Tuesday, September 15, 2009

Since I did not run yesterday, I found my soapbox.

I was thinking to myself, "Self, what is it that drives medical costs?" The answer was clear to me... Sick People drive medical costs. Well, sick peple and surprises. If we can cut down on sick people and surprises, we can probably drive down the cost of medical care and related things like medical mal-practice suits/awards. So, anyway, let's look at the American Healthcare system and come up with a real solution, not just forcing a square peg through a round hole with the current mish mash of healthcare offerings going through Washington and hand them a real solution. Thus, I present to you Be Well America.

The Be Well America Healthcare Plan revolves around being, well, WELL. The leading drivers of health care costs have been people not following a healthy lifestyle and not letting medical professionals know about their history. As a case in point, I give you the comparison between two major hospitals and their per patient day cost of services. The Mayo Clinic in Minnesota treats many severe and complicated cases; as does the UCLA medical center. The Mayo clinic incurs a per patient day cost of approximately $58.00; UCLA costs $98.00. The main difference between the two is patient intake. When someone goes to Mayo, they are referred by their primary care physician and come with a detailed medical chart explaining what is wrong with the patient. The primary source of patient intake at UCLA is the Emergency Room. Staff has no idea what is wrong with an ER walk in without undergoing a huge battery of tests to not only find out what the problem is, but to also cover the hospital's backside to be sure they don't make any mistakes. This problem needs to be fixed!

How do we fix it? By following the old wives! You know, I'm not sure who these women are, but they are pretty darn smart. If we follow the old wives' saying that "an ounce of prevention is worth a pound of cure", we can start driving down healthcare costs. By having a long standing relationship with a primary care physician; or at least portability of electronic records given today's mobile society, a lot of the guess work can be taken out of the mix. So, how do we build doctor patient relationships? First, provide economic incentives to graduate more primary care physicians. Low interest loans, tax credits, SBA loans to establish practices and grants to put a doctor in underserved communities. Also, hospitals need to move specialists to being salaried staff rather than piece work body mechanics. Doctors are provided bad incentives when they get paid by the operation or procedure rather than a regular salary. Second, get people to go to the doctor. Since it appears we are stuck being the only healthcare system in the world burdened with the insurance industry, provide real Health Maintenance Organization coverage to every man, woman and child that is legally here in America. An HMO system as they were originally designed will set out recurring doctor appointments and offered programs to encourage healthy lifestyles. Insurance companies love recurring visits; if patients stay healthy, profits increase. That's a lot better than sying no all the time. Third, provide the citizenry with financial incentives to maintain a healthy lifestyle. Make health-club memberships tax deductible as long as you can show proof that you are going to the gym. Get a tax re-bate of a portion of your insurance premiums for maintaining good health (lowering blood pressure and cholesterol through lifesyle changes, not medication). You can even get a credit for buying the Wii-Fit game. If the American People can take responsibility for themselves, which they have shown an ability to do over the years, they can do their part and NOT BE A VICTIM! GET UP OFF THE COUCH AND PUT THE SUPER SIZE AWAY! GO FOR A WALK EVERY DAY!

What, on top of living healthy lifestyles and maintaining a relationship with a doctor and your records needs to be done? Well, let's look at the insurance industry: Health insurance is the only form of coverage that I know of that you fully expect to use. Car insurance is there if something un-expected happens, homeowners insurance is there in case of a fire, life insurance, beyond just being a forced savings account is there in the case of an un-timely death. Health insurance is used to spread timing risk and subsidize people who don't take care of themselves. The only problem is that health insurance companies, being driven by the bottom line, think that risk management revolves around saying no. By having commercial insurers handle the HMO, regular care levels and letting a "public insurer", not an option be the major med carrier we can have real risk management in the major medical arena. This will drive down insurance costs by paying lower HMO rates to insurers and by havving a non-profit carrier handle the really big stuff. The goal of covering everybody leaves doctors and hospitals competing for patients, not for insurance carriers.
These are a few thoughts, by developing and maintaining records, fewer mistakes will happen, thus fewer lawsuits. By maintaining healthful lifestyles, we will see fewer chronic health issues; as well as raise healthier children. We don't need government to take care of us, we need to take care of ourselves and have Uncle Sam be there, to quote my godfather, "in the dawn and dusk of life". That's all I have to say about thaaaat.

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