Monday, April 1, 2019

They're Looking At Health Care All Wrong


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.

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 perservatives 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 exhorbitant 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.

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.

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) 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. As it turned out, I did not have PML. But $2,000.00 was wasted in getting to 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.

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. And that is the only type of insurance that should be subsidized by the government (with the exception of Medicare and general health care for the poor - Medicaid)

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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