For those of us who feel comprehensive health care reform is not needed, I would like to present the following case. I recently had a middle aged man who had undergone a common procedure on his kidney a few days prior. He had this procedure done in a city about 4 hours away. I asked why he didn’t have the procedure closer to home, and he answered that nobody took his MediCal. However, since he had been in the military, he was able to have the VA do it, but 4 hours away was their closest location with urology services. When I saw him, he had an infection. He needed to be admitted, and unfortunately, he had to go back to where the procedure was done. And of course, he needed to go there by ambulance, just in case “anything happened.” Naturally, this was the middle of the night, and so we had to get the medics and ambulance and send them on an 8 hour round trip ride to transfer this patient, who could easily have been treated closer to home. Follow up will be very difficult for this patient, as he will undoubtedly not drive 4 hours unless absolutely necessary.
I wish these stories were unusual, but they are not. I realize there is no perfect system, but our current method is so inefficient and expensive, I have to think there are better alternatives.
{ 5 comments… read them below or add one }
The problem is that the government is setting the prices (fee schedules). And in other scenarios, the insurer is setting the fee.
Here’s a radical idea: Let the producer of a product or service set the fee. The customer decides if he wants to buy.
Here’s how it works. I assume it was a urology procedure, such as prostate removal. Urologists specify their own fees. Some will charge $1000, others $10,000 for prostate removal. The customer (patient) does his own market research, chooses a urologist, gets the procedure, and pays the urologist.
Maybe the customer has health insurance such as private insurance, Medicare, or Medicaid. The insurer reimburses the customer as per it’s own pre-set fee schedule: it might be $500 or $5,000. The insurer probably shouldn’t reimburse more than the cost of the procedure, but that’s between the customer and the insurer.
If the customer paid $2,000 for the procedure but his insurer reimbursed only $1,200, the customer can complain to his insurer or congressman, and consider switching to a new insurer.
My name for this radical concept is “the free market.”
This is how most of the U.S. healthcare system worked before 1985. Has all the government and third-party interference since then helped? Has it made medical care less expensive? Is it more readily available? No, no, and no.
The free market works for numerous products and services, such as food, clothing, housing, gasoline, massages, cosmetic procedures, veterinary services, cars, trucks, oil change services, etc.
You think medical care is too complicated for the consumer to understand? It’s not as compicated as buying a house, and nearly all medical care costs much less. Even a years’ rent on an apartement is more expensive and rental contracts are complicated.
-Steve
These are important points. At the center of it, is whether health care is an entitlement, or whether it should be purchased by individuals based on their ability to pay.
And I think if we decide to allow free market forces to govern the cost and availability of medical services, at some point we will have the following question. What level (if any) of services should the taxpayers provide to the citizenry free of charge when they are unable to pay for even basic healthcare?
The average person will die quicker without food than without medical care. Yet our society still has not declared access to free food to be a fundamental right. We have a right to purchase just about any kind of food we want, as much as we want and can afford.
For those without money to buy food and without resources to grow or hunt it, the safety net is: help from relatives and friends, charity, soup kitchens, food banks, and food stamps.
That safety net food may not be the highest quality and convenience, but adequate. Is there a significant starvation problem in the U.S.? No. 65% of us are over-nourished (overweight).
I’m in favor of a government-run healthcare safety net for those unable to provide for themselves, but only after help from friends, relatives, and charity is exhausted.
You know doctors and hospitals already provide lots of charity care. And doctors don’t even get a tax write-off for it.
There’s so much corruption in politics that inviting even MORE government involvement in healthcare would be an unmitigated disaster.
-Steve
I started a long rant, but I would be preaching to the choir.
One thing that really seemed to increase costs with different procedures for my wife was repeating tests, even when the tests were recent.
I can understand an unwillingness by a physician to use the test results of others in certain situations, but not all. I’m sure there are reasons beyond my layman knowledge, so I’ll sit and let my feet hang down for explanations.
I talked this idea out with a lot of friends and they all seem to think it’s great.
Put a tax on all imports with it’s sole purpose to pay for health care for all Americans.
If this makes the imports so expensive that companies will start making the goods in America again… Well what’s wrong with that??