Health care in America is really expensive, so expensive that it’s out of reach for millions of people. But it doesn’t have to be that way. Insurance middlemen and other for-profit parts of the system drive up the cost with waste that has nothing to do with providing health care.
A new report by the influential Institute of Medicine finds that the U.S. wastes as much as $750 billion every year — about one-third of every dollar — in its health care system. This waste — resulting from needless spending on overhead and administration — has deadly results. The committee estimates that “almost 75,000 needless Ai??deaths could have been averted in 2005 if every Ai??state had delivered care on par with the best performing state health.”
The report lays out a number of broadAi??recommendationsAi??for eliminating this waste, including centering care more closely around patients and bringing a lot of the paperwork involved in health care into the Digital Age.
But there’s one very simple solution for eliminating this waste. If the U.S. had a single health insurance program like Medicare covering everyone, we could eliminate 30 percent of our health care costs that go into the administration, profit, and other costs that result from having thousands of different private insurers acting as middle-men. Covering everyone and saving money in the process. Now that’s progressive.
Medicare is not people care. It is as wasteful as OBAMA’S PLAN. I FOR ONE DON’T WANT MY MEDICAL RECORDS IN DIGITAL FORM. ON A COMPUTER. THAT CAN CRASH OR FAIL OR SOMEONE CAN PUT THE WRONG INFORMATION INTO. HELLO SYSTEMS FAIL COMPUTERS FAIL PEOPLE THAT PUT THE INFO ON THE COMPUTER. FAIL!!!! BUT GOOD OLD PAPER FILES YOUR DR HAS DON’T. !!!!!!!! IN MY. MED FILE ” ELECTRIC ” It SAID I HAD UDERIN CANCER. WOW! !!! IM A MALE. DIDN’T KNOW I COULD GET THAT TYPE Of CANCER! !! LIKE I SAID MEDICAL RECORDS ON ELECTRONIC Files. IS A VERY BAD CHOICE! !!! THANKS PRESIDENT. OBAMA. FOR YOUR CONCERNING. But IT SHOULD BE UP TO ME OR YOU. OR ANYONE. WHO Wants TO Make THAT CHOICE IN THERE HEALTH CARE. NOT. JUST OBAMA’S AND HIS ADVISOR’S IDEAS
O and also computer medical records can be hacked into and stolen like you’re. Credit cards. People can get in to them steel them. Ect. Hello Americans. Let the president and his advisor’s make that choice for you. Not your choice but their choice .. YOU HAVE A CHOICE AND A VOICE! !!!! USE IT OR LOOSE IT. YOU CHOOSE
Mistakes are made all the time on paper. Get real. My doctor asked me (reading my chart) if I had had a high Cholesterol number before on a blood test.. and I said, “it must be a mistake, because NOBODY has taken any blood from me!” We have already lost the battle on health care, that is why Obama and Congress finally decided to do something about it. A physical nowadays (with insurance coverage) consists of listening to your heart, taking your blood pressure, saying ahhh, and asking if you have any concerns. No blood tests, no anything at all. Not even discussing medical recommendations for my age group. My doctor doesn’t do dittly anymore and it is because of the Insurance providers that give him incentives to NOT TREAT me for anything. If you want to waste your money on a bunch of crap designed to make you give up instead of getting health care, I guess that is your prerogative. As for me, I am sick and tired of wasting Billions on heath-care that does nothing. My father waited weeks for approval for his cancer tests and treatments and he died because his cancer was fast moving. Don’t say Obamacare will do this. It has already been going on for years. At least Obama is trying…
Certainly there is administrative waste of billions in America’s current healthcare delivery system. However, that alone is NOT why healthcare is so expensive.
