Letter: States must control medical costs

After savoring the latest news about Anthony Weiner on cable channel news (the latest poll, the panel of pontificators —- it’s as if Weiner was created especially for cable news), I switched to C-Span 3 just in time to catch the opening presentation at the National Governors’ Conference (Aug. 2).

It was by Dr. Jeffrey Brenner, of Camden, N.J., a primary care physician working to bring adequate care to the Medicaid recipients of this poor city. He cited the usual suspects — the high cost of everything in medical care, the overuse of technology, inadequate control of repeat hospitalization of chronically ill patients and more specifically the astronomical cost of emergency room care.

No magic bullet is available, but he promoted more frequent home care of the chronically ill with complicated, multiple problems, who account for an inordinate amount of medical care/cost. The corollary of more nurse visits to patients’ homes is decreasing the number of hospital beds, which makes more nurses available for patient care instead of paper-shuffling and computer watching.

States have the power to control costs by managing contracts for medical care, but few have the stomach for it. This entails taking on the hospital industry as well as those who oppose cost control philosophically. It is not easy to decide which of these tasks is the more daunting, but there is little chance for change without it.

Even morbidly ideological governors showed real interest in Brenner’s presentation (would you believe that Arizona Gov. Jan Brewer has tackled this issue?), obviously because of the budget-bashing nature of medical care they must address. I looked in vain for Gov. Bobby Jindal at this meeting, but he was nowhere in sight. In Louisiana only time will tell how privatization will affect our medical care quality and cost.

With Congress not even allowing Medicare to bargain with pharmaceutical companies to reduce medicine costs, there is little real possibility of their embracing overall cost control. However, a number of governors have recognized the obvious, and are making real efforts to tackle the ever-increasing costs.

I can’t finish without giving a shout-out to Mike Thibodeaux for his (letter Aug. 17) stirring, if apoplectic, call to arms against Obamacare. It is a marvelous demonstration of the mentality of the Tea Party/CPU (conservative parallel universe) inhabitants. By their monumental intolerance of any deviation from their party line (Sen. Tom Coburn a RINO?!), they have effectively crippled the Republican Party in national elections, delivering the presidency and the Senate to the Democrats by nominating unelectable (and frequently bizarre) candidates.

Thanks, Mike!

Herb Dyer

retired physician

Baton Rouge