Tuesday, October 29, 2013

Dear Politicians: Its Health Care Not Health Insurance, Stupid!

Can we reset this entire healthcare argument to focus on the real issue here? The issue is healthcare not health insurance! This is driving me nuts. We don’t go to the insurance company to diagnose our runny nose do we? We don’t ask some insurance bureaucrat to reset our lower back due to a tweak we have after lifting a box the wrong way, do we? We don’t go to the insurance office to get a prenatal exam during pregnancy, do we? NO we go to the doctor’s office.

We have been so programmed to deal with insurance companies for healthcare issues that we can’t see the forest through the trees. We should be dealing directly with our doctor to set up our appointments and make payments according to the services provided. Instead we are calling insurance companies to discuss co-pays and coverage of basic services that actually are already affordable.

Now we are on the cusp of adding government bureaucrats into the mix of insurance bureaucrats to get in the way of the relationship between us and our doctor. What are we nuts! The answer is not to empower more useless paper pushing or key banging office people to manage such a simple transaction. Just as you go to the mechanic to fix your car and then you pay the bill, you should be going to the doctor, receive your care, and pay your bill.

The biggest issue that drives the “need” for insurance is the fear of taking ill and needing critical or chronic long term care. The fear of bankruptcy is the biggest driver of insurance. Just like we fear fire and flood destroying our housing investment, in healthcare we fear a heart attack, a cancer diagnosis, or some other illness because if we don’t have insurance it can bankrupt us! What if the issue of going bankrupt from a healthcare issue could be solved? How would that change the complexion of healthcare?

From the service provider side, doctors, nurses, and hospitals fear being sued for mal-practice. They have to carry mal-practice insurance which increases costs and does little for the betterment of healthcare. Actually it has created a “lottery” mentality where any “mistake” is treated as a ticket to Easyville! No doubt there are circumstances where doctors or hospitals are negligent, but lawyers have made an industry of suing doctors for every issue just to get in front of an ignorant jury that award large paydays. Most of the time these frivolous lawsuits are settled to reduce the time and effort it takes to fight the lawsuits. The way to fix it is to have jurists that understand medicine instead of the normal jury process. A “jury of your peers” in healthcare are people that understand healthcare, and I’m not suggesting this to put the fix in for doctors, but to put people on the jury that understand the complex arguments that we just are not educated to understand. It also would reduce the emotional component of “regular” jurists that end up awarding ridiculous amounts for things that are not malpractice. As healthcare professionals know, there is inherent risk in certain procedures. If we don’t address this doctors will stop doing surgeries that have any risk and who benefits from that? What if mal-practice lawsuits were changed? How would that change the complexion of healthcare?

Eliminating insurance from preventative care, removing the fear of bankruptcy due to an illness, and mal-practice reform would be three steps that would change the face of healthcare for the better. If we did those three simple things to start we could then look at the market and see what other issues we could improve through free market principles.

The debate about healthcare should not be dominated by insurance but rather the improved delivery and management of healthcare. Oh and the biggest change of all: get politicians out of our doctor’s office!

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