CBS Attacks On Medical
Profession Justified
Daily Observer
July 26, 1976
Recently television
treated its audience to an hour-long expose entitled “Money and Medicine” or
vice-versa. It depicted the rip-offs in the
various health schemes, Medicaid, Medicare, and HMO’s.
The show
demonstrated medical parlors set up in the east
There was
no proof by CBS or Frank Reynolds, the reporter, that the patient was not
getting reasonable care. Certainly, the
patients that were interviewed did not complain. The bald fact is that they probably – as a
mater of fact, undoubtedly – were receiving more and better care than they had
ever received prior to the formation of these establishments.
The fact
that billing to Medicaid might amount to hundreds of thousands of dollars is
really not important enough to be attached by pious medical functionaries
speaking from government pulpits, who claim this or that was unnecessary.
The
economic facts are that Medicaid pays too small a fee for services to permit
profitable practice. It actually is a
system wherein the doctor subsidizes the system with personal service in
addition to his taxes. However, if a
number of services can be performed, then the structure can become
profitable. If, therefore, the patient
can get his callouses pared, the tartar taken from
his gums, shots for his kids, blood pressure checked, and some physiotherapy to
relieve pains so he can go back to work, then the system is working, the cost
is reasonable, and CBS nor the public has a complaint. then the Medicaid
parlors are practicing preventive medicine by cleaning the patient’s gums,
prevention recessing and erosion and pyorrhea that would cost the taxpayer more
for future dental work.
In another
segment, there was an exposure of the laboratory set-up. A Dr. Brown of Metpath Laboratories, “exposed” kickback operations. Actually, if CBS investigated Metpath, they might find that the cost of Metpath service to the doctors and to referring
laboratories differs by a considerable factor from the price they charge a
patient for the same services. Certainly
the walk-in price for laboratory tests is not the same as the bulk price. This might also be termed a kick-back.
Dr.
Brown’s sanctimonious concern for the taxpayer was touching, but the net result
of knocking the competition is to make his outfit larger.
Now the
fact that there might some chicanery in any laboratory transaction funded by
the government, or by anyone else, is testimony to man’s second nature. But the few cases of thievery that Dr. Brown
exposed are not representative of the laboratory profession in New Jersey,
because Dr. Brown and two or three other giants control about 90 percent of the
work that is not done by hospitals.
In fact,
the new technology forces companies to seek more business, even “break-even”
Medicaid business, just to stay alive.
The government as giant purchaser, in seeking the lowest price and
forcing doctors to charge the lowest price available in the community, is in
reality a monopolistic purchaser that creates monopolistic providers.
In the
third part of the program, CBS exposed the rip-off by some HMO’s.
There were
a number of speeches by pious bureaucrats waxing indignant about the way that
the government tax money was being spent.
The audience could justifiably have come away with the impression that
the entire medical system was created just to rob them.
The
ultimate thrust of the program was that there is nothing wrong with medicine
that can’t be fixed by policing it to assure that there will be no stealing,
waste or irrelevant service rendered; that the tax dollar will be well-spent if
behind every doctor we place a policeman – who could even be dressed as a nurse
or an orderly. CBS leaves the audience
with the impression that this would be cheaper than the current cost of medical
care.
CBS
introduced the concept of therapeutic guidelines (now law) into the program, as
if the complexities and sophistication of medical practice could be reduced to
outline form.
I daresay that
the definition of what constitutes necessary medical care will not be defined
by humane considerations so much as by the purse. It should not go unnoticed that, by
advocating policing, bureaucracy perpetuates its own jobs.
The
concern of CBS with my tax dollars is touching.
I would like a similarly searching program on the squandering of tax
dollars on the deductible luxuries corporations indulge themselves with. Many a medical fee could be paid with those.
The system
that closes seven hospitals to keep Yankee Stadium open is corrupt, and will
not be purified by casting its guilt at others.
The attack
was scurrilous, and the AMA is remiss in not buying an hour on television to
look at the other side of the coin about the good medicine that is practiced,
the honest doctors, the decent laboratories.