Stanley Feld M.D., FACP, MACE
Dr. Tom Price, a Republican member of Congress from Georgia, the new chairman of the Republican Study Committee wrote an article in the Wall Street Journal that mimics my proposal for repairing the healthcare system. Someone should start listening to physicians.
During the last eight years the Republican Party has had a great opportunity to repair the healthcare system. I believe many Republicans in the House and Senate know what needs to be done. No one has taken a leadership position to do.
Now we have leadership that wants to do the right thing. Unfortunately the present leadership does not know the right way to do the right thing.
Consumer driven healthcare with the consumers owning their healthcare dollar is the way to repair the healthcare system. Personal responsibility for one’s health has been labeled conservative idea.
The concept is neither right wing nor left wing. It is simply logical. Self responsibility is the engine of American progress. Very bright liberal thinkers have advocated self responsibility. President Obama strikes me as one who can solve problems using logic and not right or left wing ideology.
I have pointed out the therapeutic magic of positive physician patient relationships. The government’s goal should be to nurture these relationships. It should provide a system that allows access to affordable, quality health care for all Americans. It should not nurture government dependency. It should also ensure that medical decisions are made in doctors' offices, not in Washington or some by “independent “board (Federal Health Advisory Board) removed from the bedside. It should help educate both patients and physicians about best practices of medicine. Patients should make the decisions for their healthcare.
“This board would offer recommendations to private insurers and create a single standard of care for all public programs, including which procedures doctors may perform, which drugs patients may take, and how many diagnostic machines hospitals really need. As with Medicare, for any care provided outside the board's guidelines, patients and physicians would not be reimbursed.”
All the stakeholders have been villains in the never ending escalation of costs to the healthcare system. I have blamed the healthcare insurance industry for being the worst villain. Its administrative service cost and waste as well as inflated overhead and excess executive compensation add 150 billion dollars to the healthcare system. It has lead to unaffordable premium costs, increased deductibles and co-pays, decreased patient access to care as well decreased reimbursement to physicians and hospitals. The reason everyone is “gaming” the system is the system reimburses waste and penalizes best practices. .
As Winston Churchill once said; “ Never has so much been paid to so many for so little” in the way of value added service to patient care.
I am presently reading John Bogles book “Enough”. In his book he describes the reason for rise and the fall of the financial sector. He could easily substitute the healthcare sector for the financial sector.
“That any endeavor that extract value from its clients may, in times more troubled than these, find that it has been hoist by its own petard”- proved not only eerily prophetic, but surprisingly timely. The industry has been blown up by its own dynamite.”
Tom Daschle has stated that the FHAB’s standards would serve only as a suggestion to the private market. Dr. Price points out the impeding results of Tom Daschle’s proposal.
“He has proposed making the employer tax deduction for providing health insurance dependent on compliance with the board's standards.
In an overtly political ruse, Democrats will claim they are dictating nothing to private providers, while whipping noncompliant insurers in place through the tax code.”
“To be sure, this strategy seeks to eliminate private providers completely. Forced into accepting rigid Washington rules and unsustainable financing mechanisms under Mr. Daschle's plan, most private insurers would be quickly eradicated.”
I believe the healthcare insurance industry has resigned itself to this faith. It is focusing on generating its income as an outsourced administrative service provider for the government’s massive new healthcare federal bureaucracy. The healthcare insurance industry has done very well with the Medicare Advantage programs and Medicare Part D. They have also done very well in the state of Massachusetts. It is making excess amounts of money under government sanction by controlling the healthcare dollar.
Who losses? The primary stakeholders lose (Patients and Physicians). The government also loses because it has formed another inefficient bureaucracy. America cannot afford Medicare in its present form much less expand it.
Dr. Price goes on to say; “This patient-centered approach must be built upon two pillars: access to coverage for all Americans and coverage that is truly owned by patients.”
“Through positive changes in the tax code we can make health-care cost effective and create incentives so there is no reason to be uninsured. This way, care is purchased without government interference between you and your doctor.”
Consumer driven healthcare using an ideal Medical Savings Account is a healthcare system that will be able to align all the stakeholders' vested interests.
I expect a great debate to start shortly.