Quality Medical Care is Cost Effective Medical Care


By Robert Knutzen, PNA CEO

The chaos resulting from the rollout of the Affordable Care Act (ACA) has obscured a serious issue facing an unsuspecting public going forward.

"The Wall Street Journal attempted to explain the issue in a front page story by Timothy W. Martin on December 30, 2013. The gist of the story is best explained by the first paragraph:


"Thousands of people are cramming in tests, elective procedures and specialist visits before year's end, seeking out top research hospitals and physician groups that will be left UNAVAILABLE to some 2014 insurance plans under the new health law, health-care providers say."

The skills available from all physicians and hospitals are not interchangeable. Insurance Plans that exclude access to "Centers of Excellence" are not offering quality care nor are they saving money. It is clear to every observant person that highly specialized centers of excellence have been created all over the US in order to train the best and brightest in the medical field and to improve their skills and delivery of service. Centers of; bariatric surgery, vision care, trauma care, cardiac care, and many many more are available to those who wish to take advantage of the improvements being made on a daily and monthly basis. The cost was intended to be reduced because the best of care could be delivered efficiently, quickly and with the least amount of complications thereby keeping the cost of care down. These centers are not just private hospitals they exist in universities across the country.

The Medical profession recognizes that a high degree of specialization is often required for optimum, permanent results.1-7 Restricting patient access to specialized care results in poor outcomes and excessive medical costs over a patient's lifetime.

It is my business as a pituitary patient and advocate to interact with sick patients every day; patients who often need to undergo brain surgery. With care provided by experienced specialists, patients most often recover, resume a normal life and keep their careers and families intact. That is modern medicine as it should be practiced.

It is unthinkable that we would let the medical achievements of the last 30 years slip away in the name of one size fits all / one doctor is as good as another medicine? It is neither smart nor cost effective......

1Erturk E, Tuncel E, Kiyici S, Ersoy C, Duran C, Imamoglu S. Outcome of surgery for acromegaly performed by different surgeons: importance of surgical experience. Pituitary. 2005; 8(2):93-97.
2Ciric I, Ragin A, Baumgartner C, Pierce D. Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery. 1997; 40(2):225-236; discussion 236-237.
3Barker FG 2nd, Klibanski A, Swearingen B. Transsphenoidal surgery for pituitary tumors in the United States, 1996-2000: mortality, morbidity, and the effects of hospital and surgeon volume. J Clin Endocrinol Metab. 2003; 88(10):4709-4719.
4Barker FG 2nd. Craniotomy for the resection of metastatic brain tumors in the U.S., 1988-2000: decreasing mortality and the effect of provider caseload. Cancer.2004; 100(5):999-1007.
5Ahmed S, Elsheikh M, Stratton IM, Page RC, Adams CB, Wass JA. Outcome of transsphenoidal surgery for acromegaly and its relationship to surgical experience. Clin Endocrinol (Oxf). 1999; 50(5):561-567.
6Birkmeyer JD, Siewers AE, Finlayson EV, et al. Hospital volume and surgical mortality in the United States. N Engl J Med. 2002; 346(15):1128-1137.
7Barker FG 2nd, Curry WT Jr, Carter BS. Surgery for primary supratentorial brain tumors in the United States, 1988 to 2000: the effect of provider caseload and centralization of care. Neuro Oncol. 2005; 7(1):49-63.