Today Paul Krugman argued that if you care at all about the healthcare crisis — especially the 50 million uninsured — then you HAVE to support some scheme reminiscent of either Canada or the UK.
Sorry, we disagree. We want something to be done and think the current system is horrible, but don’t accept that a gigantic public scheme is the answer. Here we propose several ideas towards the idea of improving healthcare and reducing costs.
Again, the key point is that fixing healthcare will require a series of changes and reforms to fix multiple broken areas. There won’t be a single magic bullet.
Why do we go through the trouble of making an appointment several days out, then spending hours in a waiting room, only to have the doctor see us for 15 minutes and prescribe us antibiotics. Instead, should just be able to pop into a clinic, get a quick diagnosis, and a prescription without all of the rigmarole. Of course, some ailments that seem simple, will turn out to be above the walk-in clinic's paygrade. In which case, they'd have the ability to kick you up to some more specialised.
This follows along with the idea of more walk-in clinics. We don't need someone with 12 years of education to tell us we have a urinary-tract infection. Let's ignore the AMA, and create medical professionals with just a couple years of education, and much less student loan debt who will do routine tests at much lower costs.
Employee-sponsored health insurance is a dumb relic from WWII price controls. By incentivizing employee-sponsored insurance, we've choked off the individual market, making it much harder for freelancers, and other people who don't want to work for a big company.
It doesn't make sense to 'insure' against medical events you know are going to happen -- namely the expected, month-to-month check ups and routine tests. Whole Foods CEO John Macky has pushed for more use of high-deductible plans, couple with health-savings accounts that encourage the patient to act more like a consumer of health, while also getting protection against a truly unexpected medical event.
By limiting where insurers can compete, we've ensured a practical oligopoly, with all the pricing power that that usually entails. Let's end this regulatory relic now.
A common argument in favour of socialized medicine is that we need to protect children, who (realistically) are powerless to take control of their own health. So, rather than some huge blanket scheme affecting everyone, let's actually just focus on children specifically, by expanding aid to states.
The grocery chain Safeway says it has saved money by providing financial rewards to employees who make healthy decisions. Thus, the employer is not just a provider of insurance, but a party with the tools to actually incentivise a healthy workforce.
Here's one that's not strictly about healthcare, but very much related: Let's stop subsidizing sugar! This is so obvious and insane, it's amazing we're encouraging farmers to grow (more cheaply) one of the least healthy, obesity-causing substances in the world.
We waste a lot of money treating kidney patients on dialysis while they wait for someone to either a) die or b) donate a kidney out of the goodness of their heart. Let's create a safe market, where donors have an incentive to give, and patients can get off painful/expensive dialysis. The concept can be applied to organs other than kidneys, though it would be a good start.
Over and over again, we hear about how if we only got more IT in healthcare all would be solved. Unfortunately, that's total nonsense, especially since the companies we're looking to save us -- Microsoft, IBM, etc. -- are old relics with an incentive to sell expensive, highly-complex packages. What we need is true reform -- a new generation of lightweight web-based technologies that focus on usability and customer experience -- really putting the patient in control. Think of Hulu for healthcare. It hasn't been done yet, but there's a huge opportunity to apply the lessons of Web 2.0 to electronic health.
Lawyers add costs to the health system in all kinds of ways. First, there's the obvious way, in that they frequently try suing the pants off professionals, forcing doctors to get very expensive insurance. But what's more, is that they contribute to the overtesting culture, as doctors order up extra tests and exams, just so they can't get sued.
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