The healthcare issue, while complex, has basically two fundamental components which must be solved: costs and access. A large part of the reason that medical care is so very expensive now is because the cost of a medical education is so very high. That education cost is figured into every billing sent by physicians, clinics, hospitals to insurance and patients. Most patients are unaware of this factor. The majority of healthcare providers graduate with enormous loads of debt hanging over them like swords of Damocles; the only way they can pay off these immense debts is to figure them into what they charge insurances and patients. If, instead of prospective healers paying for their healthcare training, the government would pay medical schools, nursing programs, residencies and fellowships, based on each program’s number of enrollment, just like should be done with public schools, not only would such educational endowment attract more altruistic people into healthcare professions but it would also lower the costs of medical services by eliminating individuals’ debtloads. I do not advocate that beneficiaries of medical education never pay anything back to the government. I suggest they pay in services rendered after attaining their degrees. Say, an individual wanted to become an X-ray technician and his/her training consisted of three years — after graduation that person would work for six years in whatever location the government designated. At the conclusion of those six years, she/he would be free to practice wherever he/she desired. In the case of physicians, training might be four years of undergraduate pre-medicine, four years of medical school, five years of residency, two years of fellowships and/or other specialty training; so, physicians might owe thirty or more years of service in a community designated by the government before being allowed to choose their practice sites. This system could possibly solve the underserved areas problem in America. Once, an M.D. begins residency training, she/he would be paid like any other doctor for services rendered. Another feature of such a system would be the encouragement of more persons who are poor and/or from minority backgrounds to strive to enter healthcare professions. Many individuals who want to be healers cannot because they simply do not have the funding to pay for their education.
Oh, I realize the A.M.A. and other groups will object that such a system makes healthcare professionals “employees” of the government. From a certain perspective, it does, even if they are not “salaried,” but compensated for services rendered. But healers should be most interested in serving their communities, not in their personal profit. I believe it would help weed out those people who practice healing arts just for money, as well as quacks. In the event that any individual quit the training before attaining the requisite degree, she/he would then owe the government the cost of the training already received.
The other side for those who are already physicians, nurses, radiologists, anesthetists, etc. and currently practicing, not just those in “critical areas,” they ought to have their debtloads forgiven to lower medical costs.
But other factors also impinge on medical costs. Healthcare industries such as pharmaceutical firms and medical appliance/equipment companies are for-profit businesses which have no ceiling on the per cent of markup they can charge hospitals, clinics, doctors’ offices, etc. Many hospitals operate for profit as well. All the component costs and any inflation these contain are ultimately figured into the billings that insurance and patients receive. Insurance, of course, reflects all this plus their own ever-increasing margins of profit back to patients and/or employers of patients as premiums, creating a spiraling cycle with no termination in view. Competition among insurance companies will never LOWER healthcare costs, but it could RAISE them further. Government mandate that every citizen must become insured through selection of a private insurer will ultimately only impoverish most patients further, thus making this recession even worse. Already physicians are planning to “recoup” perceived losses under the Obama plan by soliciting just those patients who choose to go with “high deductible insurance plans” with therapeutic SPECIALS that will fall cost-wise within the deductible range which the insurance will not have to pay anything on. Medical debt is the number one cause of individual bankruptcies in America right now.
Only through discharge of medical training debt through forgiveness coupled with future medical education funding AND through elimination of private insurance by instituting a one payer plan with standardized payments for therapeutic procedures/treatments AND freezing prices on medical technology/drugs can medical costs be contained. For a one payer plan, first the government would need to establish and maintain in an ongoing fashion a database of all conditions detrimental to health and all the appropriate therapies for each with a correlated payment amount. This seems like an immense task (and it is) but some of this has already been done by C.M.S., hospitals, university schools of medicine and health consortiums. All their efforts would need to be combined into one cohesive database. Payments to healthcare providers should reflect the seriousness of the condition, the risk/benefit ratio of the therapy, and the efficacy of the outcome to the patient. In other words, a physician prescribing an antibiotic for a respiratory infection would receive less compensation than a physician performing a laparoscopic cholecystectomy who would receive less than one doing a heart transplant. An office visit for a wellness checkup would be compensated less than hospitalization.
