10 Actions That Will Reform Health Care

It seems like nary a week passes that someone does not propose a way to “reform” health care, mostly by expanding it to cover everyone in the way that some other countries do.  Never mind that health care in those countries fail to help much of anyone – everyone gets the same ineffective medical care, which some knuckleheads think is the best that we can do.  It may be bad, but everyone is treated equally badly, right?

 Wrong.  In truth, we have the finest health care in this country that money can buy, as evidenced by the fact that people from the countries that have “socialized medicine” flock here to get care when they are seriously ill, if they can afford the price.  That said, we could be doing a lot better job of health care in the USA, if we were to adopt 10 simple changes.  Of course, few people want to press for these changes, as they would interrupt the ability of the “Medical Industry” to extort high fees for mediocre service.

 To be honest, I have had corporate health care.  I have paid for my own health insurance.  I have spent years being uninsured.  I have been qualified for care under the Veteran’s Administration, and have qualified for Medicare.  So my observations are based not on dogma or political beliefs than on direct experience.  Here are the 10 changes that we need to make today:

  1.  Shut Down Medical Fraud.  The Medicare program alone wastes billions of dollars each year — $528 Billion in 2010 alone, and climbing, according to the non-partisan Congressional Budget Office.  Rather than demand that this be fixed, we continue to elect the same crooked members of Congress who turn a blind eye to this fraud, much of it committed by doctors who contribute to Congressional campaigns to keep the fraud going.  And this does not even begin to touch the billions of dollars of waste and fraud in the Medicaid and private insurance programs.
  2.  Enact Tort Reform.  Medical mistakes are horrendous, and many of them deserve to be resolved through the courts and censure of doctors who are inept.  That said, there is simply no excuse to today’s culture of lawsuits every time a medical effort does not turn out perfectly.  In spite of what medical people may want us to believe, medical science is imprecise.  Even the best doctors and nurses make honest mistakes or are imperfect – or sometimes simply can’t do more than their best.  States that have enacted medical tort reform have more doctors and nurses in practice, with lower insurance costs.  This means lower costs for medical care for consumers.  Medicine should never be a profit center for attorneys.
  3.  Get rid of medical insurance.  Period.  The day this nation began employer-paid medical insurance was the day that quality began to decline and costs increase.  Instead of expanding health care insurance, we should scrap the whole bloated, ineffective system.  Truth is, smart investors buy the minimum of life insurance, auto insurance and home insurance.  Just enough to cover what we need.  Why, then, must we have health insurance to cover routine medical visits and prescriptions?  Instead, make visits to the doctor a part of normal life payments, like gasoline for our cars and food for our bodies.
  4.  Demand an estimate up front.  We would never hire an auto mechanic or plumber to do a job without getting an estimate up from.  But when it comes to medicine, we pay people to make their best guesses, regardless of the outcome, and pay whatever they demand that we pay.  This leads to “ganging on,” in which a simple trip to the doctor for a sore throat becomes thousands of dollars in unnecessary tests and “consultations” by doctors who never actually see or treat you.  Much of this is done to cover your doctor against the inevitable lawsuit in the event he or she is wrong.  See Item #2 above.  In any event, demand an estimate up from for the total cost of treatment, so that you as a consumer can decide whether it is worth the cost to you.  Remember that 90 percent of all you will pay for health care your entire life will be spent in the final three months of your life in a useless effort to extend your life a few more weeks.
  5.  Demand that your doctors know what things cost.  Truth is, they do not.  Doctors will gleefully require to you take hundreds of dollars in tests, having no idea what they cost you.  They will call for dozens of x-rays (at $1200 or more each), MRI scans (at $5,000 or more each), and will put you into the hospital for “observation” (at $5,000 per night or more).  If you ask them what these “services” will cost, most have no idea.  If you challenge them, you will get a lecture on how irresponsible you are not to have an insurance plan that covers any amount of your money they wish to spend.  Don’t fall for this – if your doctor cannot tell you the estimated cost of every prescription and procedure they demand, change doctors to someone who can.
  6.  Return to House Calls.  We’ve gotten rid of the simple house call by family practitioners.  Instead, medical practices demand that we come to their offices, where we will often sit for an hour or more waiting on them to have time to see us for ten minutes.  In the meantime, we sit in waiting rooms where we are exposed to a variety of illnesses – some of them incurable – in order to not inconvenience the medical staff.  Better for all around if we return to a system in which doctors serve their patients.  At the same time, they can allow patients to stay in their own homes, where most studies show they recover more quickly.  If your doctor demand that you sit for an hour or more in the waiting room because they do not know how to manage their time, they should pay us for the inconvenience.  What’s more, staying at home in your own bed, even if you pay $200 per day for a private nurse, is $4,800 less per day than being admitted to the hospital.
  7.  Make better use of technology.  Why on earth should we have to go to a doctor’s office, exposing ourselves and our children to a variety of diseases, to learn what we already know — that the kid has an ear infection, we have a bladder infection, or to get a flu shot?  The Veteran’s Administration is making excellent use of call-in nurses, who can weed out the routine from the dangerous.  The rest of medicine needs to catch up, and quickly.  Anyone who has a personal computer or a cell phone should have access to a nurse or medical assistant capable of writing prescriptions and making judgment calls.  Without being sued if they make mistakes.
  8.  Make better use of nurses.  With all due respect to those who give sponge baths, change bed pans and otherwise do the dirty work in hospitals, surely we do not need highly trained nurses to do scrub work.  Nurses spend years in training and experience to do much of the work in medical offices, and they should be turned loose to use that training to help patients and lower the cost of medical care.  I have never met a nurse that did not know their medical stuff, but I have met many who were disrespected, under-utilized and underpaid.  It is time to bring these medical professionals into their own.
  9.  Demand more information about medicines and procedures.  You should never take a new medication without knowing how it works and what it does, including side effects.  Shockingly, many medical doctors are totally ignorant of the side effects of medicine, including effects that can cause you to suffer suicidal ideology, hallucinations and delayed stress syndrome.  Read every label, and demand to know if the medicine you are taking could kill you with a heart attack, destroy your kidneys or cause you to violently attack your loved ones.  Your doctor must give you this information before you hurt yourself or others.  Trust to your medical professional?  Trust is earned, not simply given.
  10.  Demand that everyone pay for their health care.  Truth is, most people can’t pay the ridiculous costs of health care in this country.  The leading cause of bankruptcy among middle class families I that they are hit by a simple medical emergency that – in spite of having “health insurance” – destroys them financially.  Why do we permit this?  People who come in to this country illegally can get unlimited free health care that we pay for, while we go bankrupt trying to simply protect our families.  Even retirees on Medicare have to pay something for their care.  The laws should be changed so that everyone pays something, even if it is minimal.  The free ride for medical care needs to end.

 These are not the only suggestions that need to be considered.  We need to examine why prescriptions in this country cost three times or more what they cost in other industrialized nations.  We need to figure out why a medical degree costs hundreds of thousands of dollars.  Why the cost of medical technology is going up, not down as it is for nearly every industry.

 But these ten suggestions are a place to start, if consumers and taxpayers have the guts to demand them.


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