I have said this before, and I am sticking to my guns. Healthcare reform is needed. I began with 7 points, it grew to 8. Now, after discussions with the healthcare professionals in my family, I add a 9th and a 10th.
1. Insurance should be for catastrophic losses only, not for every-day run-of-the-mill healthcare expenses. Let's say I have a cold that has been hanging on for more than two weeks. My boss says, "hey Ben, do not come back to work until you have seen a doctor." I go see the doctor, he says I have a sinus infection and gives me an antibiotic. If I make an average wage/salary, there is no reason to bill my insurance for any of it. I should be able to pay for both the doctor visit and the prescription out of my own pocket with my own money.
Sure, doctors may make less money from our little visit, but they will have more freedom and more satisfaction in their jobs.
With Obamacare, there is an individual mandate, meaning that each person is required to purchase insurance, but there is not a mandate for a doctor to take you as a patient. That is a key point. If my company pushes me to an exchange, will I be able to find a doctor who will treat me? Obamacare does not answer that question. If the costs are low enough for me to pay for it out of my own pocket, will that question matter?
To accomplish this, costs for doctors to do business will have to be lower. Medical equipment and malpractice insurance are some of the bigger costs that doctors face. There are many other unneeded day to day expenses for doctors as well.
2. You have to entice lower-risk people, meaning the young, into insurance plans. You also have to find a way to include immigrants and non-citizens, who are usually younger, into the insurance pool to help diffuse the cost. Obamacare, in part, does this, but not completely. Some even say that that there are incentives to for younger people to pay the penalty rather than to pay for insurance.
3. Tort reform is needed to end defensive medicine.
4. Realistic care for the elderly to improve the quality of life, not just delay the inevitability of death.
5. Train more providers who are not doctors to assist in medical care, this include hiring more Physician Assistants and Nurse Practioners. Let me just say, you should see how my kid'd orthodontist handles his practice. He has a staff of around 20 assistants, with around 10 of them working at one time. He glides around the room on swivel chair from patient to patient, only doing the work that he is required to do and ensuring that his assistants do not do anything wrong. This man has it down. Many medical practices would operate with lower costs using this model.
6. End the use of the emergency room for medical issues that are not a life and death emergency. This would probably take a marketing/education plan much like the "this is your brain on drugs" campaign, but if effective, could send a strong message.
7. Alternative payment methods. No one should get it for free, but if you can not pay the bill, some community service agreement should be worked out. The doctor/clinic/practice/hospital could write-off the expense. The community would be served. People will not be afraid to see the doctor out of the fear of being left with a big bill.
8. Aggressively prosecute medical fraud.
9. Require that all doctors have business classes as part of their medical training. A medical practice is a business after all.
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