Thursday, June 8, 2017
Book Review by Dave Racer
Building any kind of enterprise on the foundation of a false assumption is not only fool-hearty, it is expensive and can be dangerous. Greg Scandlen, in his must-read new book, Myth Busters: Why Health Reform Always Goes Awry, proves this in his first chapter.
I have read dozens of books on health care – reform, practice, theory, finance – and most have been helpful. I’ve written and/or edited 18 books about healthcare myself. Here’s my confession: I wish I had consulted Greg Scandlen on “Roemer’s Law” early on.
In 1959, Milton Roemer, MD, published a study that changed the dialogue about the delivery of and payment for healthcare. Roemer, who had advocated for a single-payer healthcare system for America during the 1950s, claimed to have “…found a correlation between the number of hospital beds per person and the rate of hospital days used per person,” as Scandlen reports it.
Roemer’s Law, succinctly states “A built bed is a filled bed.” The unproven idea assumes that people are eager to enter hospitals. Based on my own experience, I can attest to the fallacy of this myth.
Still today, healthcare reformers have bought into the idea that the supply of medical and hospital care has to be limited and/or controlled by third parties and governments. If not, they warn, doctors will prescribe as much care as possible to line their own pockets. Hospitals will overbuild and somehow go out and recruit patients to fill their beds. Scandlen destroys this myth showing that hospital occupancy rates declined “from 77 percent to 67 percent” during 1970-2000. And while anecdotal “evidence” may exist about doctors here and there over-prescribing out of personal greed, this does not call for a government takeover of healthcare.
The myth perpetrated by Roemer’s Law continues to be foundational for federal and state government control over our personal healthcare. It has led to strict regulation of the patient-physician relationship so much so that today, physicians are not free to practice as they believe best for patients, and patients have no clue about the cost of their healthcare.
Third-party payers and government bureaucrats have insinuated themselves into the financial transaction between patients and their physicians, hospitals, pharmacies, and medical device suppliers. Patients have almost no incentive to save money or shop for healthcare value when someone else pays their bills. Meanwhile, patients have to pay the price fostered by another myth, that insurance companies are fighting to reduce the price of care.
“You may have noticed in this sorry saga that all of it was pushed by academics and politicians, and all of it was imposed upon hospitals, doctors, employers, and insurance companies. Who is missing? The patient/consumer/employee/taxpayer,” [emphasis added] Scandlen writes.
In this great book, Scandlen destroys the arguments supporting 30 predominant myths, each of which contributes to the high cost of healthcare. This book needed to be in the hands of lawmakers and regulators decades ago, but I’m glad it’s available today. I recommend it to anyone, especially politicians and academics, that believes we ought to get the facts right before setting on the laws and regulations that govern our individual healthcare.
Scandlen, Greg. Myth Busters: Why Health Reform Always Goes Awry. First Printing. Pennsylvania: CreateSpace Independent Publishing Platform, 2017. 160 Pages. Paperback.