Politicians and pundits on all sides are looking at health care costs all wrong. They are all focused on INSURANCE, and not the cost of the health care, itself. And whenever you insert someone else between you and a product or service, that person needs to be paid which only serves to make the product/service more expensive. And insurance always increases the cost of things, because medical providers can charge more to insurance companies because they have deeper pockets than individuals, and there are few restraints on increasing costs since insurers just pass those costs on to the individuals paying the premiums.
If we want to decrease the expense of health care, we must first address the actual needs and the costs of those needs, and THEN we can address insurance to cover them. In this post I am not going to include the lifetime damage to bodies because of vaccines which are literally designed to weaken the immune system (or it would destroy the vaccine) which, in turn, makes the patient much more susceptible to more serious autoimmune diseases. I'm not including that here, as it is far too late to change what already is. But people should seriously consider swearing off ANY vaccines henceforth.
First and foremost we need to address the poor lifestyle choices that contribute to 70% of all health issues. One hundred years ago the average person was in good health, barring an injury or contagious disease. In nature, the normal state of health is good health, and poor health is abnormal. We have managed to turn that on its head with our proclivity towards making poor choices like smoking, too many sweets, fake foods (if it wasn't food a hundred years ago it is not food now), an over abundance of chemicals and preservatives and an aversion to actual exercise and physical labor. You don't have to be a doctor to understand that our choices are largely responsible for our health. It is estimated that over 70%, and perhaps as much as 80% of all health care needs are attributed to poor lifestyle choices. If we were to all live by the Biblical statement, "All things, in moderation", and get sufficient exercise, we could cut health care costs in half.
And we could cut them even more by using our tax system to discourage poor and harmful lifestyle choices and apply those taxes to directly reduce the cost of healthier options. For example, increase tax on sodas and cigarettes and use those taxes EXPRESSLY to reduce the cost of healthy, whole food and/or fitness equipment or gym memberships.
Costs can be reduced further by capping malpractice awards. Medicine is an imperfect science; honest mistakes can be made. The ONLY lawsuits that should be permitted are for instances of gross neglect or incompetence, and then the awards should be capped at reasonable levels. This would reduce costs in two ways: first, by reducing the exorbitant costs that doctors and medical establishments must pay for malpractice insurance, and second, because doctors will not feel obligated to "over-test" in an effort to cover their butts. Currently, doctors must test a patient for many things unrelated to the health issue, just to play it safe and not risk a lawsuit.
To reduce health care costs further, it is as simple as stopping the "revolving door of referrals." If you know you need a gastroenterologist, why should you be required to first see a personal care physician for a "referral"? The cost of seeing the PCP adds significantly to the cost. We should be able to schedule our own appointments with specialists as long as we already know the diagnosis.
Case in point - I suspected my medication for ulcerative colitis may have caused PML, a serious viral infection, so I wanted to see a professional to get an MRI to see if I was infected. I had to first see my PCP ($225) to get a referral to see the neurologist ($640) who referred me to an unnecessary HEART specialist (my heart is perfect and had nothing to do with my issue) at a cost of $1200, who then, finally, got me an appointment for an MRI ($1550). A total of $3615.00, when all I needed was the MRI at less than half that cost. And as it turned out, I did not have PML. But $2,000.00 was wasted in getting that eventual determination.
Now that we have lowered the actual costs of health care into the realm of sanity, we can NOW address the cost of insurance. Having reduced health care costs by at least 50-75%, it is safe to assume one of two things - either the cost of insurance can be reduced by 50-75% OR most people can afford their health care costs without the need of insurance, as they would only be paying as much for their health care as they would have had to pay in insurance deductibles, anyway.
1) INSURANCE. Insurance always increases the cost of things, because medical providers can charge more to insurance companies. Since the insured does not have to pay much of the bill, he has no cause to complain. This is precisely why medical providers charge much less to those without insurance. If they can charge less to one person, they can charge less to all. Also, insurers are classic "middle men", who must be paid for the services(?) they provide.
Solution: the caps that Medicare and Medicaid put on medical services should be across the board, regardless of insurance. Doctors would not lose money as long as the following solutions are also included in the health plan.
2) EXCESSIVE TESTING. Doctors order many more tests than are necessary in order to protect themselves from expensive malpractice suits. All those unnecessary tests get expensive. Patients should be offered the option of declining additional tests and signing a waiver of liability. Which brings us to...