ALL healthcare professionals and ALL healthcare institutions would need to be compensated through the government program, not just the physicians, and payments would need to be both standardized and yet reflect the quality of the care given the patient. For instance, better nursing services, more accurate lab tests, better hospital care would need some system of improved rewards tied into better outcomes for patients. Here is a possible example: for a standardized four-day hospitalization of a person with pneumonia, there would be a base amount relative to the condition (pneumonia) and methods of treatment — to that amount could be added extra for the nurses if their care were extremely solicitous and resulted in the patient recovering faster or more completely than predicted. The scale of these payments for healthcare services for providers should be adequate to provide those providers comfortable living, whether these individuals are physicians or technicians or nurse practitioners or orderlies or clinic clerks or whatever, even though the amounts for each service would vary due to depth of medical involvement. But professions in healthcare should not be, as some currently are and many others are not, highways to wealth. People should enter and work in the healing professions because they desire to HEAL, not because they desire to become rich and/or powerful.
Access if also solved by the one payer plan as well since, literally, everyone who resides in the United States would get coverage — no exceptions. Once everyone was enrolled in the new plan, Medicare and Medicaid could be jettisoned because they would be redundant. Under this system, instead of having insurance companies collect premiums from both employers and employees as is currently done, additional taxes to fund healthcare would be gathered as another 10% (in addition to the 50%already levied as my suggestion for government operation) from business PROFITS combined with a second 10% tax deduction from individuals’ paychecks. I suspect this would more than pay for this healthcare system. Using my current income as an example, I would be paying $80 every two weeks for an annual contribution of $2,080 (contrasted with my current biweekly contribution of $200). One salaried physician I know would be contributing $69,000 annually. Multiply this by EVERY person working in America! Since the employers’ contribution into the fund comes as 10% from PROFITS, rather than a matching premium on each employee, the annual amount would vary but simultaneously relieve a substantial portion of overhead that gets figured into the costs of commodities and services. Yes, the more one earns as an individual, the more one pays for identical coverage but that coverage should pay for everything except cosmetic procedures and discrimination on the basis of wealth would be eliminated.
There will be, of course, people who will argue that such a system destroys the incentive to succeed. Not really, either for individuals or for enterprises! I have experienced 0 income; it is a nightmare; no sane person desires it. Undoubtedly, there are lazy people who may content themselves with less income, but for every one of those there will be five or more people just as industrious in order to gain more for themselves and their enterprises because, while taxes would increase, so would shares of the resources for both individuals and businesses.
The other argument that will be heard against such a plan is that hardworking people will be paying for healthcare for the indigent. Yes, we will be and we should be. The largest group of non-taxed people will be children, our future, those too young to work. Unless we wish to re-institute child labor (and that idea is abhorrent), children will get healthcare provided from the incomes of others. Children are ALREADY dependent on the incomes of others. Parents now must provide for them. But should parents alone be responsible for the health of children? Are not children an investment of society in a future and do we not want them to be as healthy as possible so that, when they achieve adulthood, they will contribute their full potential — physical, intellectual, social, spiritual — to society? Today there are too many parents unable to provide for their children’s optimal health. Such burden should be shared because really it DOES take a community to rear a child.
Other indigent people are adults who have been unlucky: laid-off because their employers downsized, unable to get employment because they have been injured or contracted a serious disease, lacking skills because the educational system did not work for them, and other reasons. Why should they be denied healthcare when its provision might empower them to overcome such non-productive state? What about people who contribute towards the good of society but who are not paid, such as stay-at-home mothers or family caretakers and volunteers for non-profit organizations? Do they not deserve healthcare so they can continue to contribute to society in their own ways? Sure, a few people may try to abuse this system and freeload off society as indigents. But, remember every therapy provided will need documented necessity for compensation, and no system, however designed, can be devoid of the potential for abuse.