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First off, I must say that I am certainly no expert. I have one semester of Health Law, Ethics, and Policy to go along with my own readings on the matter. Anyway, here are a few of my thoughts:
- We need to change the business side of health care delivery. There is a general resistance to entrepreneurship coming from the existing general hospitals and special interest groups. These groups have consistently lobbied Congress and state legislatures to create regulatory roadblocks impeding the ability of specialty hospitals and clinics to begin to offer their services and create competition in the market.
- Another obstacle is the lack of access to financial remuneration on the part of these innovative health care service providers. Think about it: new business models only succeed if some payer (see: government) is willing to recognize their value. Under the current scheme the dominant payers (Medicare/Medicaid) resist paying these new providers who just might be more efficient than what we have now. What then happens is that without money coming in from the government, which pays roughly 55% of all health care costs in the US, these new models fail (and would fail even faster under a single-payer system). However, if your company intends to change the current system, you are more likely to get paid. I ask you this: if you were an investor/businessman, which route would you take? I think it's clear you would choose to invest in improving the current system as opposed to making innovations in health care delivery.
- Medical licensing requirements: Now, I don't mean to say that doctors should not be required to be licensed to practice medicine. This is important to our safety. I am saying that these requirements have increased costs to the patient as well as waiting times to see your physician. In a way, you have the physicians themselves through different governing boards determine where and how their competitors practice, thus stopping efforts to reduce costs right in their tracks. Why is it necessary for an M.D. to see you for a cough or a sprained ankle? Couldn't a nurse practitioner or P.A. do it for you? And at much lower cost to you? This wouldn't just save you money, it would open up the doctors to treat the most serious cases in a more timely manner. I would like to see more nurse practitioner-staffed clinics with greater responsibility allotted to them. The time is rapidly approaching when the shortage of doctors will reach a critical level. Doing this now will ease the burden on the health care system.
- The health care debate should include more than just covering the uninsured and controlling costs. It should also be about innovation and fostering a positive environment for those who seek to improve the quality of care through innovation. Robert Reich, the former Press Secretary under President Clinton, in 2007 stated that "using the bargaining leverage of the federal government to force drug companies and medical suppliers to reduce their costs means less innovation." Why spend billions and billions of dollars to discover a better way to heal if the government is then going to give you fifty cents on the dollar for it?
Anyway, those are a few of my thoughts that I prepared while studying for my Health Law final exam. Again, I'm certainly no expert. However, from what I know of the bill that is about to pass the Senate, they're going about it all wrong.
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