3) MALPRACTICE LAWSUITS. Believe it or not there are people who sue just to try and wrangle money out of doctors and hospitals. In many cases the medical providers simply settle out of court - it's cheaper. And when they don't, awards can be in the millions, so malpractice insurance is very expensive - a cost that providers must pass on to their patients.
Solution: Put reasonable caps on awards. And only proven gross negligence should be allowable as "cause". Medicine is not cut-and-dried science. That's why they call it the PRACTICE of medicine. Nothing is guaranteed, and doctors - just like you and me - can make honest mistakes.
4) REFERRALS. The medical community thrives on the "patient revolving door". No matter what you see the doc for, chances are he will try to automatically set you up with a "follow up" visit - costing you more money. In most cases it is not necessary. In some cases any "follow up" could be done by phone without cost if your issue has been controlled or eliminated, but that would not put extra cash in the docs pocket.
And then there is the "referral merry-go-round". You may know that you need to see a "gut" specialist - a gastroenterologist. But you can't just make an appointment with one, because your personal care physician can't tap your wallet that way. Nope. You gotta go see him, first, and pay for that office call just to have HIM set up an appointment for you with the gut guy - who may, in turn refer you to some other doctor.
Solution: Patients should be able to make appointments directly, without a PCP go-between, if they already know who they need to see. EXAMPLE: I had a gastro guy in Maine. I have UC. I moved to VA and knew I needed to have a new gastro guy. But to get one, I first had to get a PCP give me a referal. I KNEW what I needed - there was no need to have a PCP tell me what I already knew, and charge me $220 to do so.
5) PRESCRIPTION DRUGS. These are a license to steal, especially when they keep changing the use of the drug. Drug manufacturers have 7 years to profit as much as possible from their drug before the patent lapses and others can make cheaper generic versions. It's called the "exclusivity period". Designed to help them profit after investing so much into it. But they often profit TOO much. If they can find another use for the drug when the 7 years is up, they can keep their monopoly on it for another 7, and so on. That said...while the R&D is done in America, most drugs are actually manufactured overseas, predominantly China. It makes good sense to bring that manufacturing back to the states and by a non-profit government agency, then sold on a non-profit basis. Big pharma can make their R&D profit, but manufacture and packaging should be on cost basis, to reduce the cost overall.
Solution: First, exclusivity periods should not be permitted more than once per new drug. And if generics can be made so much more cheaply, then so can the original product IF the research and development costs were offset. This can be accomplished by having the government subsidize the R&D, reducing the cost to the drug maker. And by subsidizing, those costs are divided among all taxpayers, and not just the sick. If taxpayers can foot the bill for treadmills for shrimp, or tunnels for turtles, I think the health of the people should be getting first dibs on that money. Subsidize R & D, and remove that cost from the product.
6) UNHEALTHY LIFESTYLES. This is the BIG one. If people were to choose healthier lifestyles, there would be far less need of health care to repair the damage. From the foods we choose to consume, to the amount of exercise we participate in, and to other choices such as smoking, alcoholism and drug addiction, poor lifestyle choices are responsible for more than 80% of all health issues.
Solution: Poor lifestyle choices should be taxed - those whose poor choices drive up the cost of health care should be responsible for those extra costs. Increased taxes on products such as tobacco and alcohol should be put into a fund specifically designed to subsidize health care, or to help offset the cost of any exercise equipment, athletic gear, or gym membership to encourage exercise. Unhealthy foods and drinks should be taxed and the money collected should be used specifically to reduce the cost of healthier, natural choices which are currently too expensive for many, which contributes to unhealthy choices. In this way, those responsible for higher health care costs would be paying for it, keeping costs down.
The actual health CARE, and not health INSURANCE is what the government should be subsidizing.
So why don't those in the Democrat leadership want to make these simple changes to improve health care and reduce its cost? Because that is not what they want - they want government to CONTROL health care. They understand that if they control your health care, they control YOU.
As a final thought, assuming we bring costs down significantly, the ONLY insurance a person should need is catastrophic insurance, to cover things most people cannot afford, such as cancer treatment. If insurance covers only catastrophic issues, the cost is significantly reduced even more.
