Best Care and Outcome - Insurance or Government or Golf?
Play a round of golf with someone and you will know their integrity and moral fiber; more on that after the immediate problem.
In a perfect world, doctors could spend time diagnosing, performing or ordering tests and procedures that could improve the quality of life and save lives in the process plus be assured that they would be able to charge a reasonable fee for their services and be paid. All of this without the overwhelming staff needed to comply with Insurance and Government interference in the process. In reality, that is a simplification of how things were handled until the 1970's and those times will not return. There are individual tests today that are performed that (without adjusting for inflation) would cost about as much as a new car in the '70s. It would be very easy to find a system that would work if money were not an issue, but that cannot happen. We have the capabilities today to perform procedures that were science-fiction just a few years ago.
Now enter politics, stage right or left, depending upon your preference. Both Senator McCain and President Obama are mostly wrong in possible solutions. But I would love to get them into a room with doctors, patients, hospitals, drug companies and patients to work it out. I would naturally be happy to moderate only if both of them insist. Here are the problems:
Doctors, Hospitals, Drug and Insurance companies are in business to make money (not a bad motive). Government is very inefficient in spending money and has never canceled a program even if it is a failure, but will respond to public pressure...Insurance, not so much. If you have read my few earlier posts, you are aware that I am a fan of doctors and health care providers that spend every day dealing with immediate and urgent decisions. Insurance companies have the luxury of dealing with statistics and cost/benefit ratios that will yield the most return on investment. Example; I don't know for sure, but would bet a month's premium that somewhere in most companies, someone would be able to tell you if it is cheaper to cover flu vaccines than the potential cost of treatment for those who may get the flu.
If we are planning to make sure that everyone has access to health care, then there must be an emphasis on keeping doctors in business and attracting new doctors and nursing staff. Hospitals must have some assurance that they will be able to survive with the growing number of people who can't pay. If we want the new and innovative drugs for treatment, we must insure that the drug companies are able to make a fair profit without Americans being the ones to pay the premium costs and allow other countries to buy the same drugs cheaper.
If you have ever visited Mayo Clinic, Cleveland Clinic or other major multi-specialty facilities, you will see people from all over the world coming to the United States to get care. These people are obviously wealthy and can go wherever they want without any concern for costs. Why come here? Because, the countries' health care systems whom some would want us to emulate are dysfunctional and an elite few can come here because they will get the best care.
Drug companies charge more in the United States because they can. We can no longer subsidize the cost of treatments to other countries. Insurance companies must make a fair return on investment, so the easiest way is to start at the bottom of the chain with the patients, then doctors, then hospitals to inundate with paperwork to further add to costs.
We need to find a way to determine ahead of time what procedures will be allowed without preconditions, what the approximate cost will be and at what point the health care provider must contact the insurance company. The Government cannot use "reform health care" as a code for simply an arbitrary reduction of what is paid to doctors.
As an immediate improvement,I personally think that doctors should be allowed a tax deduction for any care that is given to uninsured patients if the patient does not have coverage because of circumstances outside of their control. Also, that would reduce dramatically those going to the Emergency Room at hospitals because they do not have insurance and cannot pay. For a longer term solution, there is a place for Government involvement with Medicare, Medicaid and some general regulations on the system without going "Socialist".
There is the possibility of a hybrid system that would allow for "Free Market" insurance policies, either group or private, with an upper limit for catastrophic illnesses. The Government could provide additional coverage, for a cost to businesses or individuals, for any catastrophic coverage. There would naturally have to be safeguards to insure that companies would have a benefit not to cancel insurance because the Government will handle it if they don't. I don't have the answers, but a lot of questions. Which leads me back to the "room full of people" to decide the future of health care. Which gets me back to GOLF.
For those who do not play golf, it is the only game where the player himself keeps his score for each hole and will penalize himself. If you have played, you know how it works. A person's true core values are more apparent in golf than any other sport. A person can tell you they had a 4 even though it was 6. They can kick the ball from behind a tree when no one is looking. We genuinely appreciate a good shot and good sportsmanship from our competitors. So, we need to screen those on the committee for health care reform by playing a round of golf with them. If they are competitive, yet honest and civil, then they can be part of the process. We can admire those who disagree with us if only we knew that they are honest and sincere in their opinions and solutions. Maybe we should even allow golf as a legitimate medical deduction...I know I would feel better.
