THE MORNING SHOW
Dr. Andy Lazris
Curing Medicare from a Doctor’s Perspective
Andy Lazris, MD, is a practicing primary care physician who experiences the effects of Medicare policy on a daily basis. As a result, he believes that the way we care for our elderly has taken a wrong turn and that Medicare is complicit in creating the very problems it seeks to solve. Aging is not a disease to be cured; it is a life stage to be lived. Lazris argues that aggressive treatments cannot change that fact but only get in the way and decrease quality of life. Unfortunately, Medicare’s payment structure and rules deprive the elderly of the chance to pursue less aggressive care, which often yields the most humane and effective results. Medicare encourages and will pay more readily for hospitalization than for palliative and home care. It encourages and pays for high-tech assaults on disease rather than for the primary care that can make a real difference in the lives of the elderly.
Lazris offers straightforward solutions to ensure Medicare’s solvency through sensible cost-effective plans that do not restrict patient choice or negate the doctor-patient relationship. Using both data and personal stories, he shows how Medicare needs to change in structure and purpose as the population ages, the physician pool becomes more specialized, and new medical technology becomes available. Curing Medicare demonstrates which medical interventions (medicines, tests, procedures) work and which can be harmful in many common conditions in the elderly; the harms and benefits of hospitalization; the current culture of long-term care; and how Medicare often promotes care that is ineffective, expensive, and contrary to what many elderly patients and their families really want.
When Medicare was created back in 1965, approximately 8% of our population was 65 or older and Alzheimer’s disease, now a major item on the Medicare tab, was not even a recognized condition. Current projections, however, estimate that by 2050, that number will rise to 20%—or some 88 million adults. Who will care for our elderly, and how will we be able to afford the $1.2 trillion doctor’s bill?
-Medicare is the most efficient, broad-based medical care system in this country, but it’s not without it’s problems
-What is wrong with Medicare and how can it be fixed?
-Why is it so hard to spend less?
-Medicare is generous paying for hospital care, stingy for home and palliative care. Elderly want care in home.
-Why do the frail and people with dementia do poorly in the hospital?
-How to tell whether a medical drug or procedure is of value to you?
-How does Medicare control the pool of doctors, primary care vs. specialization?
-Why do stents cost so much? Incentives for procedures, in-hospital treatment.
-Dementia now medicalized. Medicare money spent on technological care, not in ways that actually help the patient.
-Medical billings set by what highest paying insurance company pays.
-Emailer asks about doctor’s running tests and procedures on elderly people every 6 months. Protocol-based medicine and medicine by the numbers.
-Does having Medicare Part B mean you’ll be subject to more procedures?
-Home care costs paid out-of-pocket by patient but covered if in hospital or nursing home.
-Who pushes for the medical care? Patient vs. family desires.
-How much does medical spending help people? Approaches to cutting costs: rationing of care vs. only spending on what is helpful.
-Medical tests, drugs and interventions being a necessity vs. being the start of a conversation.Saving money by giving patients choices.
and so much more!
a docs perspective on curing the medical system and medicare, june 23, 2016