Reimagining Healthcare
Everyone and their uncle is trying to capitalize on our broken healthcare system. They think they can fix it. Even the techies think they have an answer. They don’t. Why? It’s simple. They are all trying to reimagine healthcare by leaving the insurance industry and the government in the equation. That problem is unsolvable because they are the problem! Now remove the insurance industry. Remove the government. Let’s say everyone has some catastrophic plan that is reasonable in cost. You can’t tell me this is impossible to do. And let’s say that for a cheap monthly fee the only thing that is covered is after you pay $5000 of your own money (and maybe that is less depending on income). Let me repeat that. NOTHING IS COVERED! Guess what would happen? Patients would shop around. Doctors would be paid in cash and the prices wold come down because there is no more coding, no more billing, no more accounts receivable. Since overhead is less, the cost is less. If doctors don’t lower their cost, patients will go elsewhere. Also, patients would only get prescriptions that are reasonable in cost. The cost for diagnostic studies and MRIs come down. This is capitalism and it works.
Now why do I believe this? Because I have seen it. With high deductibles and health ministry plans, patients are shopping around. They are doing it already and they are doing a great job at it! I have helped them find lower costing medications by using services such as goodrx.com. I have found them a place to get a back MRI for $500. I have found them a cardiologist center that does stress echoes for $225. It is happening already and it puts the patient’s skin in the game. And it turns out direct primary care works perfectly with this plan. The problem is that all the savings are going to the insurance companies.
Remove the government and the insurance companies from healthcare. They do nothing and are not needed. Let’s change Obamacare to CatastophicCare* and we will make healthcare cheaper and better for everyone. That’s Reimagining Healthcare.
*Sure, there are some details and minor glitches left out here but they are easy to fix and no plan is perfect. But I would put this concept against any other idiotic plan out there that plans to remove doctors, reward insurance executives or let administrators be the gatekeepers of healthcare.
Hard to stuff that genie back into the bottle–I graduated in 1981, and an intermediate office visit was $18, cash (or vegetables or eggs, as I worked in a federal health manpower shortage area). Insurance was just to cover “major medical,” and preventive services entailed Pap smears for women, occasional blood pressure checks and tetanus shots for adults. I think practitioners of “direct primary care” (new name for concierge medicine) are practicing in this kind of world, but if everyone did, the majority of the US would not be covered. Yes, patients should have skin in the game and we should all know what everything costs (and what the charges are, often very different)
This is already happening!! My daughter has a deductible of $3500!! Guess what? She looks around for the cheapest costs for labs, meds, and doctors because she has to pay it herself. Her plan reminds me of the first insurance plans that only paid for the hospitalization not doctor calls. Of course we didn’t have people who sued at the drop of a hat so that the primary dr. had to refer you because you MIGHT have something exotic and you’d sue him if he missed it. We didn’t have drug companies putting billions of dollars into commercials so that the patient DEMANDS a drug you know won’t work for him. Your model works for people who are smart and have enough common sense to accept that some illness can only be managed not cured. It works for those who don’t have chronic illness dogging them. It works if the patient doesn’t get admitted to the hospital. I would stop all drug ads–let’s see what happens to drug prices then. Oh and what happened to the rules about no more gratuities to docs? That’s going on stronger than ever.
Such plans are now, as you know, outlawed by the ACA since normal people cannot possibly act in their own best interest without the guiding hand (or fist) of big government. First dollar insurance coverage has always been expensive. In the not too distant past, many smart self employed professionals like lawyers, accountants, real estate agents and small business owners would buy a high deductible plan in case they got hit by a truck and would pay their primary care costs which would rarely exceed $1000 per year. Obamacare outlawed that and now many of these people now pay $600 per month or more for plans with a $6000 deductible. I’m sure this is not news to the readers of this site; I do wonder if the voters who wanted a government run health care utopia will ever realize their folly.
Thanks, Seneca – there’s something about the concept of “fairness” that brings out the meanness in some people. For some, fairness is making sure that nobody gets it any better than you do.
I remember the “catastrophic health care coverage” that is now outlawed – that was Senator Ted Kennedy’s Liberal Pink Socialistic haze of a plan that now seems quite conservative indeed.
What we have now is wishful thinking from the bottom of the cliff, that nobody has really believed in levitation sufficiently in the past. Majik!