Lola Butcher

The California patient-dumping scandals highlight the fact that America has no health care system. Rather, care is provided–or not–by a bunch of disconnected providers who occasionally throw up their arms in despair and throw patients into the streets. In some cases, literally.

The fact that this happened even once should make every member of the health care industry–and that includes policymakers, payers (and, yes, health care writers)–ashamed that this could happen in our country. The fact that it has happened repeatedly is a cry for leadership to create a real system in which patients are not abandoned.

Hospitals love to brag about saving people’s lives. But those brags ring hollow when patients are being mistreated because hospital administrators do not know what to do with them.

The inevitable never disappoints.

Everyone who understands health care agrees that primary care physicians should get more money. And anyone who is paying attention to the big payers–the federal government and employers–knows that they want a zero-sum game. 

That means other health care providers will get less money if the PCPs get a raise–and that means squawking is inevitable.  Surgeons recently emitted a squeal by sending a letter to the Medicare Payment Advisory Committee protesting its recommendation that PCP pay rates should be increased in a budget-neutral way.

The Wall Street Journal’s terrific Health Blog interviewed Christian Shalgian from the American College of Surgeons to learn:

“We as the surgical community don’t have a problem with increasing payments to primary care physicians…(but) when MedPac is making a recommendation to do it in a budget-neutral manner, that means we as a surgical community will be cut in order to increase payments to primary care physicians. We have a fundamental problem with that.”

And so will lots of other physicians. Sit back and watch the “Who’s the most important physician?” debate unfold. It should be fun.

Now we’re getting somewhere…. Consumers Union  announced this week that it will rate hospitals using the Dartmouth Atlas of Health Care data.

Because of CU’s expertise and reputation, this is likely to finally give the Dartmouth Atlas attention that it deserves. Many hospital CEOs should be very worried about this development, as it will allow patients to quickly and easily identify hospitals that perform poorly in certain areas. Listen for the howling to begin.