New ideas about Health care delivery

IS IT TIME TO RETHINK THE CURRENT HEALTH CARE DELIVERY MODEL?

 DO NOT GIVE UP FREEDOM, CHOICE AND CONTROL

 

 

 

The system we have today for health care delivery is the same idea that started 6 decades ago, you pay a premium for insurance and the insurance company pays for the service. This is true whether it is private insurance companies or government run insurance. Hardly anyone pays for their own health care directly and most don't even pay the premium. This system tends to remove incentives by consumers to be conscious of costs. There have been moves to increase deductibles, co-pays and  consumers share of the premium in an effort to encourage consumers to be conscience of cost savings, but it has been largely ineffective.
 

There are moves being made by health care providers to get out of the insurance based system. One idea that is being used on a limited basis is called Boutique Medicine or Concierge Medicine, were a doctor or group of doctors now charge a limited number of clients an annual fee and then provide health care. They no longer take payments from Insurance, Medicare or Medicaid. Another that I have heard about is  Clinic's run by Orthopedic doctors that have a flat rate of say $300.00 cash for their diagnosis and evaluation, then a flat rate price of around $8000.00 for a knee replacement. These are pure free market ideas that eliminate insurance and cut the costs of business and red tape. This same system is available in some other countries like India where you can have open heart surgery in the $10,000 range including your stay there. Sadly those who espouse government run healthcare believe that such practices would be made illegal and all providers would need to work for the government. While these providers now are limited and small in number, if allowed and encouraged they could begin to encourage competition in health care, they advertise their prices and open up some options to consumers.
 

Of course, there always is the problem of those who do not have the resources to be part of such a plan. Why not eliminate Medicaid, and in a cooperative effort expand the clinic system that has been around forever in America. These clinics would be administered by a local hospitals, they would be staffed by nurse practitioners and interns, overseen by doctors. They could also encourage qualified volunteers. Citizens under a certain income would be assigned a clinic and charged a monthly premium based on income. They would also pay a set amount say $20.00 per visit. These clinics would take care of minor injuries, immunizations, evaluations etc. and distribute common drugs like antibiotics. They would be subsidized if necessary by former Medicaid money. They would be encouraged to be self supporting as much as possible. More serious problems would need to be moved on to another facility. This could possibly provide better health care because of its availability. We are seeing Hospitals expanding local care facilities now.

 

Whatever reforms are to made should include a group of random selected providers who are not affiliated with any lobbying group or special interest and engage in listening sessions to see what reforms would help providers cut their costs. Doctors now have large staffs just to keep track of regulations, paperwork and claims. This all raises costs. Why not have one universal form that everyone can use to file a claim. Malpractice insurance often costs $250,000 a year, this needs to be addressed. This could be replaced by an independent group that investigates malpractice in a professional way and makes recommendations as to ratings on doctors and penalties.

There is and has been a lot of pressure to go to a government run system, Medicare for all they say. They fail to address the problem that the subsidizing of Medicare by private insurance through cost shifting has been a large factor in the rising cost of health care. Does anyone really believe that the medical profession will attract the best and the brightest if they will be working for a large government run bureaucracy that will do its hiring and promotions with an eye to social engineering as much as good health care. You can bet that would be the end of all malpractice claims as most government entities are immune from such claims. You can also bet that at certain age, whether it 75 or 80, your access to care will become limited. Americans spend $3.8 trillion on health care a year. This is very close to the entire budget of the Federal Government, which has not balanced a budget since 1969, shortly after the passage of Great Society spending programs. To finance a government run health program could result in  possibly a 30% increase of the Federal budget. Also a 30% rise in taxes. While it is true that the money is spent one way or another, this needs to be a last resort as once the move is made to government health care it will never be reversed. Rather than these large comprehensive reforms that often slip in political ideology and special interest motives, we need to address targeted solutions one thing at a time. It should be an evolution not a revolution.