Wilmont Kreis

In summary, the healthcare system has become cumbersome to the point of being dysfunctional. Our proposed new system, which I originally endorsed, will clearly not solve things. As it is now it is also overly complicated with too many moving parts. There is clearly no perfect solution, but we can do better. More next time. Read More 

When Medicare and Medicaid arrived, the pot became much larger, and possibilities to increase income improved. Read my three books THE CORRIDOR, THE PAIN DOC, AND THE LABYRINTH for great examples. At the same time, the insurers and now the government began to fight back with deductibles, co-pays, and piles of bureaucracy and paper work. When I first entered practice the three-man group had all the billing done by one part time employee armed with a pencil and a pad of bills. Now such a practice might have four or more full time people with computers to do the same work. This type of inefficiency has invaded every corner of medicine. Read More 

Insurance companies were very clever, but in general physicians are a very intelligent group. They would not be where they are today if this was not so. New ideas to “game” the system arrived, creative billing, always doing the most expensive procedure, streamlining systems to see more patients. I do not claim this included all physicians, but it’s very easy to rationalize using the newer, more costly, but not necessarily superior diagnostics or treatments. Read More 

It did not take long for employers and insurers to take notice rising fees, after all, they were the payers. Insurance companies began to ask doctors and hospitals to “participate in their plan.” In return they would send patients their way and, at first, even pay the participating provider more. Once the “hook” was set, the fees began to drop, and if unhappy providers “dropped out” they would not be paid at all. Read More 

Unfortunately over the ensuing years two predictable things occurred. With more secure payment, technology soared and with it price. Secondly, people came to expect the best and wanted the newest and most expensive care and drugs even when their physician told them they were more costly and not any better—or even inferior. In addition, patients and providers wanted coverage for office visits, drugs and other things. Of course, doctors, hospitals, drug companies, etc. had no qualms about raising price. Since the patient wasn’t paying, he didn’t care. Read More 

In the mid-20th century, technology blossomed along with cost. With the post WWII industry came the idea of “hospitalization insurance” to cover the increasing cost of hospital care. Organized labor soon saw this as a worthwhile benefit and soon many hourly workers had this wonderful security. In the early days, employers were also happy as they could satisfy the workers with relatively little cost.
Now it’s your turn. Let me know how your rate your current “healthcare insurance”. Read More 

Everyone remembers their grandfather (or great-grandfather) lamenting how the birth of his first child in the hospital cost $30. Doctors were dedicated, hospitals had community support, there was little expensive technology, and patients reached into their pocket for the money. THE CONSUMER WAS THE PAYER! Read More 

Since I began blogging (and writing) about healthcare fraud, I have been asked repeatedly, “How did we get into this mess and how do we get out?” How did the U.S. come to have healthcare twice as costly as any other country and still be ranked 37th in the world in healthcare (just below number thirty-six, Bulgaria)? Let’s spend the next few weeks investigating. Read More 

We hear regularly of drugs once thought safe now having serious problems, implants that were “the best” failing in a short period of time, or drugs widely used for years that are later found to have unexpected and sometimes disastrous long-term side effects. If this is not serious enough, we also occasionally hear of botched or ignored findings in the early research that if heeded would have averted problems, but the rush to market prevented this. This is usually not presented in the media with the same flair seen in the advertisements or release announcements. Read More 

The Labyrinth is now available on Kindle as well as print on Amazon.com