President Obama is talking about serious healthcare reform — sort of

There’s a reason why President Barack Obama was elected last November. It was not a fluke. He has the ability to explain things. He whittled down the whole healthcare problem to a little but more than a 30-second explanation.

See the President’s explanation here:

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The president has a commanding knowledge of all the different permutations of how to fix healthcare. What I’ve been talking about on this blog is what I think is a simple, straightforward solution healthcare. Again, because I think this is critically important, we need to define our goals. I believe the goals of healthcare reform are to produce portable, efficient and cost-effective healthcare. If you look at the healthcare problem and come up with different goals then your solutions will probably be different than mine. I accept this.

In my mind, the best way to produce the desired outcome (portable, efficient and cost-effective healthcare) is to do the following:

  • In 2007, Americans spent $2.2 trillion on health care. Of this 2.2 trillion, $700 billion was given to the health-insurance industry. If we take the $700 billion and use it to cover the 46 million Americans who are currently uninsured, we can do this and have plenty of money left over to repair other sectors of the healthcare industry. Take Medicare, Medicaid and other state and federal health care programs and roll them all into a single payer (government) system.
  • We can control costs by paying primary care doctors and hospitals a lump sum of money at the beginning of every year to take care of a given population of patients. This will decrease the incentive for hospitals and/or doctors to see patients over and over again not because the patients need it but because they want the revenue. (The vast majority of doctors and hospitals are ethical but there are some bad apples.)
  • We can control costs by negotiating drug prices with the pharmaceutical companies. We can save billions of dollars by decreasing the amount that we spend on drugs. We can also save money by doing comparative studies. We need government-funded drug studies which would compare drug A to drug B. Also, to entice the pharmaceutical companies to participate and not oppose this measure, I think that drug patents should be increased from the current 20 years to 30 years. (Remember that the patent covers the time the drug is being developed and tested. So the effective patent time is probably somewhere around 7 to 12 years.) In this scenario I think the American people win by getting drugs at lower prices and pharmaceutical companies can recoup some of their losses through the extended patent time.
  • If we develop a single payer system (government payer) then everyone, every American, is invested in all of our health. To put it another way, if I stay healthy, that will save you money. (Republicans should love this.  This is personal responsibility that Republicans talk about all of the time.) Therefore, it is in our best interest to give people incentives to stay healthy. Their health care will cost us less and that’s good for everyone. Americans who are healthy and watch their weight should be rewarded for “good behavior.” Every other year, these Americans should get a rebate. Also, Americans who change their habits, who lose weight, who watched their diabetes and follow their doctor’s advice should also get a rebate. Now, besides the rebate for each of these categories can be negotiated but the principle is we should reward good behavior for the simple reason that good behavior saves us money.
  • The government will need to negotiate prices for multiple types of Durable Medical Equipment. This would include things like hearing aids, wheelchairs, those scooters, x-ray equipment, CT scanners and titanium rods that are used to fix femur (thigh bone) fractures.
  • Finally, we have some Americans that are incredibly smart and they know they want. You order your own test!! If a 25-year-old twists his or her ankle while rollerblading, they know they want an x-ray of their ankle, why can’t they get that without having to talk to a nurse and see a doctor? Why can’t they go to the emergency room and ask for an x-ray their ankle. Their ankle was x-rayed and within 30-60 minutes they are handed a written report by the radiologist. Then, if their ankle is broken, they can see the physician. If not, they take the responsibility for putting on an ace wrap if they would like to. Allow Americans to do this no more than five times a year so that no one abuses the system. Mothers that think their two-year-old baby has strep throat can take their child to the emergency room and simply go to the lab and get a rapid strep test. They can have their answer in less than five minutes. If the test is negative, the mother knows that she can just treat the symptoms, if she is comfortable with that. On the other hand, if the test is positive, the mother can then see the physician. Why can we make this or some variation of this become a reality.

