Ex-Obama advisers suggest typical answers to reduce healthcare costs. The lack of creativity is not the answer to what ails us fiscally.
by William D. Charschan DC,CCSP, author Cheating Mother Nature, what you need to know to beat chronic pain.
Health Care Overhaul, Version 2.0. Their biggest idea is a first-ever budget for the nation’s $2.8-trillion health care system, through negotiated limits on public and private spending in each state. While this is what Massachusetts is currently going to try, placing global limits on costs has not stemmed the rising costs of care in other countries. What it has done is slow the rise in costs down by placing fiscal caps on the cost of care. ( read about this here)
While cost controls may sound promising, not addressing the root cause of rising healthcare costs is an in the box failure of think tank proportions. In other words, too many people who are supposedly experts who think alike using ideas that have not solved problems in other countries, but merely slowed down the march to higher future costs since this does not effectively address expectations in the healthcare system.
Why expectations? As discussed in previous blogs, Allopathy, the system that is commonly viewed internationally as western medicine does little to understand problems, but tries to use symptoms as the basis for diagnosis, and then address those symptoms with a drug or other substance, with the idea that there is a chemical solution for what ails us. Furthermore, Allopathic physicians know little about the musculoskeletal system, which is 55% of the body and is entwined with other systems. Somehow, we have gone toward a model of specialization, with the idea that the different parts can go bad and need to be treated, ignoring the systems they work within. Allopathy has convinced the international public through drug companies and government means that they have the answers, the public needs all the screens and monitoring for them to stay healthy and that aging is a disease. The model has gone away from the 40 year old model of primary care doctors who take the time to help figure out the problem, with the occasional use of a higher priced specialist, while specialists in today’s model receive many referrals because primary care has been starved financially.
We are all built a certain way, and come from gene pools with certain idiosyncrasies, so the way we feel, due to personal bias is meaningless. In other words, if you are tight all the time, and you have been this way from the age of 6, you consider this normal. When it hurts, it is not and it requires a doctor to help us figure it out because the healthcare system wants us to not understand what hurting means. Since the system is based on a faulty premise of symptoms (which at times is used effectively, but often abused), many people endure avoidable procedures, tests and treatments that either do not work or make their problems worse.
If you need proof that these ideas will fail, look at many of the nationalized healthcare systems with care rationing that still experience rising costs. China was recently noted as another country that has problems with cost.
Other systems, outside of allopathy are not as integrated as they should be such as acupuncture, naturopathy, napropathy, chiropractic because they are not considered as essential to the world’s ills, yet, medicine knows nothing about the bodies energy systems, musculoskeletal systems and cares little about how it all integrates. The use of drugs solves little, but keeps people on the hook because this business model is about subscription usage, rather than cures.
What we need to do today to fix the system
- Primary care needs to be able to spend more time with patients, especially the elderly ones and be paid appropriately for it. If not, more doctors will leave these systems and more referrals to specialists will occur, no matter how you cap costs.
- Better funding for primary care will bring more specialists into accepting patients for primary care, saving the costs of test after test since fewer referrals will be necessary.
- Better integration for many providers such as chiropractors who were thought of as alternative, now are used more effectively with allopath’s. More open mindedness of solutions should be the rule, with these providers and their research being better funded for what they do as well as research into how to more effectively use these professions to solve problems.
- The health care system needs to stop coming up with new ways to screen people for sickness. As we saw a few months ago, this does not work and much of this is being invalidated. Wellness care is where the system needs to go.
- The system is filled with health care propaganda. The public needs to understand when they truly need the help of a doctor and when they do not. Right now, those visits are mostly done out of fear. Knowledge will change many of the reasons people visit their doctor.
- Many nurse practitioners and other healthcare extenders can perform many of the mundane physician tasks such as vaccinations and basic subscriptions. There use will likely grow, since they can be used more effectively in the coming years.
- Electronic health records systems must be easier to use and standardized. These systems are a burden on the system in their current state. They slow the doctor down, have too many menus and add hours to a doctor’s day. A better system would be user friendly, intuitive and take minutes per record to document what has been done. Since the system would be standardized, doctors all over the country would be able to utilize this national data base which would eliminate duplicate testing and provider a better consistency of care.
- Stop looking at aging as a disease. It is not, it’s a process. This should not consume the amount of resources it does not without having a long term benefit. Our current model is torturing our elderly and needs to be rethought.
- Take a serious look at when and for whom technology can be helpful. Many preemie children are saved, only to have horrible physical problems for the rest of their lives. Was the use of the technology appropriate? The system and the parents are expected to then spend years caring for these mistakes. Just because the technology exists, it does not mean it is appropriate to use it. If there was not a third party paying for this huge waste of resources, it would never be used. We need to create appropriateness criteria for when to use technology to save a life and then have the long term view of what will this life be like if we do. Currently, we treat and then suffer the consequences of poor decision making for years later.
- Hospitals and doctors cannot charge what they feel like to people. Currently this model has created a system where if you have insurance, the cost is way lower, but if not, the prices have nothing to do with the realities of what is being done. The same for doctor visits. While primary doctors have real competition from walk in clinics keeping the prices in check, other specialists think nothing of charging someone out of the network $300 or more for a 15 minute consult, yet the in network rate is more appropriate. What is a consumer to do? Prices are based on the fear index, not on the work done.
- Single payer is the way. Currently, our system is out of control, and insurance companies are part of the problem, since they paved the way to the 10 minute primary care visit, a huge driver of referrals and their associated costs. Inner city hospitals have gone under because of Medicaid underpayments, Medicare is in the middle and insurers are paying for the underpayment of Medicaid. We will eventually end up with Single payer, however, politically, it is not currently possible. Meanwhile, a scheme like Medicare for all would reduce our costs 20% over night. For those who are concerned about the government run healthcare system, the VA and Medicare are successful system the government runs. Private insurance has failed us and continuing a failed experiment does not make it work better, it just costs more.
What do you think? As always, I value your opinion.