>>>I've suggested (among a lot of other things) that MD's were in bed with big pharma and I still that that that's true.
>>>At least here in Hamilton, NJ, the MD's I see just don't make enough money from their practices so they have to find other ways to pay the rent. Last year I had a >>pretty serious health bout (happy to say that I won) and my MD spent a lot of time with me in the hospital.
>>>I saw what Medicare paid him and I make more money doing a couple of simple SSRS reports than he did while saving my life.
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>I used to think it was Oscar Wilde who quipped "beware the poor physician" but I can't find the quotation now. It's still true but perhaps as a testament to honor, a majority of young MDs chooses not to fleece the system but to opt for salaried status. No longer are MDs the epitome of small businesspeople/partnerships who can innovate for the benefit of local communities; now they are waged shift workers who play no part in billing (so can wring their hands virtuously about costs without pressure to sacrifice their own income) and can head off at end of shift with "the system" responsible for any unmet clinical need. I've seen that elsewhere and it's a tragedy that I think now is past the tipping point in the US too.
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>>>Insurers, as you point out, have a perverse incentive. The more hospitals spend the more they make.
>>>As I've pointed, hospitals have become money pumps for political hacks.
>>>The CEO of a local hospital was formerly a dem political leader here in Mercer county. That's the norm now.
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>That's the American Big Business way. Healthcare is big business and with MDs driven from the field as gatekeepers and patient advocates, executive responsibility is to maximize revenue including selective boondoggles and favor. They're doing what they're supposed to do. Your objection should be to the corporatization of healthcare and loss of MD gatekeeper role that to this day in other health systems, is highly effective at controlling costs.
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>When I trained, physician parsimony, morality and intellect were linked so there is fulfillment in efficiency. We also considered that there is art and science in medicine, with most getting those around the wrong way so that the holding of hands is replaced by the reading of signals from machines with that called science. Such concepts are long gone in the frenetic pace of modern medicine with blunderbuss testing, liability defensiveness and massive non-patient time to manage electronic health records and payer demands.

And don't forget the cost of liability insurance and lawyer pay and huge settlements based on "junk science" ala John Edwards.