Thursday, March 11, 2010

Risks, Alternatives, Cost Control and Health Reform Twitter #HCR

Let’s talk about these powerful words in relation to the current health care crisis.

If the doctor patient relationship was established with a greater risk component, then the patient and not the doctor would be assuming the risk of deciding upon a treatment protocol. In my opinion, this is a healthy way to contain costs in health care. Law suits are not driving up the cost of health care but any medical professional will tell you that defensive medicine practices are. If the medical professionals shift the risk to the patient, then patients will be assuming risks for treatment. I recommend this shift for several reasons.

  • The growth of alternative medicine in providing comfort where cures do not exist
  • The growth of defensive medical practices
  • The growth of information sources now available to patients that did not exist 20 years ago.
  • The need to tie cost containment to health care delivery systems
  • The growth of electronic means of reporting and monitoring medical treatment

So let the patient beware. One of the reasons that health care has had explosive costs is because health care does not have reciprocal mechanisms built into it which occurs in our free market. This has been a primary cause why health care costs have gone out of control. It also has had an impact on the growth of bio-medical stocks exploding growth in a recessive economy. If the government is going to write a bottomless check for health care, then why not invest in it? Most investors wisely see that they would be foolish not to. The argument that we have the world’s best health care and it should be protected is breaking down. This week The Cancer Society reported that PSA blood testing in 50 year olds is a cash cow that is not delivering any real benefits for many men. I still believe that we have the best health care delivery system, but unchecked medical research and development can not survive on a bottomless pit of borrowed money.

Alternative medicine can provide relief to people where a cure does not exist. For example, pharmaceuticals are not the always the best way to manage pain. They can lead to addiction where withdrawal is just as significant as the pain they are attempting to control. The alternative medicine field is less expensive than the traditional medical practices. They have less burden of regulatory compliance and few defensive medical practices because the patient assumes the risk. Electronic portable devices have made the monitoring and reporting of medical treatment portable. Patients can now monitor their own vital signs and feed back that information to a medical professional with wireless technology.

Perhaps in the future a consumer protection agency for patients can be established that will protect the interests of patients. This regulatory idea is far more preferable to defensive medical practices that encourage medical professionals to exacerbate costs to protect themselves. It is not medical malpractice law suits that are raising our health care costs. It is the threat of them. Medical professionals tend to be compliant individuals that cross their "t’s" and dot their "i’s". They will do everything in their power to avoid being accused of negligence. These people have good values that are being turned on the ear because of the threats of law suits.

Tuesday, March 9, 2010

Why insurers don't control costs

I read Ezra Klein's article in the Washington Post today. It is titled ...  Why insurers don't control costs
From Wikipedia ... "Health insurance like other forms of insurance is a form of collectivism by means of which people collectively pool their risk, in this case the risk of incurring medical expenses."

The pooling of medical expenses is a good idea. The problem with our insurance is that it is managed badly. Employers paying 70% of the cost is a bad idea. The risk must be shared for cost containment to work. Otherwise it is viewed as an entitlement that we deserve. I would prefer the private sector doing this, but we are saddled with Medicare now so fix it.

We do not deserve anything that we do not pay for. If we are going to use a single pay-or system then raise the tax for Medicare and bail it out. Begin to pre-pay Medicare instead of pay as you go. When we pay forward our medical expenses through a pay roll tax we will treat it differently. The magic of compounding interest will put us in the enviable position of having medicare surpluses.

Contain costs by introducing more reciprocity into the health care delivery system. Open up choices for patients to consult with medical professionals and not just doctors. I even think that alternative medicine can provide more comfort at less money than our current system.

Get rid of defensive medical practices. Patients should be aware that all surgery and medical treatments have some risk. Assume the risk or refuse the treatment. Medical reporting and monitoring should become electronic to reduce mistakes and decrease administrative costs. Wireless devices make every home a hospital

I am for any business that is profiting from health care paying an excise tax on profits. If a company is benefiting then they should share their profits with the recipients of health care to lower costs.