Why Now?
Friday, February 04, 2005
  Health Care Problems
It is a reality that an individual, no matter what the source of funding for medical care, has almost no choices. Doctors and other medical services providers, with the legally mandated exception of hospital emergency rooms, select whom they will accept as patients. Almost all specialists require a referral from another physician before they will even consider a new patient.

If you have a recurring problem that has always required the same medication, you can't go to a pharmacy, buy the medicine, and get well. You have to have a doctor write a prescription, which wastes medical resources and your money. The same goes for drugs that people take for chronic illnesses, they have to be renewed, even though the drugs only stabilize the condition.

When it comes to something that requires hospitalization a lot of people have no choice at all. The hospital may be chosen by a doctor, an insurance company, or the simple fact the there is only one hospital in the area, but the patient rarely even gets asked if they have an opinion.

You can refuse treatment, if the courts and governor don't decide to take an interest, but a second opinion is going to cost money.

The system is a mess and needs to be fixed, but a tax-exempt savings account isn't going to make anything better, and people talking about "catastrophic policies" need to see the bill for a visit to an emergency room. It doesn't take much to have a bill hit "catastrophic" levels.

The best current answer is to make the system more efficient by a single-payer system, like Medicare, that would simplify the business side of the health system. Only one set of codes, one set of prices, one billing form, one procedure for billing. The system would be administered by private contractors that were selected by competitive bids on a regional basis, just like Medicare.

This would eliminate the collection costs and problems of hospitals and doctors, reduce the size of billing operations, stabilize income for the medical industry, and generally reduce costs. This would also remove the cost of medical insurance from businesses, which would reduce their expenses.

If someone wants something more, they can buy additional coverage, as occurs in Europe and Canada. Medical providers would not be required to accept payments from the system, just as many don't accept Medicare and Medicaid patients.


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