Cream Skimming — Do We Need a Trigger Warning?

Cream skimming triggers many doctors and all single-payer activists. It might be one of the most hated, uncollegial behaviours in medicine.

No one likes a colleague who takes all the easy patients and leaves the hard ones.

No one likes the idea of for-profit hospitals skimming all the easy cases and leaving the hardest ones for the public hospitals.

Why Cream Skimming?

Cream skimming exists because some patients are hard and others easy, even though each patient often carries the same fee. On top of that, some easy medical problems carry higher fees than harder ones.

For example, a toddler with a tiny laceration generates a visit fee plus a suture fee. It takes a few minutes to fix. Toddler leaves with a sucker in one hand, a wave in the other, and a huge smile on her face.

A weak and dizzy 80 year old with 6 non-English-speaking relatives often generates the same visit fee as the toddler, minus the suture fee. No smiles, suckers or happy parents.

It happens in all specialities. Cream exists: Some patients carry less risk, pay more, and require fewer brain cells to see.

Path to Incompetence

Committed cream skimmers cannot exist for long. No one became muscular by doing easy things. Easy guarantees mediocrity at best.

Cream skimming is the path to flabbiness in medicine. Doctors get mad at  colleagues who “scoop all the easy patients.”

Doctors think that cream skimmers get ahead. Continue reading “Cream Skimming — Do We Need a Trigger Warning?”

Cost of Waiting Under Single-Payer Healthcare

Money cannot capture the cost of waiting. Single-Payer healthcare separates costs and benefits.

Politicians and bureaucrats draft attractive policies but ignore the costs of their plans.

Waiting for care robs the Canadian economy of almost $15 billion. Patients lose over $2 billion as individuals.

But money misses the most important robbery.

Many patients awaiting hip replacement cannot play with their grandkids and struggle with basic bodily functions.

Self-employed plumbers cannot crawl under cottages to fix plumbing, while they wait for new knees.

Single-Payer Costs

Waiting for care costs. Most of the costs cannot be measured. Every Mom, Dad, and business-owner puts a huge burden on all the people who depend on them, when they are forced to wait for care.

I received this from a physician: Continue reading “Cost of Waiting Under Single-Payer Healthcare”

Physicians Promote Victorian Virtues

I just finished Whole30.

The diet eliminates everything except meat and vegetables for 30 days.

Whole30 worked well and felt like death.

Doctors promote diet and exercise, all the time.

Dieting takes discipline. Discipline is a virtue. Ergo, doctors promote virtue.

Virtue is good. The lack of virtue is bad. Thus, doctors dictate morality on unsuspecting patients.

How dare they! 

Doctors do it all the time. In fact, special billing codes pay doctors to promote health. That is, government pays doctors to promote virtue.

Wait a second! That is not true. Continue reading “Physicians Promote Victorian Virtues”