US Medicare Funds Headed Toward Insolvency
Florida Doctor Says Managed Care Middlemen Get Most Money
May 14, 2009
Chunks of the American health care dollar are being siphoned off by middlemen operating HMOs, says Dr. William J. Rand.
Obama administration officials warned that the longer it takes to fix funding of the giant Medicare entitlement program, the more difficult the options will be. The newest report warns that Medicare fund depletion, accelerated by the current recession, could come as soon as 2017.
Republicans pointed fingers at Obama for not trying to fix the present system, but Dr. Rand has testified before a Senate committee on the waste and inferior care of the present system. He was asked to review the health care plan for the Bush administration and gave specific recommendations that were not followed.
Managed Care Relationships
Dr. Rand said the creation of managed care middlemen who match patients and doctors creates incentives for profit-seeking venture capitalists and insurance companies who know and care little about providing excellent health care treatment.
This has, he said, become “a breeding ground for mediocrity and the instrument of physical and mental abuse of both patients and doctors. Managed care has become a patient distribution system, brokered by middlemen” in which “corporations are skimming off 30 to 40% of the patient care dollar,” Dr. Rand said.
HMOs Take Profits out of Former Health Care Dollars
Noting that 100% of the patient care dollar once went to care for the time and labor involved in providing quality health care to patients, Dr. Rand said that now only 60 to 70% reaches the health care providers. Ironically, some patients are being brokered back to the same doctors and hospitals they had before. The only difference is that someone in the middle is keeping part of the money: someone who has no medical training and gives no health care.
“Care of a patient must not be by the lowest bidder,” Dr. Rand said, noting some of the medical horrors he has witnessed have been the result of two minute exams, misdiagnosis and other cursory treatment by doctors who get paid literally by the head as though patients were cattle instead of people. In this scenario, all patients are treated the same when some are sicker than others, or have need of more specialized care.
Medical Break-throughs and Future Health Care Cost
One of Dr. Rand’s greatest fears is that this system he sees as profit-making, rather than geared to excellence in medicine, will divert money from medical research. He points out that 10 to 15 years from now Americans should not have to be paying for Alzheimer’s disease, diabetes, heart attacks and strokes. “These now costly diseases will be a thing of the past as they yield to scientific progress,” Dr. Rand says, pointing out that “medical expenditures will fall as each disease entity is eradicated.”
Dr. Rand’s Perspective
Dr. Rand, an ophthalmologist, founded the renowned Rand Eye Institute in Pompano Beach, FL, one of the largest eye surgical centers in the country. He knows the health care system from many angles. He brought his aged father, who suffered from Alzheimer’s for many years, into his home and, at great expense, had around-the-clock caregivers attend to him. His young diabetic son has required at least four insulin injections every day to keep him alive since he was 14 months old. Dr. Rand has taught thousands of American and foreign eye surgeons, is a director of the Diabetes Research Institute Foundation and has been an advisor to both Republican and Democratic leaders.
(A companion article gives Dr. Rand's suggestions for fixing the health care system.)
SOURCE: A copy of U. S. Senate testimony by Dr. William J. Rand addressing the health care system.
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