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ShareThe problem with Obamacare and how to fix it (its not what you think?)
Many of us are listening closely to see what the Supreme court finally says on some of the important provisions of the Obama healthcare plan. The problem is being framed as a constitutional issue of liberty however, the real problems with the cost of care and the access to care could have had a better solution, eliminating the current showdown. It would have made more sense had we developed a system of cradle to grave care where the government healthcare plan took care of the essentials, and eliminated the medicaid (where doctors are underpaid), the current HMO/PPO landscape which is currently morphing from insurance carriers to self insurance using insurance carriers to pay the claims and rethinking Medicare and what seniors really need vs. what they have been taught they need.
Some who are reading this may scoff at the last statement, although many of us wonder why 85 year old aunt sadie needs 13 meds just to live and survive? In Florida, many older seniors are constantly going from doctor to doctor. What is the outcome you may ask? You already know since we all will eventually pass on to the great beyond. The trick is to do this in style. This is why how we take care of ourselves while we are young often reflects on us when we get older, whether we need replacement parts (hips and knees, heart valves, etc.).
What most people do not realize is that although this plan is about insuring everyone, it does little to fix the problem of the high cost. When we look at the previous paragraph, many of the doctor visits and procedures as we age do nothing to extend our lives, and neither do the excess drugs, although many pharmacists will share their concerns. We have been convinced by cleaver marketing and by our physicians that we cannot live without their constant monitoring. While some preventative tests do save lives, others have been proven not to and some led to interventions which clearly injured and maimed the aging individual.
Obamacare has many good preventative features including colonoscopy which is supposed to be covered at 100% (It is not always, and insurers will find ways, as they did with my wife to push the cost on to you), so its intentions are good. The move toward paying doctors more for results is the right idea except it tries to work within the current broken disease paradigm. This needs to change of course, but this plan is bold in that it at least tries to insure everyone.
For the detractors, the fact is that medicaid has bankrupted many inner city hospitals, who do not have a profitable mix of patients. Hospitals did get payments for idigent people who had no insurance, and they merely cost shifted, by charging us outrageous prices for in hospital services including facility fees, to pay for those who could not. On its surface, Obamacare should improve the funding and have more people insured. On the other hand, there will be more Medicaid, something many doctors will not take because it is below their cost of doing business. This needs to be rethought and so does the way we practice. The disease model is the main cost driver. We need to think differently but can only succeed if we change the way healthcare currently works. Not doing so will lead to cost controls, unaffordable premiums and a system that is already going bust.
How we can fix the problem with costs.
1. Get over the idea of more healthcare. This is something heard in the media. What does that mean? It brings up visions of more stuff being done for us for what outcome? What reason? This happens with seniors in their later years with no change in the outcome. Many of them would be outraged to know that most of the stuff they are on and the things that they are convinced to do either do not work or are harmful to them and they take all the pills out of fear and a lack of knowledge. This needs to change. People need to become better and more knowledgeable healthcare consumers when they are young. Decisions are best made from knowledge rather than fear.
2. Healthcare should be about helping you stay healthy. There are many things that can be done preventatively. We need to get away from the dogmatic approach of things such as worrying about our relatively low cholesterol numbers and taking something with massive side effects out of fear. You should be more fearful of the side effects.
3. Embrace competing healthcare technologies and thought processes, even if the conservative medical community finds them distasteful. There are many ideas that can possibly cure or help us find the reasons for cancer, that are outside the drug model. Recently I saw a documentary on Lymes disease showing how they persecuted doctors who used different methods of long term anti biotics sometimes over many years which finally helps the chronic form of the disease. Apparently, the recent discovery of bio film now puts into question the validity of the current guidelines which were written by health care providers who are on the payroll of insurers and big pharma. Their work helped destroy the practices of well meaning physicians who were successfully treating the chronic form of the disease, something most doctors were told could not exist because the bacteria was cured in three weeks. What they are finding out is that bio film protects the organism and many people who had lyme had long term neurological symptoms. These were known however, certain interests wanted to keep the lid on costs. I have no doubt a lack of honesty is more pervasive in healthcare than we realize.
4. Allow doctors in primary care to spend the time and pay them for that time. They must also enhance their knowledge of the musculoskeletal system. If they do not, they will order tests that could be avoided. Good manual skills will be enhanced with improved musculoskeletal knowledge and many chiropractic providers can resolve the musculoskeletal issues effectively and have proven to do it at lower costs.
5. Outcomes in healthcare can never been guaranteed, so to pay a doctor less for not getting the outcome is a double edged sword. On the one hand, there are very effective conservative ways to help people without drugs or surgery. On the other hand, after the best conservative approaches failed to resolve the problem, sometimes surgery is necessary. Most specialists should become more generalists and the pay disparity between primary care and certain high paid specialists should be narrowed.
6. People should be armed with more information and be able to handle many health issues themselves. The doctors are there to help but we have an unhealthy dependence on doctors as we age, as we take more and more dangerous meds because we were taught our lives depended on them. Did we ever need those meds? If people because more independent, and we eliminated the constant monitoring, we would need fewer doctors, not more. The wellness paradigm would provide for this.
7. Look at our processed foods from a different perspective – The government has paid farmers to grow corn instead of food in certain instances. Corn fed beef for instance is not natural because cattle naturally eats grass. Corn is a poor source of ethanol. This forced comodity prices up and these fields may be better for growing food, friuts and vegetables. Are all the genetically modified foods really safe? Does our body really understand them as well as naturally grown foods and are more natural types of farming really less productive? Maybe our go