Health Care System Hijacked
In our ongoing discussion of how our Health Care system (or more aptly-named “Sick Care” system) has been hijacked by those who profit most from it, we interview Dr. Dave Janda this week.
He recently and very publicly announced he was walking away from his clinical practice in protest of how poorly the quality-to-cost ratio has dropped in his profession.
Dr. Janda’s perspective is informed not just from his years as a practicing surgeon and researcher, but also through his involvement with health initiatives for the Reagan and Bush I administrations, as well as the National Institute of Health. His overall conclusion is that the health system now exists to serves its corporate and administrative owners, to the detriment of patients and practitioners:
I decided I needed to retire from medicine the clinical practice of medicine because I truly felt that I could no longer take care of people the way I was trained to take care of people in a high quality manner. Now I have been involved 27 years in the clinical practice of medicine. I have battled insurance companies every day of my professional career since I got done with my residency program 27 years ago. The formula that insurance companies use and government uses to cut healthcare costs is the most inhumane and unethical means of cutting costs; and that’s the rationing and denying of care. It’s what I have fought against my entire career. My approach is, if you are really sincere about cutting healthcare costs, quit trying to deny the availability and access to care — which is what insurance companies try to do. If you’re really sincere about cutting healthcare costs prevent healthcare needs. It’s the single greatest bang for the buck.
Now you’re not going to learn that in medical school. I didn’t. And here is the bottom line – prevention is not stressed in medical school and internship and residency and post residency activities because there is no money in it. Where all the money comes is waiting for the injury to happen, waiting for cancer to happen, waiting for the cardiovascular event to happen and then dealing with it. Let’s face it – in the west and in particular the United States and Canada, we’re good at dealing with problems once they occur. But when it comes to prevention, I can tell you the blowback I have gotten over the past 30 years in working in prevention is enormous.
You would also think that the insurance companies would love prevention. I mean when I first started on this 30 years ago, I was pretty naïve. I thought gosh, we are starting this non-profit research institute, I’m sure the insurance companies will help fund it. I can tell you, in 30 years of being in that organization the Institute for Preventative Sports Medicine, we never got one penny of funding from the insurance industry. And about 15 years ago I got a call from an insurance executive in New York who said, “I’m flying out. I want to meet with you.” Finally. They finally figured it out. They finally saw that hey look at these guys. They spend a thousand bucks one and it saves $2 billion. Finally, they’re going to embrace us. There I am, sitting at the desk. This big insurance executive walks in, looks at me and says, “Janda, let me tell you why we hate you.” Direct quote. I say “Hate me?,You should love me. I should be your poster boy for finding a way to help people and save costs”. He goes, “Son, you don’t understand how the insurance industry works. Let’s say the cost of insuring you is $1000. The most — according to the bean counters and the Feds — that we can tack onto that is 7% so your premium is $1070, right?” I agree. He says, “Let’s say we do all those things you talk about to save costs. We figured it out with our actuaries: the actual cost of insurance is no longer $1000 bucks, it drops to $100 bucks.” He goes, “Now, son even though all doctors are morons,” — a direct quote (when it comes to financial matters, he might be right on that) — “7% of 100 is what? Seven” . He goes, “Well, wouldn’t you rather have $70 instead $7?” He goes, “Let me tell you how the health insurance industry works: The higher costs go, the bigger cut of the pie we get. And that’s why we will do everything in our power to shut you down and shut down your prevention work.”