AMERICAN HEALTHCARE: A Different Approach.
Healthcare in America is too expensive because it is catawampus, askew, awry, and uncoordinated.
But we can have universal healthcare, include pharmacy, improve quality, save lives and save
$billions, easily and simply. The author has been a practicing physician for over 40 years, the
Medical Director of a 250 physician Medial Group, served on committees for HMOs, and authored
a book entitled “American Medicine - MisManaged Care”. He has hands-on knowledge of how the
system works.
We spend over $2.1 trillion annually on healthcare in the United States. Nearly half of that money is
wasted on inefficient administration. Canada manages its healthcare administration on 15%. A GAO
report concluded that “the U.S. health insurance system is a complex and administratively expensive
arrangement. It is characterized by a multitude of insurers, both private and public, each with its own
eligibility requirements, benefits, packages, provider rules, and claim forms.” In the Economist,
Henry J. Aaron, Ph.D. wrote: “I look at the U.S. health care system and see a monstrosity, a truly
bizarre mélange of thousands of payers with payment systems that differ for no socially beneficial
reason, as well as staggeringly complex public systems with mind boggling administered prices and
other rules expressing distinctions that can only be regarded as weird.”
Effective Management
To manage this mélange we need to have a uniform, PC based system nationwide. All
authorizations, utilization, quality control, claims management and payments must be automated.
Using an actuarially adjusted, relative value fee-based scale, expenditures can be automatically
controlled to stay within a reasonable national budget. Expenditures trending toward budgetary
excess would be automatically limited by reducing the rate of compensation applied to all providers
and all procedures. Minute adjustments will provide fiscal security and also alert the providers that
restraints are needed.
Other factors such as the costs of medicines and of Durable Medical Equipment bear heavily on the
costs of healthcare. In addition to medical services these too must be covered and limited to the
same universal healthcare budget. We must negotiate fair prices nationwide. The determination of
which drugs are available is currently controlled by business managers who lack the insight and
responsibility to the patient that are inherent in the physician-patient relationship. Choice of treatment
must rest with the treating physician. Anti-trust law prevents efficient healthcare management. It is
this massive lack of coordination that so burdens the system and costs so much. Tort reform will
also save billions and must be legislated.
Congressional Role
Congress must provide healthcare insurance for all Americans. This will save billions by instituting
efficient healthcare management made possible by:
Realigning American Medicine will improve quality of care and quality of management, efficiency,
convenience and national health. We can save billions, while we insure all Americans.
For more details and references:
Call Carter V. Multz, MD at (cell) 408-386-5050 or (phone) 408-531-0940 & 1-800-800-9111
Read American Medicine - MisManaged Care (Amazon.com)
Go to www.GoodMedicineAmerica.com. (e-mail) doc@GoodMedicineAmerica.com
Healthcare in America is too expensive because it is catawampus, askew, awry, and uncoordinated.
But we can have universal healthcare, include pharmacy, improve quality, save lives and save
$billions, easily and simply. The author has been a practicing physician for over 40 years, the
Medical Director of a 250 physician Medial Group, served on committees for HMOs, and authored
a book entitled “American Medicine - MisManaged Care”. He has hands-on knowledge of how the
system works.
We spend over $2.1 trillion annually on healthcare in the United States. Nearly half of that money is
wasted on inefficient administration. Canada manages its healthcare administration on 15%. A GAO
report concluded that “the U.S. health insurance system is a complex and administratively expensive
arrangement. It is characterized by a multitude of insurers, both private and public, each with its own
eligibility requirements, benefits, packages, provider rules, and claim forms.” In the Economist,
Henry J. Aaron, Ph.D. wrote: “I look at the U.S. health care system and see a monstrosity, a truly
bizarre mélange of thousands of payers with payment systems that differ for no socially beneficial
reason, as well as staggeringly complex public systems with mind boggling administered prices and
other rules expressing distinctions that can only be regarded as weird.”
Effective Management
To manage this mélange we need to have a uniform, PC based system nationwide. All
authorizations, utilization, quality control, claims management and payments must be automated.
Using an actuarially adjusted, relative value fee-based scale, expenditures can be automatically
controlled to stay within a reasonable national budget. Expenditures trending toward budgetary
excess would be automatically limited by reducing the rate of compensation applied to all providers
and all procedures. Minute adjustments will provide fiscal security and also alert the providers that
restraints are needed.
Other factors such as the costs of medicines and of Durable Medical Equipment bear heavily on the
costs of healthcare. In addition to medical services these too must be covered and limited to the
same universal healthcare budget. We must negotiate fair prices nationwide. The determination of
which drugs are available is currently controlled by business managers who lack the insight and
responsibility to the patient that are inherent in the physician-patient relationship. Choice of treatment
must rest with the treating physician. Anti-trust law prevents efficient healthcare management. It is
this massive lack of coordination that so burdens the system and costs so much. Tort reform will
also save billions and must be legislated.
Congressional Role
Congress must provide healthcare insurance for all Americans. This will save billions by instituting
efficient healthcare management made possible by:
- Eliminating confounding anti-trust provisions
Mandating nationwide price negotiations for pharmacy and durable goods
Facilitating a nationwide PC based healthcare management system
Employing an actuarially adjusted, relative value fee-based scale
Limiting administrative costs to 15% or less of national healthcare expenditures
Limiting professional liability tort procedures to cases that fail in a non-litigious process.
Realigning American Medicine will improve quality of care and quality of management, efficiency,
convenience and national health. We can save billions, while we insure all Americans.
For more details and references:
Call Carter V. Multz, MD at (cell) 408-386-5050 or (phone) 408-531-0940 & 1-800-800-9111
Read American Medicine - MisManaged Care (Amazon.com)
Go to www.GoodMedicineAmerica.com. (e-mail) doc@GoodMedicineAmerica.com
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |