Sunday, April 22, 2012

We Need A Health Care Reform Bill

I Posted this on Sermo, a physician discussion web site, Nov. 29, 2010, still pertinent today. In my opinion, both political parties have it wrong, we need a health care reform bill not an insurance reform bill. Isn't it time for physicians to tell the Congress and the American public that given the right tools, we can provide excellent care for all Americans costing about 15% of gross domestic product versus today's 18%. This would require a retro-fit of our medical culture, good histories, good physicals, less reliance on technology, adequate payment for a 30 minute visit and significant changes at the Congressional level. I believe we must offer the nation a viable alternative for our message to be heard.

Thursday, April 5, 2012

Patient Versus Government Centered Health Care

Published by me in the Kalamazoo Gazette March 16, 2012

Everyone wants high quality health care for all Americans at a cost that we, our children and grandchildren can afford. The question we are debating is whether the new health care law is the best approach to accomplish this goal.

Unfortunately this law intrinsically intrudes on the patient-doctor relationship, as it neglects individuality and forces a one-size-fits-all on the practice of medicine. It maintains the failed policy of price controls and central planning, with its emphasis on technology and procedures. Additionally, despite its attempt to control costs, it is extremely expensive as described by the government’s own actuaries, who predict that health care costs for the country would exceed 20 percent of gross domestic product (GDP), significantly greater than our present economy-wrecking 17-18 percent The present law, despite considerable cuts in Medicare spending, still depends on future generations to fund the health care costs for retirees, an impossible situation as the population ages.

A better approach would be to insure that all Americans have health savings accounts (HSA) along with high deductible insurance. Every HSA would be funded through tax policy accumulating over a life-time and free of taxes, specifically for each person’s use, thereby eliminating dependence on succeeding generations. For the approximately 17 percent of our population that cannot afford any type of insurance, their HSA and high deductible insurance would be funded from general treasury funds.

For the 30-plus percent or so of families receiving the earned income tax credit, these funds would be deposited in their HSA. For the 50-plus percent of American paying income taxes, a contribution to each family member’s HSA would be supplemented with a tax credit. For these two employed groups their employer, instead of providing health insurance, would provide funding for high deductible insurance. This would be in the employee’s name, creating total portability, and would cost significantly less.

The major advantage of such a plan is that the patients control the funds and would demand and obtain more face time with physicians. Physicians and hospitals would have to compete for these funds, in contrast to the present day artificially fixed payments which favors procedures and technology versus human interaction and judgment. The costs for these plans are approximately half of the present price-fixed central planning system, as demonstrated in Indiana.

The second class status of Medicaid patients would be eliminated as they would be funded at levels the same as everyone else. States could then devote their present Medicaid funds to adequately educating all our children enabling them to compete in a worldwide economy. As our national health care costs would be reduced, our goods and services would be more competitive on the world market, thus improving our employment picture.

This explains my thinking about this issue and why I joined a new national medical organization,, devoted to universal coverage that is personalized and patient-directed, at a cost our nation can afford.