South Florida Hospital News
Sunday October 13, 2019
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February 2017 - Volume 13 - Issue 8

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A Message from the President of the Palm Beach County Medical Society

As you know, 2017 will be a watershed year for medicine. Physicians have been pushed to the edge with dysfunctional EMR’s, ICD-10, programs such as Meaningful Use, and now MACRA. These programs were designed to “improve the quality of care” but most of us feel that it only creates more busy work and is the beginning of more rationed health care. This does not include the “old problems” such as low reimbursement and a broken malpractice system.

For too long, people have equated the practice of medicine with the healthcare delivery system. If you look at the advances in medicine over the last 10 years, you can truly say that we live in an age of miracles. Cancer deaths are down, we have new drugs for a once untreatable disease, metastatic melanoma. In my field, Rheumatology, we have drugs that truly prevent deformities in rheumatoid arthritis. Every medical specialty has as similar story. Robotic surgery helps improve recovery times and decrease morbidity. Doctors and our research partners in industry have responded to the challenges of our times, and hit it out of the park. The basic problem is that the economy has failed to grow at the same rate as the rate of creation of new medical treatments. The government, rather than embracing new medical technologies, tries to restrict them with misplaced costs and regulations. We should utilize these innovations to help raise the GDP. The issue is the delivery of health care. I want to make it very clear that the practice of medicine is great. It is the delivery system that doesn’t work. The high cost of medications, hardware, defensive medicine and insurance does not reflect the values of physicians. Physicians’ salaries are only about 5% of the U.S. health care dollar. The higher numbers that you see quoted in the press for physician’s payments include a physician’s every growing overhead. Physicians are disproportionately regulated. It seems that there are fewer attempts to reduce many other causes of health care costs.
 
There is a tendency in the public to blame the high cost of health care on doctors and the pharmaceutical industry. No one however, does the deep dive to see where high costs truly originate. The FDA has been a pay or play system since the 1990’s. Drug developers pay steep fees to the FDA. It now costs over 1.8 billion dollars to get a drug on market. Startup companies, should get help with innovative ideas by the FDA. Instead they are overwhelmed with high costs that force them to sell their ideas to large corporations. Short drug patents contribute to high costs. They force initial higher prices. They reduce the competition among would be competitors. Manufacturers can’t afford to get into a market when the first drug will go generic in a few years. Mickey Mouse is still copyright protected and he is almost 100 years old. A cure for cancer must be given to India and China in a few years and puts our employees out of work. American intellectual information in medicine is given away quickly, but all other industries do not. The EpiPen is a perfect example of how the government makes things worse then blames the manufacturer - but does that mess up the context? The FDA rejected 3 generic versions of the EpiPen recently. The FDA killed the competition. The FDA allows “regreening” of generic medications.
 
Currently we are left with a healthcare delivery system that is in poor balance. We need an American solution to an American problem. Hopefully in the future with new physician leaders, we will see more choices, and more competition among insurers, manufacturers, and products, so that we can see the lower prices. This can be accomplished, if many of the government induced costs and burdensome rules and regulations are scaled back.
 
Best wishes for a healthy and prosperous new year.

For more information about the Palm Beach County Medical Society, visit www.pbcms.org.

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