Friday, March 26, 2010

How Are Your Health Dollars Spent

Since everyone is talking healthcare, why don't we look at how it breaks out.

Let's take the big slices, hospital care and Physician and Clinical Services. The size of these two slices make up 52% of the cost of healthcare. If we can find a small percentage of savings in these areas, we will have significant savings overall.

I pointed out a video when I wrote "The Real Reason Healthcare is so High". We have Illegals flooding our healthcare system. How many hospitals have closed or filed for bankruptcy due to the vast cost of providing Medical care to illegals. Once they are here we become obligated, so keeping them out should be a priority when discussing ways to cut the cost of healthcare.

Doctors and even some of their staff spend large sums of money on malpractice insurance. They lose time and effectiveness by practicing protective medicine as well as battle lawsuits and the large settlements that often result. Instant wealth opportunities and gold diggers are not foreign to any business activity but they are far more prevalent in the medical industry. Simply knowing that doctors have multi-million dollar malpractice policies makes them all the more ripe for the picking. These insurance bodies often settle for large sums to avoid long battles and vast jury awards that ultimately drive up the cost of insurance for all medical personnel.

Increasing the number of doctors would help make healthcare more accessible and perhaps more affordable. The current enrollment in medical schools have dropped and the caliber of student is also suffering. Gone are the days when medicine was a lucrative practice. There is more money and less risk in so many other fields that perhaps we need an incentive system to draw in quality candidates. I know when I was attending pre-med classes there wasn't anything motivating me to finish. In fact the opposite was often more common.

HMOs have radically changed the medical profession. Their formularies and reimbursement programs take control out of the patient and doctors hands and put it in the hands of bureaucrats. This system of healthcare management has focused the industry on cost instead of outcome. The goal of the doctor patient relationship was the health and well being of the patient. Under the HMO system the goals are based on uniformity instead of best health outcome. Patients have the impression that they should have it all given the high cost of the program, while insurances try to give them the minimum they feel they need leaving doctors in the middle to negotiate the end result or fail to be reimbursed for their efforts. The HMO system has created another problem. The co-pay system takes away any incentive for the patient to learn or do basic care. The medical facility is forced into a bad guy roll by denying some level of care.
Placing the price tag back out in plain sight and allowing the patient to use their money to buy what they need would restore the patient doctor relationship as well as contain costs. The doctor only naturally will perform to the buyers level of acceptance. Third party buyers such as insurance companies and government programs take the focus off the real issue that brought this group together in the first place. Health Savings Accounts (HSAs) are a great way to put things back in order. The Personal Medical Savings Account is a far superior method for restoring some of the accountability back into the system. If someone had to actually pay for the requested service even knowing they would be reimbursed for a qualified medical visit, they would spend some time verifying and learning how to qualify. If there was the possibility that they would foot the bill they would be absolutely sure they needed to go. On the flip side if the medical facility was paid by the patient and not some formulary centered third party, they would be more prone to quality customer service. The incentive to please and help the patient would be returned to the health care industry. It would also be easier to focus on care when only patients with real needs came, hence education.

Once again a simple review of the problems with healthcare and its cost help us find ways to improve the system without having to resort to something as drastic as Obamacare. I recently wrote every senator to give them these very suggestions before they voted for Obamacare. I still haven't received a response from anyone. They sent me a generic thanks for writing letter.

The answer isn't bigger government. Looks like many got this test question wrong and failed America. It is time we a least shrunk government by every name on the "yes" side of Obamacare.

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