Idaho’s problem with its healthcare system didn’t start with Obamacare; it started long before that. The insurance companies and medical groups — or as we call them, the medical mafia — have been sucking the life out of Idahoans for years, and no one has said much about it until the decision to institute a state healthcare exchange in our state in November of 2014.
We actually counted the campaign contributions by the insurance companies and medical associations which plied our legislators into voting for this exchange. The amount of these contributions that we counted came to over a quarter of a million dollars, not including personal monies from officers of these companies.
This cartel has a lock on the in-network doctors in the Treasure Valley area which makes it difficult for competition to enter the market. It’s time to break the back of this cartel, to allow competition across state lines, and to force these hospitals and medical facilities to publicly post prices for the procedures they perform.
Would you believe that Blue Cross is a non-profit corporation and that, according to Idaho Law, the chief executive does not have to disclose his salary? We are all aware that, to control the cost of medical care and restrict competition, St. Luke’s Hospital has been recruiting the Doctors groups in the Treasure Valley for many years. Does anyone remember the Saltzer Group that St. Luke’s was forced to divest after being sued by the Federal Government under the Sherman Antitrust Act?
Hospitals have been consolidating these groups for years and offering the Doctors higher salaries and bonuses to join their complex of physicians and then charging higher rates on just about everything you can think of year after year. Why is it that in Boise, Hernia Repair Surgery costs an average of $1,650 while St. Al’s in Meridian charges $9,302.75 for a person who is over 5 years old? St Luke’s doesn’t post their costs — you actually have to call them to get an estimate.
What we are saying is that there is no transparency when it comes to the cost of medical care and the price is always negotiated between the insurance company, the medical facility, and the doctors. Why is it so difficult for St. Luke’s to post a simple schedule of costs online? We know it can be done as Oklahoma City Surgery Center offers this kind of price transparency, posting guaranteed all-inclusive surgery prices online. Even St Al’s offers a price list online.
Another question: Why don’t the insurance companies offer health insurance policies in Idaho which include coverage for complementary and alternative care as they do in Washington State? Even the Affordable Care Act offered these options under section 2706.
Health care costs in the U.S. are currently running at about $2.5 trillion per year and, while acute care is an important part of medicine, it is not the only part. The missing parts are disease prevention and health creation. The way to solve these problems is through the use of integrative medicine which includes a multi-disciplinary team of licensed healthcare providers who can offer effective treatment of chronic diseases and enhance health promotion.
These licensed professionals include naturopathic doctors, chiropractors, acupuncturists, nurse practitioners, nurses, midwives, nutritionists, and massage therapists. This group of professionals are usually referred to as complementary or alternative medicine (CAM) providers, but they should actually be called integrative health and medicine participants.
The objective is to get people healthier and thereby avoid the high costs of chronic diseases. Seven of these preventable chronic diseases — cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions and mental illness — cost our economy $1.3 trillion per year including the cost of lost productivity.[1] It should be noted that Complementary and Alternative (CAM) users were 64% more likely to report their health had improved over the last year,[2] primarily because CAM practitioners counsel patients more frequently with the promotion of good health than do conventional providers. Over 73% of CAM users surveyed reported making behavioral changes like eating better and exercising more. Much of this is because their CAM practitioners are skilled in motivating lifestyle modification.
The impact of diet and exercise changes was demonstrated in a study of diabetes where 3,234 people at high risk were picked at random to take the drug metformin or to engage in a lifestyle modification program. The onset of diabetes was cut by nearly 60% in the lifestyle group and the lifestyle group also proved more cost effective at $8,800 compared to $29,900 for drug intervention per quality-adjusted life year.[3] Unfortunately, these lifestyle programs are seldom or inconsistently covered by insurance.
Contrary to popular belief, CAM creates better outcomes for the chronically ill and this has been evidenced in thousands of studies including randomized controlled trials that have been published in top medical journals. They have consistently demonstrated superior outcomes compared to the usual conventional care. For instance, colon cancer patients who received a treatment protocol of acupuncture, traditional Asian medicine, and vitamins had a 60 – 82 percent survival rate at five years compared with a 7 – 8 percent survival rate among patients receiving conventional care.[4]
In many European countries, conventional doctors are additionally trained in CAM medicine using integrative approaches and they have incorporated CAM into their national health care systems. Studies have shown better outcomes and lower costs as a result.
Twenty percent of Idaho’s population are on — or should be on — Medicaid, and we are all aware that President Trump’s current budget calls for cutting further increases in Medicaid expenses. This will mean less money to take care of those who are unable to obtain their own health insurance policies. We need to start looking at how we deliver healthcare in our state (and in our country) because it is evident that what we are currently doing is not working. We wouldn’t rank number 37 in the world if it was.
We have 2.5 practicing physicians in the U.S. per 1,000 people in comparison to the Organization for Economic Co-operation and Development (OECD) average of 3.2. We also have one bed less per 1,000 people than do other members of the OECD. It does not take a genius to figure out that we need more conventional doctors as we will be short an estimated 90,000 by 2025.[5]
In Part II, we will discuss the benefits offered by complementary and alternative medicine and how they can be integrated into our healthcare system, saving us billions of dollars nationally.
[1] An Unhealthy America: Economic Burden of Chronic Disease. Milken Institute 2007
[2] Use of complementary and alternative medicine and self-rated health status: Results from a national survey. J Gen Intern Med. 2011;26:399-404. doi:10.1007/s11606-010-1542-3.
[3] Diabetes Prevention Program Research Group. The cost-effectiveness of lifestyle modification or metformin in preventing type2 diabetes in adults with impaired glucose tolerance. Ann Intern Med. 2005 Mar 1;142(5):323-32
[4] Colon cancer survival with herbal medicine and vitamins combined with standard therapy in a whole-systems approach: ten-year follow-up data analyzed with marginal structural models and propensity score methods. Integr Cancer Ther. 2011 Sep;10(3):240-59. doi: 10.1177/1534735411406539. Epub 2011 Sep 30.
[5] https://www.washingtonpost.com/news/to-your-health/wp/2015/03/03/u-s-faces-90000-doctor-shortage-by-2025-medical-school-association-warns
