Opinion: Healthcare Economics-Is Dr. Mackool Part Of A Trend?

August 15, 2011

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Dr. Ari Weitzner

I just saw a letter from a patient where Dr. Mackool, arguably one of the best cataract surgeons in the world,  no longer accepts Medicare. His resignation puts into sharp focus the problem with the healthcare reimbursement system- it pays a top notch surgeon like Dr. Mackool the same as an average surgeon or a surgeon fresh out of training with a fraction of his experience.  In my humble opinion, healthcare is like any other commodity- competition lowers prices and improves quality. And if doctors are paid the same regardless, you’ll have higher prices and lower quality. I therefore agree with the overhaul of health insurance- instead of setting fees to doctors, better to give Americans insurance premium price support and let Americans choose their insurance plan. You will then see an explosion in doctor-rating services (like Healthgrades, AngiesList etc.), and patients will choose insurance plans that have the better doctors. Institutions like the Mayo Clinic and Cleveland Clinic will contract with insurance plans all over the country. Expensive insurance plans that offer acupuncture, low co-pays (which encourage over-utilization) etc. will go out of business.  Bottom line- we need more capitalism in healthcare. So, if Medicare patients want access to the better doctors, they have to realize that the system is completely broken and needs an overhaul, or the better doctors will simply follow Dr. Mackool’s lead. Lastly- payments to doctors is only about 10-15% of healthcare dollars. We still need to tackle the high cost of technology, drugs and bureaucracy.

 

 

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3 Responses to “Opinion: Healthcare Economics-Is Dr. Mackool Part Of A Trend?”

  • Braden Talbot
    on August 20, 2011 9:45 pm

    What a refreshing take on healthcare economics. End government medical bureaucracy.

  • ari
    on August 17, 2011 8:51 am

    i hope to follow in your footsteps in the near future. unfortunately, here in nyc, the competition is so fierce, it’s hard to do it. in a way, i hope that congress slashes doctors’ fees 30% like it threatened last year–that way, everyone will drop medicare.

  • David Richardson, MD
    on August 16, 2011 9:26 am

    I will also be opting out of Medicare and all third party insurance as of January 1, 2012.