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Good-Bye from Bizarro World

Rick Johnson, for HealthLeaders Media, February 14, 2008
Judging by recent happenings in the healthcare industry, I must have somehow slipped into the parallel Bizarro World.

In case you're not familiar with the Bizarro World--or Htrae--allow me to explain briefly, at the risk of exposing my inner nerd. The Bizarro World, as illustrated in Superman and other D.C. comics, is a backwards planet that is socially the exact opposite of our Earth. Down is up, black is white, good-bye is hello, and most importantly wrong is right.

I'm generally a well-balanced guy, but clearly I must have landed on D.C.'s Htrae. Why else would I see stories like these:

More physicians lead to worse care: As we anticipate millions of baby boomers getting older, sicker, and needing more medical care, some have concluded that we need fewer--not more--physicians. This article in The Atlantic (online) summarizes this position well. In the meantime, the number of primary care providers is dwindling and community hospitals across the nation--especially in rural regions--are beginning to see signs of a physician shortage. The story rightly points out that too many docs in urban markets can drive up the cost of care, but then the piece leaps into the Bizarro World when it claims that for the good of the nation's health we should clamp down on the number of physicians we train.

Bizarro Bush's budget: I wrote in last week's column about the president's proposed $3.1 trillion budget that calls for slashing that albatross entitlement program, Medicare. But what I didn't note is the negative effect the proposed 2009 budget would have on teaching hospitals. The Association of American Medical Colleges argues the plan would cut indirect medical education payments by more than 60 percent, with devastating effects on medical education in our country. Physician training and medical research clearly are not priorities on this backward planet I find myself on.

Blue Cross' bizarro biz plan: California's largest for-profit insurer had already battled bad press over unfairly canceling policies. What would be a good PR strategy? Well, on the Bizarro World you don't want good publicity, so the Blues plan sent a letter to providers telling them to report discrepancies between their patients' medical conditions and the information in their applications. In a sign that gives me some hope that I'm still home, the Golden State's doctors riled against the plan and the insurer back-peddled.

Why would ERs ever be a good safety net? The Los Angeles Times--the Bizarro World's favorite publication--picked up a study by the American College of Emergency Physicians that reported one in five emergency room physicians claim they "knew of a patient who had died because of having to wait too long for care." The article concludes that ERs lack the capacity to serve as the nation's healthcare safety net. One problem, of course, is the unreasonable expectation that ERs provide primary and often charity care rather than what they are designed to do.

Obviously, all of these disconnects are because I must have switched places with bizarro Rick, and they probably make perfect sense to you. Should I go missing, don't fear; I'm just off looking for a way back to my home planet. Until next time, hello.


Rick Johnson is a senior editor with HealthLeaders Media. He can be reached at rjohnson@healthleadersmedia.com.

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