The Fix
If you want to fix American healthcare, first Congress should set a realistic national healthcare
budget. In 2008 we spent $2.1 trillion.
Let’s start there.
Next, cap administrative costs (including insurance company income and administrative demands
on the clinics and hospitals) at 15% annually. That’s what the Canadians spend on administration.
It's a lot of money: $300 billion. $200 billion of this should be used to compensate organized
medicine committees of practicing physicians in utilization management and quality assurance.
Limit insurance company involvement to financial management, and if necessary--sales, and then
let the insurance industry sort out how they should spend their portion.
And cap the healthcare providers, doctors, clinics, hospitals, labs, imaging, pharmacy and all at
85% or $1.78 trillion. And let them work out how to spend it. The various members and elements
of medical profession already have professional organizations that can represent them in
negotiations between themselves. This must cover all Americans. Even non-combat military. Yes,
that is universal healthcare. We are the only developed nation that doesn’t have it.
It’s a mistake to ask business people or legislators to dictate medical practice. Leave that where it
belongs, in the hands of the actual treating doctors. Business people and legislators lack the
knowledge needed to perform that task well. That holds true even if the administrator is a
physician. Healthcare decisions should come from the bedside not the boardroom.
Anti-trust law must accommodate the collaboration between providers and carriers that will support
these efforts because there are great savings to be found in a simple coordinated nationwide data
management and administrative system.
Go to Vegas, or look at Amazon.com and see how their computers can calculate variations in
odds and sales every second, all day long. Hire actuaries to design a statistical program that will
compute expenses against the budget on a day to day basis. Tie-in all payments under the budget
and adjust payment rates automatically to stay in budget every day. Doctors and hospitals have
used the relative value scale for recording services and claiming fees for many years. The system
is already in use. It just needs to be applied in a coordinated way. Altogether, this program will
reduce administrative costs and save about $380 billion for patient care. And keep pricing fair
under the budget.
A non-litigious system for medical injury compensation will save billions more. Litigation should be
limited to claims that can’t be adjusted by statute and negotiation.
Fair, negotiated pharmacy pricing will also contribute to the savings. Additional savings would
accrue from including workers compensation healthcare and the VA in this program. We don’t
need to rebuild the whole system. Use what we have but make it efficient and coordinated and
keep it under budget.
The data and each of the several steps outlined briefly here are explained in detail in the book
American Medicine MisManaged Care. There is really nothing new here. We're just not doing it
right yet.
If you want to fix American healthcare, first Congress should set a realistic national healthcare
budget. In 2008 we spent $2.1 trillion.
Let’s start there.
Next, cap administrative costs (including insurance company income and administrative demands
on the clinics and hospitals) at 15% annually. That’s what the Canadians spend on administration.
It's a lot of money: $300 billion. $200 billion of this should be used to compensate organized
medicine committees of practicing physicians in utilization management and quality assurance.
Limit insurance company involvement to financial management, and if necessary--sales, and then
let the insurance industry sort out how they should spend their portion.
And cap the healthcare providers, doctors, clinics, hospitals, labs, imaging, pharmacy and all at
85% or $1.78 trillion. And let them work out how to spend it. The various members and elements
of medical profession already have professional organizations that can represent them in
negotiations between themselves. This must cover all Americans. Even non-combat military. Yes,
that is universal healthcare. We are the only developed nation that doesn’t have it.
It’s a mistake to ask business people or legislators to dictate medical practice. Leave that where it
belongs, in the hands of the actual treating doctors. Business people and legislators lack the
knowledge needed to perform that task well. That holds true even if the administrator is a
physician. Healthcare decisions should come from the bedside not the boardroom.
Anti-trust law must accommodate the collaboration between providers and carriers that will support
these efforts because there are great savings to be found in a simple coordinated nationwide data
management and administrative system.
Go to Vegas, or look at Amazon.com and see how their computers can calculate variations in
odds and sales every second, all day long. Hire actuaries to design a statistical program that will
compute expenses against the budget on a day to day basis. Tie-in all payments under the budget
and adjust payment rates automatically to stay in budget every day. Doctors and hospitals have
used the relative value scale for recording services and claiming fees for many years. The system
is already in use. It just needs to be applied in a coordinated way. Altogether, this program will
reduce administrative costs and save about $380 billion for patient care. And keep pricing fair
under the budget.
A non-litigious system for medical injury compensation will save billions more. Litigation should be
limited to claims that can’t be adjusted by statute and negotiation.
Fair, negotiated pharmacy pricing will also contribute to the savings. Additional savings would
accrue from including workers compensation healthcare and the VA in this program. We don’t
need to rebuild the whole system. Use what we have but make it efficient and coordinated and
keep it under budget.
The data and each of the several steps outlined briefly here are explained in detail in the book
American Medicine MisManaged Care. There is really nothing new here. We're just not doing it
right yet.
LAS VEGAS HOTELS RELEASE ODDS
UNNECESSARY TORT LITIGATION COSTS $97 BILLION per YEAR. |
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