We are incredibly innovative. It is possible for us to develop a system that is paid for by the government, that is cost-effective, portable and efficient. Let’s be innovative, what are your thoughts?

  • http://www.inspiritry.com Dr. Mike & Anne McCrady

    What the President hasn’t clearly said and what we need to hear is that we are in a medical bubble caused by the kind of excess that led to the financial bubble. The system is broken. Doctors, hospitals, pharmacies, labs, medical supply companies and home health agencies are incentivized to make as much money as they can by providing more and more services. Insurance companies pass along rising costs to inflate their profit margins. Uninsured people or those with unhealthy habits wait to get medical care until they are very sick or use high cost options like emergency rooms which everyone else pays for. And worst of all, the rest of us – the insured — want unlimited medical attention without considering cost or effectiveness because our employer or insurance company pays the bill. The President needs to show us how health care reform is another American crisis waiting to happen, and we should be clamoring for change!

  • http://www.mithaimate.com/ sweets

    oh Really are you serious ??????/

  • http://www.whereistheoutrage.net ecthompson

    I thought I was. Are you serious? :-) We can do this all day.

  • Mike

    Where is the money coming from?!?! Medicare and medicaid are bankrupt. If the government can’t even provide health care to some of the population, it is absurd to think that they can be trusted with handling it for the entire country.

    The plan is un-American because it goes against the competitive spirit of this country. Money is an incentive for progress, and doctors and pharmaceutical companies currently have it as a motivation. Single payer means lower payments to these crucial people, and less medical development and reduced quality of care. Only a democrat would think that people are just going to keep working hard out of the kindness of their heart when it is more profitable not to do so.

    And I also have to comment on the point about patients ordering their own test: how about when they don’t order the test that they actually need?! Then they will be seeing a doctor who has attended 4 years of medical school plus a 4(+) year residency to treat their condition that has become far worse than it would have been had a doctor been seen in the first place.

    Paying doctors a lump sum basically eliminates the whole idea of their business: provide quality care so that patients (customers) will return and spread the word about the business to other patients (customers). Why continue to work hard when the check will come in the mail at the beginning of the year either way?

    I don’t agree with one point mentioned here. The disaster we have now is better then the Apocalypse that this will be. I hope everyone who approves of this plan dies while waiting for an appointment to see a doctor about the lump in their mouth.

  • http://www.whereistheoutrage.net ecthompson

    Mike –

    The government, as you know, ebbs and flows. There are cuts and there is spending. The funding for medicare and medicaid has ebbed and flowed but yet everyone within those programs have been taken care of.

    Money isn’t the incentive for every thing in this country. If so there wouldn’t be any open source software but there is. Doctors, hospitals and other heathcare professionals will continue to make money.

    Are you saying that you don’t mind paying much higher premiums in order to keep private health insurance in place. We can do that. It is just that most Americans don’t want to cough up an extra $200 – $300 billion. Maybe you do.

    You hope that people die. Really.

    We aren’t going to magically turn into England. The private hospitals will continue to be private. The private MD’s will continue to be private so that long wait times will not happen. It just will not. Americans will not stand for it and they will go to another MD. That MD will get paid and the other will not. Why is this so hard to figure out?

    Again, I don’t think that you are correct. If you would like, the physicians can get paid quarterly. The point is to remove the incentive that some believe MD’s have to see patients more frequently than necessary. Remember the MD isn’t paid for sitting around. If the MD isn’t taking care of patient’s he/she doesn’t get a check. If the population that he/she is taking care of isn’t healthy or getting healthier then that physicians loses out on bonuses. If you would like to put in patient feedback as a parameter then you can. You should also know that currently it isn’t abnormal not to get paid for months after doing a procedure. Insurance companies delay and delay paying MD’s and hospitals. It is standard procedure.

    Finally, if you think that you are smart enough to get your own xray why can’t you? If you screw up, you can still go to the MD later that same day. What’s the problem? I thought that R’s liked choice or options?