Judging from the tone of the front-page story in yesterday’s Bulletin, you’d assume St. Charles and local physicians have come up with the magic cure for what ails our local health care system.
The doctors and St. Chuck’s have joined forces “to adopt a shared vision for improving health care in Central Oregon,” the story reads. “The group of physicians, known informally as the Physician Alliance, and the board of directors of Cascade Healthcare Community, the parent company of St. Charles hospitals, have committed to working together to create an integrated health care delivery system that would enhance care, reduce costs and improve the health of the community.”
Reading between the lines of this syrupy rhetoric, it’s easy to see what’s really going on here: St. Charles has made a shrewd strategic move in its ongoing war against Bend Memorial Clinic.
“I think our community is sick and tired of the rancor in the medical community that has been so evident,” said Dr. Michel Boileau, a leader in organizing the physicians’ group.
“Rancor” is a bit of an understatement; BMC and St. Charles have been going at each other like the Crips and Bloods for years, battling over the medical turf of Central Oregon. The results have not been healthy for the innocent bystanders (patients) -duplication of services, lack of cooperation and communication among doctors and facilities, unnecessary and expensive and sometimes redundant testing.
With its latest move, St. Charles has thrown down the gauntlet to BMC’s doctors: Either join in our effort or look like you’re against better medical care.
“We have a chance to build something new here, and all physicians who agree with the philosophy are invited to join,” Boileau said.
Mike Bonetto, a spokesman for Cascade Healthcare Community, was considerably more blunt:
“What we’ve put out there is mom and apple pie. If you’re not aligned, you’re going to have to explain why. You’re going to have to defend that decision to your patients.”
It will be nice if this initiative succeeds in ending the regional medical turf war. But in the long run we think it’s going to fail, because it doesn’t address the root problem: our profit-based, competition-driven medical care model.
Under that model, doctors are, in effect, piece-workers; they get paid for each patient they see or procedure they do, rather than being on a salary (unless they work at the Mayo Clinic or a few other unusual establishments). So their financial incentive is to shuttle patients in and out of the office door as fast as possible.
Because the present model puts hospitals and clinics in competition with each other, each competitor feels it has to have the same high-tech gizmos its rivals have. If one of them has a CT scanner, the others have to get CT scanners too or risk losing business to the competition. If one has an MRI machine, they all have to have an MRI machine.
Since that hardware is too expensive to just sit there, doctors have to make sure it gets used – the more often the better. And as a further motive to make sure it gets used, the doctors themselves often are part-owners of the facilities that do the CT scans and MRIs.
The “free marketplace” model of competition and profit maximization supposedly is what made America great, and in many ways it has. But in the area of medical care, that model has failed totally. Whether America’s political leaders have the imagination, or the balls, to replace it with something that makes more sense remains to be seen.
This article appears in Jul 23-29, 2009.
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CHC and BMC are a sorry sacks. They are about the bottom line and treat their employees like indenture servants to them. After all if you live in central Oregon than you only have them as a choice. They slashing pay and benefits for years now they are just obvious about it because they feel the economy is the perfect opportunity to stick it to them again. This co-op is another way for them to reduce your choice in the market. Now they wrap it in the “for the good of the patient” but you hit the nail on the head. It is another way to grab bigger control of the medical community. And if this was a true free market would this be a good place to look at some possible anti-trust or some other monopoly busting setting. Remember that CHC either owns or has some sort of “agreement” with every hospital in central Oregon.
As for politicians, not only do they not have the sack to replace it. They have allowed the AMA, big Phamra, and the insurance industry to spread lies about how change well cost lives and get in between them and their doctor. People trust their doctor to make the best medical choice for them. Many people also think that their car salesman help them get the best deal too.
Welcome to company medicine where we all owe the company store. Much like it was in the days of working in the coal camps. If you need medical help they are going to take it out of you ass at the price they say not a price set by competition as there is none in town.
concerned
Having worked in the medical industry on both sides of the fence, I saw and still see the greed from those that are supposed to “care” about providing care to those in need. Nothing has changed either from the facility or physician side of this issue. I don’t deny all deserve to earn a decent living, make a profit, however, there are far too many, including myself who cannot afford insurance. Ultimately, those of us who find we’re in need of medical care often won’t seek care only making health issues worse. A feeling of despair, to be put in a position of failing health and possibly losing the security of a low or moderate home and any meager savings held. Does anyone care? Unfortunately, apparantly not. The bottom line for facilities and physicians is dollars, not “the good they can provide.” Because there is no ’emotional’ connection by either, they will continue the greed at any cost. They deserve kudos for accomplishments, and a “shame on you” for putting greedy profit above human kindness, losing compassion for an ailing human being. Many lose at their game playing, for family members of the sick watch their loved one wilt away, losing home to bankruptcy, selling what they have to pay for all of those tests, procedures, medicine etc…. and when all is gone, “who really won?” In the end, “who” had the better quality of life according to the oath taken? Certainly not the patient who couldn’t afford health insurance or didn’t quite qualify for a state program.
A very sad thought for someone with a heart and soul..