Together, these things are not difficult to achieve. Certainly, many people will still make lifestyle choices detrimental to their health, but the high taxes on those things would help offset the costs incurred. In other words, people choosing to harm themselves would be the same people carrying the brunt of the costs of their treatment. No longer will you and I be paying too much for insurance because someone else chooses to drink, smoke or junk food themselves into oblivion.
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If we want to decrease the expense of health care, we must first address the actual needs and the costs of those needs, and THEN we can address insurance to cover them. In this post I am not going to include the lifetime damage to bodies because of vaccines which are literally designed to weaken the immune system (or it would destroy the vaccine) which, in turn, makes the patient much more susceptible to more serious autoimmune diseases. I'm not including that here, as it is far too late to change what already is. But people should seriously consider swearing off ANY vaccines henceforth.
First and foremost we need to address the poor lifestyle choices that contribute to 70% of all health issues. One hundred years ago the average person was in good health, barring an injury or contagious disease. In nature, the normal state of health is good health, and poor health is abnormal. We have managed to turn that on its head with our proclivity towards making poor choices like smoking, too many sweets, fake foods (if it wasn't food a hundred years ago it is not food now), an over abundance of chemicals and preservatives and an aversion to actual exercise and physical labor. You don't have to be a doctor to understand that our choices are largely responsible for our health. It is estimated that over 70%, and perhaps as much as 80% of all health care needs are attributed to poor lifestyle choices. If we were to all live by the Biblical statement, "All things, in moderation", and get sufficient exercise, we could cut health care costs in half.
And we could cut them even more by using our tax system to discourage poor and harmful lifestyle choices and apply those taxes to directly reduce the cost of healthier options. For example, increase tax on sodas and cigarettes and use those taxes EXPRESSLY to reduce the cost of healthy, whole food and/or fitness equipment or gym memberships.
Costs can be reduced further by capping malpractice awards. Medicine is an imperfect science; honest mistakes can be made. The ONLY lawsuits that should be permitted are for instances of gross neglect or incompetence, and then the awards should be capped at reasonable levels. This would reduce costs in two ways: first, by reducing the exorbitant costs that doctors and medical establishments must pay for malpractice insurance, and second, because doctors will not feel obligated to "over-test" in an effort to cover their butts. Currently, doctors must test a patient for many things unrelated to the health issue, just to play it safe and not risk a lawsuit.
To reduce health care costs further, it is as simple as stopping the "revolving door of referrals." If you know you need a gastroenterologist, why should you be required to first see a personal care physician for a "referral"? The cost of seeing the PCP adds significantly to the cost. We should be able to schedule our own appointments with specialists as long as we already know the diagnosis.
Case in point - I suspected my medication for ulcerative colitis may have caused PML, a serious viral infection, so I wanted to see a professional to get an MRI to see if I was infected. I had to first see my PCP ($225) to get a referral to see the neurologist ($640) who referred me to an unnecessary HEART specialist (my heart is perfect and had nothing to do with my issue) at a cost of $1200, who then, finally, got me an appointment for an MRI ($1550). A total of $3615.00, when all I needed was the MRI at less than half that cost. And as it turned out, I did not have PML. But $2,000.00 was wasted in getting that eventual determination.
Now that we have lowered the actual costs of health care into the realm of sanity, we can NOW address the cost of insurance. Having reduced health care costs by at least 50-75%, it is safe to assume one of two things - either the cost of insurance can be reduced by 50-75% OR most people can afford their health care costs without the need of insurance, as they would only be paying as much for their health care as they would have had to pay in insurance deductibles, anyway.
A PROPOSAL:
1) INSURANCE. Insurance always increases the cost of things, because medical providers can charge more to insurance companies. Since the insured does not have to pay much of the bill, he has no cause to complain. This is precisely why medical providers charge much less to those without insurance. If they can charge less to one person, they can charge less to all. Also, insurers are classic "middle men", who must be paid for the services(?) they provide.
Solution: the caps that Medicare and Medicaid put on medical services should be across the board, regardless of insurance. Doctors would not lose money as long as the following solutions are also included in the health plan.
2) EXCESSIVE TESTING. Doctors order many more tests than are necessary in order to protect themselves from expensive malpractice suits. All those unnecessary tests get expensive. Patients should be offered the option of declining additional tests and signing a waiver of liability. Which brings us to...
3) MALPRACTICE LAWSUITS. Believe it or not there are people who sue just to try and wrangle money out of doctors and hospitals. In many cases the medical providers simply settle out of court - it's cheaper. And when they don't, awards can be in the millions, so malpractice insurance is very expensive - a cost that providers must pass on to their patients.
