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“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Monday, March 17, 2003

    Read this for more about the choices docs are facing in medicine these days. Dr. Bradley is a family practice doctor who closed his practice and now works "fast track" shifts in the ER. Want to know why? Read his blog. I like. Oh, and the book he named his blog after, "Kill as Few Patients as Possible," is excellent. I highly recommend it.

    Got this email from a reader:

    I thought I would give you insights from an employer who has to pay for
    those expensive health insurance premiums. Health care costs are
    reducing wages, increasing prices and increasing unemployment.

    Here are the percentage increases Blue Cross has charged our company
    for the last four years-20 percent, 22 percent, 25 percent and 27 percent. 10 years ago, the
    annual cost to the company for family coverage was 1500 dollars. This year the
    cost is 9000 dollars. That is 4.33 per hour added to the cost of having an

    The employers have put pressure on insurance companies to reduce their
    premiums. The insurance companies have responded by prescribing
    treatments, limiting fees and approval for certain treatments....

    All true. In some situations now, employees are getting nasty surprises for treatments they thought were covered (as per the Wall Street Journal last week). One patient was trying to get a bone marrow transplant for cancer. The transplant and meds were covered, but the search costs for the donor were not. She spent several thousand dollars on a donor search. In another case, a patient developed breast cancer, which was treated... but when a tumor developed in the other breast, treatment for that was not covered. Insurance companies may be partially responsible for these scenarios, but the employers' coverage choices are part of it too. They're desperately trying to keep costs down so that they can stay in business. So that means that even people who are "covered" by insurance aren't completely covered.

    When things get this out of control, something has to give. I don't know what it's going to be - but I think that health care will be different in five years, and really different in ten years.



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