Stanley Feld M.D. FACP,MACE
There are so many little changes that can have a big affect on repairing the healthcare system.
These changes would go a long way in putting consumers in control of their own health and healthcare dollars.
President Obama and the Democrats want to make consumers dependent on government. Most Republican politicians do not understand the healthcare system’s problems.
Republican senators and congressmen have not been able to come up with a viable solution because they are influenced by vested interests other than the consumers’ vested interests. .
Republicans cannot understand that consumers are smart. Most know how to spend their money wisely. Consumers can solve problems if they are given the right tools and incentives.
In last week’s Republican debate Mike Huckabee got close when he said we have to solve four chronic diseases and the costs to the healthcare system would plummet. He mentioned diabetes, heart disease, cancer and lung disease. He was almost correct.
The care of chronic diseases that are manageable consume 80% our healthcare dollars. Most of the 80% is spent on the complications of these chronic diseases.
Motivating patients to become the “Professor of Their Disease” can prevent at least 50% of the complications of these diseases.
Mike Huckabee missed that part. Patients must be provided with financial incentives to prevent a chronic disease from occurring in the first place and then learn how to prevent complications from occurring.
I am publishing the spring of 2007 blog summaries to demonstrate that none of the obvious fixes have been executed to put consumers in a position to make wise choices and be responsible for them.
Stanley Feld M.D.,FACP,MACE
The solutions I have proposed are all directed to a patient centered, patient driven, and patient advantaged system. I will review the proposed solutions in the next two blogs.
The government must enact legislation so that the providers and the insurance companies post their range of prices. The government has to empower the patient with negotiating power to get the best price.
There are many different prices paid for a service depending on the negotiating power of the purchaser. The net effect of this total price transparency will be lower the prices and decrease cost of health insurance.
Consumer must demand real price transparency. Aetna’s declaration of price transparency last year was a rouse. The hospital associations of Wisconsin and now Texas have developed web sites to provide hospital retail prices.
We have little idea how much the government or insurance companies pay for these services. I assure you the discount is very deep and the hospitals are satisfied with the payments.
The automobile industry has figured out how to deal with total price transparency and the Internet publication of the MSRP, the invoice prices and the average prices paid for an individual automobile.
We should demand that the healthcare system does the same. The system should be set up where patients can negotiate price pre or post treatment. Sometimes the patients need a care emergently and are not in a position to negotiate in an emergency room.
- Elimination of a two tier payment system with hospital clinics receiving more money for procedures than outpatient physician clinics for the same procedures. Eliminate the restricting of payment to the physicians’ office clinics as long as there is proof of equal quality and qualifications to do the procedures in the physicians’ office. This can serve to increase price competition for services. Price competition is a vital element on the repair of the healthcare system.
- Expand consumer driven healthcare using the ideal Medical Savings Accounts and not the present Health Savings Accounts. I have made clear the difference between the two. The ideal Medical Savings Account would be to the patients’ advantage and not the insurance industries advantage. The ideal MSA would serve to motivate the patient to shop price and quality because they are spending their own money. It would also encourage adherence to treatment for the same reason.
•Create a level tax-exempt playing field for the self-employed and uninsured
so they can buy insurance with pretax dollars. Provide those who qualify for subsidy with a subsidy to pay for their Medical Saving Account. If they use the healthcare system appropriately or they do not have to use the system they should be rewarded with a lifetime tax-exempt contribution to the consumers trust saving account. Incentives on all levels drive a market based free enterprise system.
•Administrative waste in hospitals should be penalized and not rewarded.The system of payment presently is very opaque. For example payment for some chemotherapy is 10 times the cost of the drug.
Yet an oncologist is not permitted to administer the drug in his office for one and one half times the cost of the drug. It is estimated that $150 billion dollars are wasted on administrative costs in the hospital and in the insurance industry. These costs add not value to the treatment of patients. Increased executive salaries and increasing construction of enlarging hospital facilities absorb the administrative waste. The brick and motor expansion of hospitals should be over since much can be done on an outpatient basis.
These are some of the solutions necessary to repair the healthcare system. The solutions have to be instituted as a total plan and not introduced piecemeal. Each of the pieces of the solution is dependent on each other in order to have a positive effect on repairing the healthcare system. Next time I will review the other elements of my plan needed to Repair the Healthcare System.
April 03, 2007
There are two more parts to go. If only our elected officials would listen. The only way that will occur is if consumers start making demands. If the politicians do not listen them kick them out of office.
The most profound thing said at the Republican debate last week was by Marco Rubio. He said the traditional media is the Democrats largest and most powerful special interest group.
I suggest people start reading between the lines of the New York Times articles for a start.
Wake up, America.
The opinions expressed in the blog “Repairing The Healthcare System” are, mine and mine alone
All Rights Reserved © 2006 – 2015 “Repairing The Healthcare System” Stanley Feld M.D.,FACP,MACE
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