar i t y Ca r e

Overa l lB u d g e t

Cos t perp a t i e n t v i si t

FQHC $ 1 5 M $ 1 5 0

Z a r e p h a t hH e al t h Ce n t e r $ 6 0 , 0 0 0 $ 1 5


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Th e Oa t h o f H i p p o cr a t e sB e f o r e : I will give no deadly medicineto anyone if asked, nor suggest anysuch counsel.

N o w : I will give no drug and performno operation for a criminal purpose, farless suggest it.


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Li v e r p o o l Ca r e Pa t h w a y H ea v y s e d at i o n - patients typically die

in 33 hours. 2 0 0 1 - recognized model of the National

Health System (NHS) 2 0 0 4 - approved by N ational I nstitute

for Health and Clinical Excellence (NICE)


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Li v e r p o o l Ca r e Pa t h w a y

In England, 2 9 % of patients who diein the hospital have received LCP130,000 patients


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Re ce ss a p p o in t m e n t t o r u n M ed i ca r e -Ju l y, 2 0 1 0 l a t e r r e si g n e d

Sp e n t s ev e r a l y e a r s i n t h e U K- l o v e s t h e N H S

"The more I have studied it, the more I believethat less discretion for doctors would improvepatient safety," Berwick told the Boston Globe in2004. "Doctors will hate me for saying that."

Do n a ld Ber w i ck , M D


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1 5 a p p o i n t e es , n o n e h a v e t o b e p h y s i ci a n s

N o l eg i s l at i v e o v e r s i g h t

They will have the power to decide who gets careand what care they get. The end result will berationed care.

I n d ep en d en t Pay m en tAd v i so r y Bo ar d ( I PAB)


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1 ) Repea l Obam aCar e2 ) En d t h e I PA B3 ) En d g o v er n m en t m an d a t e s o n

i n s u r a n c e4 ) En d t a x p r e f er e n ce f o re m p l o y e r p u r ch a se d in s u r a n ce

H ow t o Pr o v i d e t h e BestM ed i c al Ca r e i n a t i m e o fSca rc i ty?


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5 ) Rest o r e t h e f r e e m ar k et t om e d i ca l ca r e

6 ) En d cr o n y ca p i t a l i sm

7 ) Rep lace t h e Med ica iden t i t l em en t sy st e m w i t h r e alc h a r i t y

H ow t o Pr o v i d e t h e BestM ed i c al Ca r e i n a t i m e o fSca rc i ty?


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1 . Est a b l i sh n o n - g o v e r n m en t f r e ec l in ics ( NGFCs) w i t h FTCAm e d i ca l m a lp r a ct i ce co v e r a g e

f o r v o l u n t ee r m ed i ca lp r o f e ssi o n a l s ( VM Ps) .

Za r e p h a t h Ch a r i t yHea l t h Car e Act


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3 . VM Ps w h o p r o v i d e t h e f r e e ca r ew i ll b e g iv en f u l l i m m u n i t y f r o mm e d i ca l m a l p r a ct i ce cl a im s int h e i r p r i v a t e p r a ct i ce s.

Za r e p h a t h Ch a r i t yHea l t h Car e Act


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Th r ee Cs o f Access t o Car e

Ca sh c o m p l e t e t r a n s p a r e n c yCa t a st r o p h i c I n s u r a n ce w i t h o u t

g o v er n m en t m a n d at e sCh a r i t y r e a l ch a r i t y

a a p s o n l i n e . o rg

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Health Care Reform Without the Smoke and Mirrors. Alieta Eck, MD