digitalBush

courtesy of SarahMcD ॐ

Like everyone else in the country, I'm watching our lawmakers like a hawk with regards to this national healthcare agenda. In my first article of this series, I identified that the true problem is rising costs. Healthcare providers are held to a higher standard in the professional world. They are, after all, responsible for an important part of our lives. It's their knowledge and judgement that protect and cure us from sickness and disease. A poor diagnosis could delay treatment for a very time sensitive illness and which could possibly make treatment impossible. That is a huge responsibility.

So, why is it that we frown upon a $100 visit to the doctor to diagnose and recommend treatment for a sinus infection? In order to get to the point where that doctor was allowed to make that diagnosis, he or she had to go through 8 years of school and 3 to 8 years of residency and internship. They have to maintain continuous education after they are "done". And, if that isn't enough, they are potentially liable if they misdiagnose your symptoms as a sinus infection instead of a brain tumor. Compare the effort involved in that $100 visit with something like a lawyer or a mechanic and you will see that you are getting a bargain.

While I believe that we can do some things to help lower the costs, you still need to take into consideration what you are paying for. Now, let us explore the ways where we can lower costs here.

1. Reduce the healthcare provider's susceptibility to frivolous lawsuits. Providers still need to be able to be held accountable for their wrongdoings, but the provider needs to be protected as well. Guidelines should be (may already be?) defined for proper treatment paths. Complaints will go before a board and suits can only go forward if the board determines malpractice.
2. Let the government provide incentives to get physicians into general/family practice or rural areas where coverage is needed. If the provider gives a 5 year commitment to help out where needed, the government could help remove some or all of their loan burden. After they've completed their 5-year commitment, then they can go and pursue their specialty.
3. Use technology to streamline the medical billing process. As a worker in this field, I can say that the healthcare industry's use of technology sucks. There are "standards" in the x12 837 document that no one follows. It's a EDIFACT document which is archaic, hard to read, and hard to parse compared to XML. I would love to see a true set of standards and tools evolve that would help make medical billing quicker and easier for everyone. This would drive down the costs and reduce this large piece of overhead from the current system.
4. Focus on wellness instead of the cure. I think that our country's overall health could be improved if people were required to have a yearly checkup in order to maintain health insurance coverage. Many illnesses could be caught in early stages and treated before they have an opportunity to become a problem.
5. Bring some sense of responsibility back to the consumer. I think the best thing that's happened regarding my insurance was our company's move to a HDHP + HSA. I'm responsible for that first $5,000/yr for my family. After that, the insurance steps in 100%. Lower insurance premiums mean I can put more into my HSA. No co-pays mean that I can budget for my actual total healthcare costs. No surprises. This makes me more aware of how our healthcare dollars are being spent and gives me some opportunity to make decisions about our care.

There are five points that have been bouncing around in my head for a little while. In my mind, any government bill which doesn't address these basic points is fiscally irresponsible. Taxpayers deserve to have their money go as far as possible with minimal waste.