6 Ideas on Reducing the Cost of Healthcare
Mar 13, 2017 16:33:56 #
Tell me what you think about these specific ideas on how to reduce the cost of healthcare in this country. Do you think they should be incorporated into whatever governmental policy emerges from either Obamacare, Ryancare, or some as yet healthcare program to be proposed.
1) Higher co-payments for patients. We already have them and we accept them. I would make them higher so that we begin to pay a significant portion of our care out of our own pockets. Raising co-pays would make us all think about what tests, treatments and other procedures we really need. For the first time, we’d think about the cost of our care. The level of co-pay would be subject to a means test and scaled to income. Those with more would pay more, those without would pay less. The irony is that right now we all pay out of pocket without any kind of adjustments or means testing – a multi-millionaire can have the same co-pay as an assembly line worker. We should change that. People need to become consumers of health care so that they, not insurance companies, not the government, actually see, feel and pay the bills. That will force producers of health care – doctors and hospitals – to push down prices and drive up quality. That's what happens with groceries or television sets or computers.
2) Price transparency. We can go online and shop for cars, vacuum cleaners, bicycles. We can compare prices, repair records, user opinions. Try that for the colonoscopy or the knee operation you are told you need. It is not possible. We need to move quickly towards easily available published costs for common medical procedures and hospital stays. We need to know what we are paying for, what the costs will be, and whether we would be better off going to a different, less costly hospital or doctor. Singapore does it, as do other East Asian nations. In fact, their systems demand it. We should as well.
3) Take health care out of the job. Everyone should be buying health care on their own. Level the playing field. Expand the use of Flexible Spending Accounts and Health Savings Accounts. Allow federal tax credits for the purchase of catastrophic health insurance.
4) Change the focus from sick care to preventative care. Realize that physicians cannot heal. Pills or treatments only synthetically enhance or suppress a natural bodily function in an attempt to speed the recovery process. The artificial environment created in the body by these medicines, however, often leads to an extensive list of harmful side effects associated with a so-called “cure.” This all comes back to cause and effect. Most sickness is unnecessary. If you participate in high-risk behaviors such as sexual promiscuity, illicit drug use, eating only junk food—the causes—you will be more prone to sexually transmitted diseases, HIV and obesity-related illnesses—the effects. The opposite is also true. If you eat nutritious foods and make sure to have appropriate balances of vitamins and minerals—the causes—you can avoid many unnecessary illnesses and overall have more energy and vibrancy—the effects. A healthy human body is able to naturally fight off many viruses and bacteria. If a person does contract an illness, a strong immune system will often mean the symptoms are very slight. Benefits of a healthy diet include a reduction in the risk of stroke, cardiovascular disease, diabetes, certain cancers, and coronary artery disease. These five maladies alone account for 74 percent of the total fatalities attributable to the U.S.’s top 10 “leading causes of death” (Centers for Disease Control and Prevention).
5) Replace the Fee for Service model (medicare, Medicaid, and private insurance) with an "accountable health care organization" or an "integrated care provider." Instead of being paid a fee for each service, the provider is paid a fixed annual price to do everything for the patient (with limited exceptions for catastrophic care). Instead of making more money by dialysis and amputation of limbs of patients with diabetes, the provider now has an incentive to keep the patient healthier by nudging them towards better lifestyles. The provider hires social workers in lieu of more surgeons.Comprehensive providers are not a radical concept. The Kaiser health system in California works this way. The Veterans Health Administration (VA) is a public model. Several states, including Texas and New York, are moving to integrated care providers for all Medicaid recipients.
6) Allow Medicare to negotiate Drug prices with the Pharmaceutical companies. In 2006, when Democrats wanted to change the fledgling law to let Medicare use its enormous leverage to bargain with drug makers, we thought such a step was premature. Eight years later, however, the rosy stories about how well private insurers were keeping prices down turn out to have been exaggerated.
Part D has cost less than predicted because fewer people signed up than projected and because drug prices fell as fewer blockbuster medicines came to market and expensive drugs came off patent, allowing inexpensive generics to replace them.
The discounts available to private insurers pale beside the ones the government gets for Medicaid. According to the Kaiser Family Foundation, Medicaid's practice of setting minimum discounts, and bargaining for more, yields savings three times bigger than the ones private insurers get for Medicare Part D. When the government is spending taxpayer money, that's just too big a discrepancy to ignore.
How much could Part D save? The Congressional Budget Office says that simply giving Medicare's low-income beneficiaries the same discount available under Medicaid would save $116 billion over 10 years — serious savings that could cut the cost of the program by roughly 10% a year. By some calculations, extending Medicaid-style savings to all 35 million of Medicare's Part D beneficiaries could save an additional $39 billion over 10 years.
Drug makers give the familiar argument that cutting prices will reduce research and development, stunting the supply of new drugs. But Part D is already a windfall for drug companies, which spend more on marketing medicines than they do on basic research anyway.
Although Congress could get a better deal for taxpayers by letting Medicare bargain, proposals to do so are going nowhere on Capitol Hill, where drug makers wield considerable clout. That's something to ask candidates about the next time they complain that government spends too much on health care.
