Alright, so Congress can't figure out how to overhaul healthcare for some reason. The best we keep hearing is to make it easier for everyone to get healthcare insurance. In my opinion they are ignoring the main problem about healthcare in the United States.
It doesn't work.
Sure, if you need to go to the ER because you had an accident with a power tool, and they need to stitch you up so you won't bleed to death, that's one thing.
But cancer, diabetes, thyroid problems, heart disease, etc...
Do you see many of the friends and family members you know with these conditions making full 100% recoveries?
If I had to point my finger at one target, I would say the issue is that it is more viable for hospitals to keep their patients coming back in order for them to stay in business. Because doctors/hospitals get paid by insurance companies no matter what, it becomes less important to ensure that the patients actually recover from their condition, and more important that doctors see as many patients as possible each day. To complicate the matter pharmaceutical companies offer financial rewards to doctors who promote their drugs, even if the drugs will not necessarily help the patient at all. There are many drugs that are being used that have harmful side effects. These side effects offer additional opportunities to capitalize on the patients by prescribing additional drugs to counteract the side effects. And the circle continues.
Doctors in the current U.S. medical system have a tendency to perform battlefield medicine. What that means is as long as the patient no longer has the symptoms they are complaining about and can perform their daily business, the doctor is satisfied. The problem with this idea is that treating a symptom usually does not cure the patient of a condition. What typically occurs next is additional symptoms will show up as the patient's condition worsens. These symptoms will in turn be "treated" while the actual issue is ignored, until the point when the body gives up and cancer or death occurs.
So....in my mind it is more important that we fix THIS issue in the U.S. healthcare system, more than ensuring that everyone can get insurance. After all, what's the point of having health insurance if the healthcare you receive doesn't help you?
Here is what I propose to help fix the healthcare system in the United States:
Make doctors more accountable by withholding payment until a patient is truly well again. If you are a doctor and you don't get paid after failing to properly treat your patient, perhaps you might start actually taking the time to listen to your patient, try to find the source of the problems, and not just give them some pharmaceuticals that will only make their symptoms go away.
Prevent insurance companies from paying doctors until a patient has determined to either a) have cooperated with the doctor's treatment plan and shown significant improvement or b) has been shown to not have complied with "doctor's orders".
Create an independent group that assesses whether patients have or have not been "cured" of their original condition enough so as to not continue to have issues with their health. This group will also assess whether the patient actually followed the doctor's recommendations - in the event that the patient did not follow orders, payment will be sent by their insurance company to the doctor/hopsital anyway, and their insurance premiums will go up.
Forbid the practice of SPIFs or kickbacks to doctors who prescribe new medications being pushed by pharmaceutical companies. Money from pharmaceutical companies should have absolutely NO impact in a doctor's decision making process when it comes time to treat a patient. However, it might not be a bad idea to reward pharmaceutical companies when a particular drug works well for a patient in the form of a gratuity from the hospital/doctor who treated the patient in question.
Look...the current healthcare system is a mess because people are trying to make money, and they way they are going about it is all backwards. Because of this priorities have gotten thrown out the window, aside from the priority of getting money. Let me try to explain my line of reasoning.
A patient's health should be the first priority. Anything else should come after.
A lot of people in the U.S. ignore their doctor's recommendations. The best way to motivate them to "follow doctor's orders" would be to punish them by making their insurance premiums more expensive. Don't punish people because they got sick in the first place - that's typically not something they can control. Punish them when they refuse to do their part to get better. Sadly - the possibility that their condition may get worse or they might die is typically not as much motivation as having to pay out more money each month, but hey - whatever works.
Insurance companies shouldn't have to pay a doctor if the doctor is not doing his or her job. Nor should the patient. If a patient sees a doctor several times and their health gets progressively worse each time, why is the doctor/hospital getting paid? That makes no sense at all. On the flip side, if a doctor is realizing hey - this isn't working and I'm not going to get paid until I change my approach and try harder - maybe then the patient will start getting the correct treatment for their condition.
We need an independent entity who's sole purpose is to assess patients after they have been treated is a necessary checks & balances system. The people who are in this organization should have no direct ties to hospitals, doctors, insurance companies or pharmaceutical companies - they should be completely autonomous and independent. It should be fairly obvious with most patients as to whether they are making progress or not, or whether the patient has been following doctor's orders - when I was a computer repair tech it was fairly easy to tell when someone was lying to me about what they were doing with their computer, and I suspect people lying about their eating/exercise habits would be about the same. Based on these assessments (and they would need to take place over the span of a few years to insure that everything is as it should be) this organization would make one of the following recommendations:
1) Patient is cured, pay the doctor/hospital
2) Patient has made no progress, do not pay the doctor/hospital
3) Patient's health has significantly worsened - the doctor/hospital must pay the patient the amount of money that would have been paid to the doctor/hospital for the treatment to compensate them for their loss of time and worsening condition
4) Patient has made no progress because he/she has ignored doctor's orders - pay the doctor/hospital
Oh hey - did I mention the necessity of this independent entity performing assessments would create a ton of new jobs?
I'm sure there's more to this picture that I'm missing, and I expect everyone will have their own opinions on this, but in general I think these ideas would go a fairly long way toward restoring health to Americans, as opposed to just perpetuating the problems with the current Healthcare Reform Bill.