TVP
Email The Virtual Patient
In a perfect world, doctors could spend time diagnosing, performing or ordering tests and procedures that could improve the quality of life and save lives in the process plus be assured that they would be able to charge a reasonable fee for their services and be paid. All of this without the overwhelming staff needed to comply with Insurance and Government interference in the process. In reality, that is a simplification of how things were handled until the 1970's and those times will not return. There are individual tests today that are performed that (without adjusting for inflation) would cost about as much as a new car in the '70s. It would be very easy to find a system that would work if money were not an issue, but that cannot happen. We have the capabilities today to perform procedures that were science-fiction just a few years ago.
Now enter politics, stage right or left, depending upon your preference. Both Senator McCain and President Obama are mostly wrong in possible solutions. But I would love to get them into a room with doctors, patients, hospitals, drug companies and patients to work it out. I would naturally be happy to moderate only if both of them insist. Here are the problems:
Doctors, Hospitals, Drug and Insurance companies are in business to make money (not a bad motive). Government is very inefficient in spending money and has never canceled a program even if it is a failure, but will respond to public pressure...Insurance, not so much. If you have read my few earlier posts, you are aware that I am a fan of doctors and health care providers that spend every day dealing with immediate and urgent decisions. Insurance companies have the luxury of dealing with statistics and cost/benefit ratios that will yield the most return on investment. Example; I don't know for sure, but would bet a month's premium that somewhere in most companies, someone would be able to tell you if it is cheaper to cover flu vaccines than the potential cost of treatment for those who may get the flu.
If we are planning to make sure that everyone has access to health care, then there must be an emphasis on keeping doctors in business and attracting new doctors and nursing staff. Hospitals must have some assurance that they will be able to survive with the growing number of people who can't pay. If we want the new and innovative drugs for treatment, we must insure that the drug companies are able to make a fair profit without Americans being the ones to pay the premium costs and allow other countries to buy the same drugs cheaper.
If you have ever visited Mayo Clinic, Cleveland Clinic or other major multi-specialty facilities, you will see people from all over the world coming to the United States to get care. These people are obviously wealthy and can go wherever they want without any concern for costs. Why come here? Because, the countries' health care systems whom some would want us to emulate are dysfunctional and an elite few can come here because they will get the best care.
Drug companies charge more in the United States because they can. We can no longer subsidize the cost of treatments to other countries. Insurance companies must make a fair return on investment, so the easiest way is to start at the bottom of the chain with the patients, then doctors, then hospitals to inundate with paperwork to further add to costs.
We need to find a way to determine ahead of time what procedures will be allowed without preconditions, what the approximate cost will be and at what point the health care provider must contact the insurance company. The Government cannot use "reform health care" as a code for simply an arbitrary reduction of what is paid to doctors.
As an immediate improvement,I personally think that doctors should be allowed a tax deduction for any care that is given to uninsured patients if the patient does not have coverage because of circumstances outside of their control. Also, that would reduce dramatically those going to the Emergency Room at hospitals because they do not have insurance and cannot pay. For a longer term solution, there is a place for Government involvement with Medicare, Medicaid and some general regulations on the system without going "Socialist".
There is the possibility of a hybrid system that would allow for "Free Market" insurance policies, either group or private, with an upper limit for catastrophic illnesses. The Government could provide additional coverage, for a cost to businesses or individuals, for any catastrophic coverage. There would naturally have to be safeguards to insure that companies would have a benefit not to cancel insurance because the Government will handle it if they don't. I don't have the answers, but a lot of questions. Which leads me back to the "room full of people" to decide the future of health care. Which gets me back to GOLF.
For those who do not play golf, it is the only game where the player himself keeps his score for each hole and will penalize himself. If you have played, you know how it works. A person's true core values are more apparent in golf than any other sport. A person can tell you they had a 4 even though it was 6. They can kick the ball from behind a tree when no one is looking. We genuinely appreciate a good shot and good sportsmanship from our competitors. So, we need to screen those on the committee for health care reform by playing a round of golf with them. If they are competitive, yet honest and civil, then they can be part of the process. We can admire those who disagree with us if only we knew that they are honest and sincere in their opinions and solutions. Maybe we should even allow golf as a legitimate medical deduction...I know I would feel better.
TVP
Email The Virtual Patient
Posted by The Virtual Patient at 3/8/2009 9:13 PM 
Categories: Uninsured,Costs,Reasonable and Customary,Pre-certification,Socialized Medicine,doctors,Universal Healthcare,Insurance,pre-existing
Tags: Patient Politics uninsured universal health preapproval cost Private Policies Socialized Medicine underinsured medical coverage doctors pre-existing health care Insurance
Categories: Uninsured,Costs,Reasonable and Customary,Pre-certification,Socialized Medicine,doctors,Universal Healthcare,Insurance,pre-existing
Tags: Patient Politics uninsured universal health preapproval cost Private Policies Socialized Medicine underinsured medical coverage doctors pre-existing health care Insurance
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