Over the Hill

We need more competition in the health-care field

Special to The TribuneOctober 31, 2013 

Phil Dirkx

A big billboard along Highway 101 in Templeton says, “Bladeless Lasik, $1,500 per eye.”

My first thoughts were “tacky” and “unprofessional.” I can remember when doctors bought only business-card size ads, and never mentioned prices.

I recently read a doctor’s ad that had appeared in the Paso Robles Leader newspaper on Nov. 10, 1888. It said, “Dr. J. H. Glass, Physician and Surgeon. Office in Adams Block on Twelfth Street. Calls by telegraph promptly answered.”

Still, that Bladeless Lasik billboard stuck in my mind and slowly changed my opinion. What if hospitals, doctors and laboratories ran ads touting their low prices? Could the price competition force prices back to sane levels?

Today’s medical and drug prices are sickening. The March 4 Time magazine was almost entirely devoted to a special report titled “Bitter Pill: How outrageous pricing and egregious profits are destroying our healthcare.”

It said that between 1960 and 2010 our health-care spending grew five times as much as our economy did (as reflected in our gross domestic product). It reported that Americans spend twice as much on health care as the Japanese do, but we still die an average four years younger.

The report was written by Steven Brill. He related several case histories including Emilia Gilbert’s. She was still repaying the $9,418 bill she got for an emergency-room visit in June 2008. It included $6,538 for three CT scans.

She’s is now 66, so in 2008 she didn’t qualify for Medicare. If she’d had Medicare, the hospital would have received only about $825 for all three CT scans.

But Brill doesn’t favor expanding Medicare to all ages. He thinks hospitals could survive it but fears the lowered incomes would discourage doctors and would-be doctors. Instead he suggests strengthening antitrust laws to prevent any one hospital from dominating an area and being too strong for insurance companies to bargain with over hospital charges.

He also recommends a 75 percent tax on hospital profits and an extra tax on non-doctor employees who are paid more than $750,000 per year. And he wants to shorten the patent protection on new medicines.

I doubt Congress would ever enact his proposals. The Time article said that between 1998 and 2012 the drug and health-care-products industry spent $5.36 billion lobbying Congress.

I fear our only hope is for the hospitals and drug industries to fight price wars like gas stations used to. Bring on medical cut-throat competition. It’s the only power left that can regulate health-care prices.

Phil Dirkx has lived in Paso Robles for more than five decades, and his column is published weekly. Reach him at 238-2372 or phild2008@sbcglobal.net.

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