Why is healthcare so costly and what do we do?

By: drrebap

Deerfield Beach

In the U.S. President Obama raved about healthcare reform and made some changes to our system but the battle of the socialist reform of healthcare and the right to financial freedom is one that can not be pulled in one direction too tightly because the rope will snap! The super size phenomenon goes beyond the waist line! Everybody wants the best of the best healthcare in the U.S. Including those who are not citizens. Including those who don't pay for it and including those who pay a lot for it... So, who wins? Nobody. Patients are rarely happy with the medical care they receive whether it's not enough time with the doctor, too much time in the waiting room, not understanding the plan of care or what their diagnosis is and that is just the office visit. Hospital stays are out of control expensive; they do have to pay for the people who don't pay afterall. And how about the deepest pockets emptying fastest? Lawsuits are out of control. While at times they are justified, there are also those times when something happened someone didn't like and they need someone to blame to make them feel better. Why is it such a fight? The common goal is health, right? We can't force healthy lifestyles and although bad choices result in the majority of the medical problems we face as a country, it is still not fair to impose food choices, alcohol and tobacco usage and exercise habits on people. But, there should be incentive to live healthier. Rewards for helping healthcare eliminate the cost of lifestyle diseases such as Diabetes, Hypertension, etc. Why do we get tax credit for energy savings but not gym memberships, annual check ups, normal BMI, etc. May sound strange but so are our priorities. More credence is given to who pays and how than what really matters, our health.
As a physician, it is not my gain. I am a primary care doctor that has to work far more and cover much more in patient care than many other specialties. Am I more important? No, that is not my point; we all are essential. My concern is reimbursement. How in the world did medicare (the govenment) set the standard for payment? Sounds a little like going to the store and setting the price for all the items and then every customer thereafter pays that price whether it's 10% less than asking price or 50% less.
The medical profession has been taken advantage of. While we are busy taking care of patients and working buried deep in charts, businessmen take over "patient care" determining the future of our system. We don't necessarily know business. Unfortuantely, we do not have any influence in how much is charged, how insurances choose what to pay for, what medications are covered, etc. We are limited in our influence over medical economics. Why does this matter to anyone who is not a doctor? Because you want a well trained physician to take the time you deserve to keep you healthy, try to prevent disease and have your best health interest at heart. Where is the reimbursement in that? Non-existant. We need to restructure healthcare. From patient care to business management, there is a lot of missing pieces to coordinate. It is similar to playing telephone and the wrong message gets convuluted and turned over time and again. What do we do?
I suggest fee for service. Billable to the patient. Forget the insurance companies. Why can't patients choose their doctor and pay for healthcare out of pocket to eliminate all the extra overhead of processing insurance claims, etc. Take the time out of collecting from insurance companies, stop the delay in patient care, increase amount of time spent with patients and in the end, likely save the patient money and not order unnecessary testing to "CYA" or "cover your ass". It is an agreement in treatment, the patient agrees to pay for a service, an expected outcome is given and any complications will determine the financial outcome of the doctor's practice just like any company would go out of business if they did not do a good job. The patient could pay a "membership fee" or just fee for service. The hospital could impose a tax for payment on those hospitalized at a higher percentage and the general population at a set percentage. What about the people who can not afford an office visit. They can go to clinics provided a percentage of this tax. Care will not be to the standard of the private practices but that is what makes the U.S. the U.S. We have to work to get better services, products, cars, homes, etc. We have the ability to pave our future. The choice is Amercia, the people can make it happen.