Reimagining Modern Medicine

You may not know it, but I spent more than 50 years in the medical field.  

First as a guy selling the newest and the most amazing technologies to doctors and hospitals.  And later on while starting and running a company bringing acute dialysis and related treatments to hospitalized patients throughout Los Angeles and Orange County.  The very first such company of its kind to do so, treating more than 10,000 patients over its 40 year history.

So this qualifies me to offer up an opinion as to how we might remake our entire our medical system.  To make it less expensive and more responsive and more competitive.  Because, Fellow Patriots, it seriously needs remaking.  I'm pretty sure you'll agree with me on that.  So here goes:

First, instead of students spending $200,000 of student debt to become doctors, I suggest that the Federal Gubmint choose to be the payor of first and last resort.  I propose that we, you and me, the Taxpayers, underwrite that expense.  I suggest that we send students to medical schools that we select and pay their entire cost of education.  And when they graduate and are ready to become practitioners, I propose that they work for us to pay off their obligations.  By working in gubmint sponsored clinics for 7 years.

We should provide a nice, new Cadillac, all their malpractice insurance with premiums paid, and an attractive $150,000 a year salary to keep them warm and fuzzy.  Insuring that there's no disincentive to taking part for them in such a plan.  Similar to those whose medical education is paid for by the military in exchange for a multi-year commitmemnt.  And keeping them from having to go to work for HMO's because they can't afford the malpractice insurance.

Right now there's a law that specifies hospitals may not refuse to treat patients (Emergency Medical Treatment and Labor Act, 1986).  They HAVE to take anyone who shows up in the emergency room.  Whether they're illegal aliens or not.  Whether they're poor or not.  And whether they have the means to pay their bills or not.  They must stabilize patients without consideration of their ability to pay.  And keeping the hospitals from dumping patients to offload their obligations.  And the cost of that treatment must be borne by the hospitals.  The hospitals then have no choice but to raise their rates and force others who have insurance to pay those costs of operation.    

Making an aspirin cost you $10.00.  Making a gall bladder operation cost you $20,000 or $30,000.  Making a obstetrical baby delivery cost you $15,000 or $20,000.

Now we all know those services don't cost them that much.  But the hospitals have no choice but to boost their rates to make up for those who cannot, or will not, pay.  They admit to this.  But they will not tell you what you'd have to pay if this law were not in force.   

But if there were a Gubmint clinic next door or a block away from the hospital, with all the costs of treatment borne by the Federal Gubmint, that the indigents could visit instead of the emergency room, staffed by Gubmint doctors, and nurses, the cost of health care would drop like a stone.  Patients would still have to pay, but only fees deemed reasonable for the area.  Sort of like an actual Gubmint NGO (Non-Governmental Operation).  The treatments they'd offer would prove to be quicker and cheaper all around.  

A broken arm?  $50.00.  A knife wound?  $100.00.  The flu?  $50.00.  Removing unpaid patient care from the nearby hospitals.    

Second. allow citizen to develop their own Medical Savings Accounts.  Right alongside their 401(k)'s.  With the Gubmint and their employee health insurance serving as the backup.  The citizen could shop around, like they do for their cars, or a new roof, trying to find out which hospital offers the most cost-effective surgeries.  And CT scans.  And obstetrical services.  In advance of need.  This would certainly lower prices almost immediately by forcing hospitals to compete with each other.  

Doubt me?  What did your last CT scan cost?  $500?  $1,000?  $2,000?  Or your last baby?  $1,000?  $5,000?  $10,000?  You don't know, do you?  All you know is your insurance paid for it.  You should know.  And you could.  By putting YOU in charge of your health care.

Why do patients go across the Border to Mexican providers?  My suggested changes would eliminate the need to do so.

Third, require all health insurance companies to pay the patient, YOU, rather than the healthcare provider.  You negotiate the arrangement with your doctors or hospitals.  YOU decide where to go and how much you'll have to pay.  And then have YOU, the patient, write a check to the hospital.  Or the doctors' clinic.  You pay them out of your Medical Savings Account.  Sort of like a PPO, except you're also the payor.  And the incentive to save would let you keep what's left and unspent out of your MSA.  Such an arrangement would put YOU in charge of your health.  Not the insurance company.  Not the hospital.  Not your doctors.  

All of these changes are based upon "Enlightened Self-Interest."  You negotiate what's best for YOU and your family.  Nobody else.  The vey essense of capitalism.  The very same way you negotiate to buy a new car.  Or a house.  You're smart enough to do those things, right?  Whose to say you're not smart enough to manage your own healthcare?  

Talk to your Congressman/woman/other.  Talk to your Senator.  We need all of you to bang the drum or your voice won't be heard over the noise made by the hospitals and the health insurance companies.  They like it exactly the way it is.  That's because they created it.  That should tell you all you need to know...