Solution: Put reasonable caps on awards. And only proven gross negligence should be allowable as "cause". Medicine is not cut-and-dried science. That's why they call it the PRACTICE of medicine. Nothing is guaranteed, and doctors - just like you and me - can make honest mistakes.
4) REFERRALS. The medical community thrives on the "patient revolving door". No matter what you see the doc for, chances are he will try to automatically set you up with a "follow up" visit - costing you more money. In most cases it is not necessary. In some cases any "follow up" could be done by phone without cost if your issue has been controlled or eliminated, but that would not put extra cash in the docs pocket.
And then there is the "referral merry-go-round". You may know that you need to see a "gut" specialist - a gastroenterologist. But you can't just make an appointment with one, because your personal care physician can't tap your wallet that way. Nope. You gotta go see him, first, and pay for that office call just to have HIM set up an appointment for you with the gut guy - who may, in turn refer you to some other doctor.
Solution: Patients should be able to make appointments directly, without a PCP go-between, if they already know who they need to see. EXAMPLE: I had a gastro guy in Maine. I have UC. I moved to VA and knew I needed to have a new gastro guy. But to get one, I first had to get a PCP give me a referal. I KNEW what I needed - there was no need to have a PCP tell me what I already knew, and charge me $220 to do so.
5) PRESCRIPTION DRUGS. These are a license to steal, especially when they keep changing the use of the drug. Drug manufacturers have 7 years to profit as much as possible from their drug before the patent lapses and others can make cheaper generic versions. It's called the "exclusivity period". Designed to help them profit after investing so much into it. But they often profit TOO much. If they can find another use for the drug when the 7 years is up, they can keep their monopoly on it for another 7, and so on. That said...while the R&D is done in America, most drugs are actually manufactured overseas, predominantly China. It makes good sense to bring that manufacturing back to the states and by a non-profit government agency, then sold on a non-profit basis. Big pharma can make their R&D profit, but manufacture and packaging should be on cost basis, to reduce the cost overall.
Solution: First, exclusivity periods should not be permitted more than once per new drug. And if generics can be made so much more cheaply, then so can the original product IF the research and development costs were offset. This can be accomplished by having the government subsidize the R&D, reducing the cost to the drug maker. And by subsidizing, those costs are divided among all taxpayers, and not just the sick. If taxpayers can foot the bill for treadmills for shrimp, or tunnels for turtles, I think the health of the people should be getting first dibs on that money. Subsidize R & D, and remove that cost from the product.
6) UNHEALTHY LIFESTYLES. This is the BIG one. If people were to choose healthier lifestyles, there would be far less need of health care to repair the damage. From the foods we choose to consume, to the amount of exercise we participate in, and to other choices such as smoking, alcoholism and drug addiction, poor lifestyle choices are responsible for more than 80% of all health issues.
Solution: Poor lifestyle choices should be taxed - those whose poor choices drive up the cost of health care should be responsible for those extra costs. Increased taxes on products such as tobacco and alcohol should be put into a fund specifically designed to subsidize health care, or to help offset the cost of any exercise equipment, athletic gear, or gym membership to encourage exercise. Unhealthy foods and drinks should be taxed and the money collected should be used specifically to reduce the cost of healthier, natural choices which are currently too expensive for many, which contributes to unhealthy choices. In this way, those responsible for higher health care costs would be paying for it, keeping costs down.
The actual health CARE, and not health INSURANCE is what the government should be subsidizing.
So why don't those in the Democrat leadership want to make these simple changes to improve health care and reduce its cost? Because that is not what they want - they want government to CONTROL health care. They understand that if they control your health care, they control YOU.
As a final thought, assuming we bring costs down significantly, the ONLY insurance a person should need is catastrophic insurance, to cover things most people cannot afford, such as cancer treatment. If insurance covers only catastrophic issues, the cost is significantly reduced even more.
Together, these things are not difficult to achieve. Certainly, many people will still make lifestyle choices detrimental to their health, but the high taxes on those things would help offset the costs incurred. In other words, people choosing to harm themselves would be the same people carrying the brunt of the costs of their treatment. No longer will you and I be paying too much for insurance because someone else chooses to drink, smoke or junk food themselves into oblivion.
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