Ah it's that time of year again. Get the kids on the yellow bus, sit in traffic and think about stuff that bugs you.
Right now, one thing is bugging me (at least more than anything else) - healthcare reform.
Yes, it's controversial and yes, it's annoying but the reality is something is going to happen this year regarding healthcare and insurance whether you like it or not. Apparently to have an opinion differing from those in elected positions makes one 'Un-American' or an extremist.
However, I am going to propose something different with this blog today. I am going to suggest that people can actually have a civil conversation and debate about creative ways to help solve this problem. Here are the rules:
1. No berating an opposing view.
2. Your argument must be supported by facts
3. Please refrain from salty language (that's only allowed by me, the host. It's the only priviledge I get to enjoy.)
4. Have fun and no solution is off limits. (That's called brain storming - something politicians in DC are incapable of doing because it involves having a brain to storm with.)
So here's my idea (yes, my bullet-proof vest is zipped up and I have my big boy pants on.)
Require surgeons to post their performance, or track record, showing how many operations they've performed, the number of medical related issues that resulted from these operations and the years of experience their staff has. Basically a surgeon would be required to give a three year history on patients after the surgery. (Think of it like the label on the back of a breakfast cereal, only something that's easily written on an 8.5 x 11 piece of paper.)
Next, after reading the 'prospectus,' allow the patient the chance to either pay A) a price that includes the ability to sue the the doctor for malpractice or B) a price that does not allow the patient to sue for pain and suffering, but only lost wages.
In the auto industry they call this 'tort' or 'no tort.'
Now before you go berzerk on me, consider the following:
According to statistics from Stanford University, in 2005 about 20 million people underwent surgery with anesthesia. 12,000 of those patients died from a surgery that was unnecessary (i.e - plastic surgery, elective surgery, etc.) 106,000 died from medication errors associated with the surgery, 20,000 from hospital errors and 80,000 from infections resulting from the surgery (National Ledger, 8/21/2009.)
Let me do the math for you. That means that .1% of all surgeries resulted in death due to hospital errors during surgery. Other patients that died were a result of surgery that was not elective and required immediacy, such as heart attacks, cancer treatment, horrific accidents, etc. Let's call these things 'unpreventable' and outside of a hospitals ability to 'fix.'
Consider some of these facts, also from the National Ledger and confirmed from other sources such as National Institute on Health.
A study conducted by the AMA revealed that despite spending $3000 more per person on healthcare here in the US compared to Great Britain, twice as many American have diabetes and we also have a higher rate of heart attacks, strokes, lung disease and cancer than our friends across the pond.
What gives?
We're overmedicated folks. A forty-year study conducted by Dartmouth confirmed that as certain areas of the country spent more on healthcare, those folks died a faster pace than areas that spent less on health care. Is less really more?
The World Health Organization in 2008 found that the US has the worst track record compared to other industrialized nations when it came to preventable deaths due to treatable conditions such as bacterial infections and and complications from surgeries (both of which occur in hospitals, I might add.)
Next, cap the number/type of prescriptions one doctor can write. Do we really need auto-refills from an answering machine at the local pharmacy? Shouldn't SOMEONE monitor how the prescriptions are working PRIOR to reordering?
From personal experience, I literally stopped taking medication because I felt better and have eliminated my acid reflux problem. I still have 97 pills left from a 100 pill order, but the auto dialer at the pharmacy called to remind me that my prescription can be refilled and to place my order soon.
I am not an automobile needing an oil change.
Instead, through preventive maintenance NOT induced by drugs (you know, running, eating better and going to bed at a reasonable time) I helped my body heal. Old fashioned approach, but something that works quite well; not just for me but for all of us. We're not unique, folks, despite what people tell us.
So there it is.
We spend twice as much as Britain for care that is worse, so the solution before you and the rest of America is to do what? Spend more money?
Money is not the answer. In fact, money is what got us into this mess. Money for the drug companies, money for the lawyers, money for victims.
No. Remove the monetary element and begin letting people choose.
I anticipate many comments, discussions and ideas. That's what this is all about.
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3 comments:
It's funny, but my son and I had this same conversation last night. Although by label we are on opposite sides, we most often find that we are both in the middle. We decided that money is the root of the problem (sound familiar?). Frivolous lawsuits and over the top settlements have added to the burden for all of us - providers and recipients. Those have to be stopped. I really like your "tort" and "no-tort" option! In addition we need to do more preventive care - OK so the drug companies and hospitals don't make as much on preventive care, but... And one more thing - and this will probably cause controversy. We need to quite using extraordinary life saving methods simply because we can. Sure grandpa lived to be 100, but the last ten years was only due to all the machines attached - there was no "life" as we define it. Yes we can save preemies born earlier and earlier, but at what quality of life? No, this isn't the so-called death squads (where did that come from anyway?) but merely being compassionate. OK – have I said enough? Sorry if any of my thoughts cause conflict.
Christian...what needs to be said more than anything is that the psychology surrounding healthcare has to change. As you stated in your blog, we ARE an overmedicated society. All too often we rush to the E/R for something that's for the most part, routine and not that big a deal. I like the idea of places like MedExpress out your way on Route 228 in Mars. Sure you can't go there at 4am, but they're open seven days a week and close at midnight. It costs a great deal of money to keep E/Rs operating on a regular basis, and if we truly understand the difference between "urgent care" and "trauma" then we can really begin to see the difference in keeping costs of healthcare under control. We do need tort reforms in place to ensure that those who make a living taking advantage of the court system are stopped dead (pardon the pun) in their tracks and that doctors can afford to practice here without having to pay outrageous malpractice insurance premiums. The recent legislation limiting mandatory overtime for nurses has also been a plus. I think we all need to sit down and have a rational discussion about Healthcare 101, (hence your blog) and share ideas of what needs to be done to combat this very sick system we have in Pennsylvania. Great blog!
This is well-intentioned but has some wrong data. England does NOT have better health care than US. Theirs is okay, but the wait time for elective surgery is too long. Here we have the best health care in the world. Something should be done to maintain that level of care. But the liability doctors face is astronomical. One lawsuit could bankrupt a solo practitioner, so many physicians are opting to leave private practice and work for industry. If you are a member of Kaiser Health Plan, for instance, your wait time for elective surgeries will be similar to that of the people in England. In other words, management of expense is the key to keeping fees down.
I don't know the answer, but I know my doctor [and my doctor-son] have both been squeezed down to bare bones by the fees they are able to collect, either from HMOs or from Medicare. The doctors are running themselves ragged just to stay afloat. They no longer make tons of money; they're reduced to the lifestyle of a laborer. It's the tort lawyers who are raking in the dough. We do need tort reform -- a cap of, say $250,000 for any malpractice injury. Plus of course, self-policing of the doctors by their professional organizations.
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