If healthcare wasn't so expensive we wouldn't even be talking about Universal Health Care. The problem with the current system is that we treat complex medical problems and patients with multiple medical issues that require too much intervention with (compared to every other industry in the nation) poor outcomes.
The best and cheapest way to treat a problem is to keep it from happening to begin with. For example childhood and adult obesity now will cost us billions in healthcare dollars later. The solution is a system based on incentives to promote wellness, exercise, education, and nutrition habits (starting at birth)that keep us healthier and prevent us from developing obesity, heart disease, diabetes, alzheimer's etc..
More insurance companies need to give breaks and incentives to those who develop healthy habits.
If the government is going to give out any taxpayer money it should be in the form of vouchers or tax breaks to purchase private insurance in return for the reciever to enroll or adhere to some wellness or preventative activity.
It's not an issue of more money, but better ideas. I live in Louisiana where we spend more money per capita on our Medicaid patients than anywhere else in the country, yet we remain one of the unhealthiest states in the union.
Even the CDC recognizes that the majority of diseases and health problems have a large modifiable risk factor involved. In most cases people can take thier health into their own hands before it gets out of hand.
-David Bock, PT
(Physical Therapist)
On our Wellness Wiki, we present a through review of our current healthcare system, which helps clarify the complex problems plaguing it. We then present sustainable ways to improve the quality, affordability and availability of care. This comprehensive strategy includes the integration of well-care with sick-care, which is consistent with David's remarks.
Steve Beller, PhD
Preventive Medicine and Wellness would be GREAT requirements to any National Healthcare Plan. Lately though, at the hospital where I work, I have seen an increasing number of admissions due to non-compliance. The diabetic who lost her kidneys to the desease, got a transplant, and is now on dialysis again because of her refusal to comply with therapy is just one example. I believe a two pronged approach to compliance is called for:
1. Post diagnosis counseling and monitoring to help those given the bad news of a chronic condition like diabetes, the psychologic and physical tools to deal with it.
2. A 10% rebate of any individual contribution to the NHP automatically deposited into a savings account, for those that comply with therapy/treatment and therefore have fewer ER or hospital admissions.
A small outlay of funds to the above initially, would save significant amounts of money down the road!
I doubt a rebate program would adequately incentivize an alcoholic, a methamphetamine addict, a compulsive smoker, or a compulsive eater. Enforced treatment will drive some into hiding. They will then serve as a pool for spreading infection to the wider public (e.g. shared needles spreading HIV, lowering resistance, contracting contagious diseases such as TB). There must be a balance between free choices, public safety, and social contract. If an alcoholic rejects a treatment program for alcoholism, does that cancel society's obligation to treat him for alcohol-related medical condtions if he does not have the money to pay for such treatment?
Respectfully Submitted,
Sketch
I agree, Sketch.
I've recently discussed this (and related) issues in a series of posts on my blog at this link on my Curing Healthcare Blog
We've got to do a much better job educating, motivating and enabling people to live healthily (and to avoid pandemics). Suggestions include having more & better after school programs to give adolescents something meaningful, fulfilling and rewarding to do with their free time instead of getting high; develop and implement innovative programs that help motivate people with chronic illnesses to do better self-maintenance (aka compliance/adherence to medical regimens); focus more on risk assessments and helping people avoid illness for which they're prone; expand public health efforts at biosurveillance (for early detection of contagious disease spread, etc.); and so on.
Steve Beller, PhD
Wellness Wiki
I agree with other posts that Insurance should not play a central role in our health care system. I believe this is essential because of the good that preventive medicine and compliance play to lower overall costs. Elimination of the role insurance companies play would permit a partial system of funding to be derived from taxes. Problems in applying preventive medicine and compliance features to smokers and drinkers, for instance (there may be more areas than just those two), could easily be resolved by taking taxes from the purchase of those commodities to cover funding for the resultant higher health care costs that those items cause. Establish the relationship between commodities (consumption) and health care. Charge a tax at the register to fund the additional costs incurred by the health care system for people that engage in verifiable behaviors that increase costs. Taxes would need to be adjusted so that they adequately cover the additional costs incurred in the overall health care system. This method would also make it a unnecessary to try and find out who is and who isn't in compliance.
Pay as you go. You gotta pay if you want to play is my motto.
Phil
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HMO originated on these principals and did a very good job of it prior to 1980. Medical services outside of the HMOs bad mouthed them ferously. As more insurance companies entered the market with HMO profit margins tightened forcing the invester market to consolidate into such large companies that they could manipulate the service industry itself. When that model started the rapid inflation in medical services and the insurance companies were threatened by intervention through Medicare they turned to lobbyist to enlarge thier margins through governmant guarantees (effectively a subsidy). The insurance companies now have no incentive to effect preventive medicine other than a show for public relation. I say that only to point out that insurance companieshave no role in solving this cost problem we have with health care.
A sensible relationship with food and exercise along with a complete cessation of smoking on a life long basis will cut health cost and care 30% or more. Doctor's have made that clear face-to-face and through media for decades. Personally I think doctors that had put in a couple of year with a patient that does not follow good preventive practices should refuse the relationship to continue and include that information in thier medical history.
Bill"for what we are together"
bill713.unity08@sbcglobal.net