1) Higher co-payments for patients. We already have them and we accept them. I would make them higher so that we begin to pay a significant portion of our care out of our own pockets. Raising co-pays would make us all think about what tests, treatments and other procedures we really need. For the first time, we’d think about the cost of our care. The level of co-pay would be subject to a means test and scaled to income. Those with more would pay more, those without would pay less. The irony is that right now we all pay out of pocket without any kind of adjustments or means testing – a multi-millionaire can have the same co-pay as an assembly line worker. We should change that. People need to become consumers of health care so that they, not insurance companies, not the government, actually see, feel and pay the bills. That will force producers of health care – doctors and hospitals – to push down prices and drive up quality. That's what happens with groceries or television sets or computers.
2) Price transparency. We can go online and shop for cars, vacuum cleaners, bicycles. We can compare prices, repair records, user opinions. Try that for the colonoscopy or the knee operation you are told you need. It is not possible. We need to move quickly towards easily available published costs for common medical procedures and hospital stays. We need to know what we are paying for, what the costs will be, and whether we would be better off going to a different, less costly hospital or doctor. Singapore does it, as do other East Asian nations. In fact, their systems demand it. We should as well.
3) Take health care out of the job. Everyone should be buying health care on their own. Level the playing field. Expand the use of Flexible Spending Accounts and Health Savings Accounts. Allow federal tax credits for the purchase of catastrophic health insurance.
4) Change the focus from sick care to preventative care. Realize that physicians cannot heal. Pills or treatments only synthetically enhance or suppress a natural bodily function in an attempt to speed the recovery process. The artificial environment created in the body by these medicines, however, often leads to an extensive list of harmful side effects associated with a so-called “cure.” This all comes back to cause and effect. Most sickness is unnecessary. If you participate in high-risk behaviors such as sexual promiscuity, illicit drug use, eating only junk food—the causes—you will be more prone to sexually transmitted diseases, HIV and obesity-related illnesses—the effects. The opposite is also true. If you eat nutritious foods and make sure to have appropriate balances of vitamins and minerals—the causes—you can avoid many unnecessary illnesses and overall have more energy and vibrancy—the effects. A healthy human body is able to naturally fight off many viruses and bacteria. If a person does contract an illness, a strong immune system will often mean the symptoms are very slight. Benefits of a healthy diet include a reduction in the risk of stroke, cardiovascular disease, diabetes, certain cancers, and coronary artery disease. These five maladies alone account for 74 percent of the total fatalities attributable to the U.S.’s top 10 “leading causes of death” (Centers for Disease Control and Prevention).
5) Replace the Fee for Service model (medicare, Medicaid, and private insurance) with an "accountable health care organization" or an "integrated care provider." Instead of being paid a fee for each service, the provider is paid a fixed annual price to do everything for the patient (with limited exceptions for catastrophic care). Instead of making more money by dialysis and amputation of limbs of patients with diabetes, the provider now has an incentive to keep the patient healthier by nudging them towards better lifestyles. The provider hires social workers in lieu of more surgeons.Comprehensive providers are not a radical concept. The Kaiser health system in California works this way. The Veterans Health Administration (VA) is a public model. Several states, including Texas and New York, are moving to integrated care providers for all Medicaid recipients.
6) Allow Medicare to negotiate Drug prices with the Pharmaceutical companies. In 2006, when Democrats wanted to change the fledgling law to let Medicare use its enormous leverage to bargain with drug makers, we thought such a step was premature. Eight years later, however, the rosy stories about how well private insurers were keeping prices down turn out to have been exaggerated.
Part D has cost less than predicted because fewer people signed up than projected and because drug prices fell as fewer blockbuster medicines came to market and expensive drugs came off patent, allowing inexpensive generics to replace them.
The discounts available to private insurers pale beside the ones the government gets for Medicaid. According to the Kaiser Family Foundation, Medicaid's practice of setting minimum discounts, and bargaining for more, yields savings three times bigger than the ones private insurers get for Medicare Part D. When the government is spending taxpayer money, that's just too big a discrepancy to ignore.
How much could Part D save? The Congressional Budget Office says that simply giving Medicare's low-income beneficiaries the same discount available under Medicaid would save $116 billion over 10 years — serious savings that could cut the cost of the program by roughly 10% a year. By some calculations, extending Medicaid-style savings to all 35 million of Medicare's Part D beneficiaries could save an additional $39 billion over 10 years.
Drug makers give the familiar argument that cutting prices will reduce research and development, stunting the supply of new drugs. But Part D is already a windfall for drug companies, which spend more on marketing medicines than they do on basic research anyway.
Although Congress could get a better deal for taxpayers by letting Medicare bargain, proposals to do so are going nowhere on Capitol Hill, where drug makers wield considerable clout. That's something to ask candidates about the next time they complain that government spends too much on health care.
Mar 13, 2017 17:37:24 #
peter11937
Loc: NYS
Reduce the unnecessary paperwork burden on the MG's, their staffs and other medical facilities. It costs sereous money and that ALWAYS gets passed on to YOU!
Mar 13, 2017 17:55:40 #
HSAs accomplish much on their own.
People spend their own money much more wisely than they spend other people's money (Government's money or Insurance company's money).
People spend their own money much more wisely than they spend other people's money (Government's money or Insurance company's money).
Mar 14, 2017 15:44:18 #
Can you take out the part about junk food? I'm 75 and still work. My 3 food groups are sugar, salt & carbs in that order. "One man's junk is another man's treasure".
Mar 14, 2017 16:15:00 #
F.D.R. wrote:
Can you take out the part about junk food? I'm 75 and still work. My 3 food groups are sugar, salt & carbs in that order. "One man's junk is another man's treasure".
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You are one lucky dude! Chalk it up to good genes. The rest of us are not so lucky.
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