The cost of health care

Medical Waste

In his column “Better, Cheaper, Easier” (December 21, 2012), Charles Morris extols the wonders of the U.S. health-care system. He is overly optimistic. The whole system is wildly overpriced—largely the result of government obstacles. I have been a practicing ophthalmologist for over forty years. Here are just five examples of waste in the system (there are many more):

1. Medicare suffers from government price fixing. Anytime there is price fixing, providers will try to get around the fixed prices. Every time you visit a medical office or have a procedure done, there is a code assigned to which a specific payment is attached. Doctors are besieged by “coding experts” who offer to teach them how to increase their income by clever coding. Many large medical practices have a coding expert on the payroll. The trick is to code an office visit or a procedure with the highest-paying code that can be justified and to write down in the patient’s medical record whatever is needed to justify that code. There are thousands of codes. The system of codes should be simplified to ensure fair payments to all—not higher payments to better coders.

2. The average Medicare facility fee for cataract surgery performed in the hospital is $1,691. That money goes to a hospital...

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