Stanley Feld M.D., FACP, MACE Menu


Dr. Feld. Why Only Pick On The Healthcare Insurance Industry?: Part 3

Stanley Feld M.D.,FACP,MACE

In summary, one stakeholder did not create a dysfunctional healthcare system. Since everyone believes the healthcare system is broken the main question is how can it be fixed.The major beneficiary of the largess and the worst offender in generating dysfunctions is the healthcare insurance industry.

As a secondary stakeholder in healthcare, the healthcare insurance industry adds little value to the treatment of a sick patient. It is essential that consumers understand the abuses to the healthcare industry in order to know the cure.

All the abuses of every stakeholder must be eliminated in order to have a viable healthcare system. The abuses and overuses have been outlined in my response to Matt Moledeski’s comment. The present dysfunctional healthcare system is the result of adjustments and reactions to changes imposed on the various stakeholders by each stakeholder to the disadvantage of the consumer.

The key questions are

1. Who is the primary stakeholder?

Answer: the patient

2. Who are the primary utilizers of resources?

Answer: the patients

3. Who should be the primary controller of the utilization of resources?

Answer: the doctor and the patient. Presently, the government and the healthcare insurance companies, in an attempt to control utilization of resources, restrict patient access to care when they deem it appropriate.

4. Who is the primary generator of disease?

Answer: A. The patient and his lifestyle.
             B. Industries promoting disease generating life styles.
             C. Industries generating toxic material into the environment.
             D. Agencies and industries that create unaffordable and inaccessible medical care.

5. Which diseases utilize the most resources?

Answer: Complications of chronic disease. 90% of the healthcare dollar is spent and taking care of the complications of chronic diseases. If we could avoid generating chronic diseases and their complications we could reduce our healthcare costs by correcting the problems in section 4. Healthcare and healthcare insurance would then become affordable.

5. How do you set up a system that encourages the avoidance of the complications of chronic disease?

Answer:A. Put the patients in charge of their healthcare dollar.

B. Let them keep the money they do not spend in a reti rement trust.
C. Insure consumers for large expenses.
D. Reward them financially for good health and the avoidance of complications of chronic diseases     and penalize them for bad health habits (i.e. obesity).
E. Require complete transparency by all the stakeholders
F. Provide an Electronic Medical Record financed by users by the click
G. Put in place effective malpractice rules to eliminate defensive medicine
H. Require hospitals to reveal actual costs of services to patients
I. Empower and require state boards of insurance to withhold licenses to sell insurance in the  state that abuse patients and physicians. The ineffective financial penalties are providing a profit center for these abuses to the healthcare insurance industry.

Consumers will boycott inefficient companies and business that charge too much.

The healthcare dysfunction started with a government entitlement rather than a government subsidy. It preceded government imposed price controls followed by healthcare insurance company abuse. Physician, patients and hospitals reacted to the abuse.

It will end with consumers controlling their healthcare dollars, employers and the government providing the funds to consumers along with financial incentives for consumers to control healthcare costs.

The concept of imposing a bureaucracy on top of a single party payer system is a solution that can not work.

The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone.

  • Thanks for leaving a comment, please keep it clean. HTML allowed is strong, code and a href.