Health Care Ideas

If you read the prior post, you understand what I mean by Old School. Unfortunately, if we don't go old school on health care, we will be forced to ration.

Over the last 50 years, we have gone from a country of people dying from acute processes to a country of people dying of chronic ones. Acute illness and injury are relatively inexpensive.

In 1960, 4.4% of the household budget went to health care. In 2005, it was 13.3%.

For over 20 years, we have had government, managed care and malpractice attorneys trying to exert control over hospitals, providers, and pharmaceutical companies. If things are doing so poorly, how can we say that these interlopers into your health are part of the solution? Perhaps, in some ways, they are part of the problem. Think of this. If a managed care organization can profit in the short term by creating barriers to you getting prevention for a chronic disease, and if you get the chronic disease and then lose your job and go onto Medicare, they have saved their money but not your health.

If they are not the answer, what is? I believe it is Old School. We need to empower each of us to become more responsible for our own health. I do not mean to imply that everything is preventable. Only a telemarketer could say that! Some conditions are bad luck or bad genes. Cancer and traumatic spinal cord injuries, for example, are largely the luck of the dice. We need to free up some health resources to research this type of stuff.

Here are some ways that savings could come about:

• We need to try to turn chronic diseases into acute ones. Free refills for medications for prevention of ravages of chronic disease. For example, antihypertensives, diabetic medications, asthma medications, antidepressants.
• Refills come in undated bottles (except for expiration date). If you manage to return to the pharmacy within 5 days either way of the last scheduled dose, the refill is free. The further away from the refill date, the higher the copay. This would encourage compliance and adherence to therapy and reduction of long term disability.
• BMI tax, with exceptions for children and those particularly mesomorphic (muscular).
• Unhealthy food tax. If it is grossly unhealthy, tax it.
• Higher cigarette taxes. Free medications and treatments for stopping smoking.
• National policy and role modeling for healthy living. Use the same marketing techniques that work in politics and TV commercials to market healthy living.
• Reward those who maintain or improve their health.
• Pay for the harm that mistakes cause according to a fixed schedule. Root causes should be found for errors and fixed, with penalties for failure to address a problem before it happens again. Wanton misconduct should be addressed by a medical board or by a criminal court, depending on the nature of the event.

You get the idea. Just these simple ideas could save us 30% or more of our health care expenditures. However, simple is the enemy of the government, so it is unlikely we will see any of this in the future. Politicians would die before asking a potential voter to look in the mirror and be more self responsible. What we will see will most likely be: more regulations. Electronic health records that will be more time consuming and will take away face time with patients and will add another layer of bureaucracy and useless auditing. Blame of everyone except those who live unhealthy lives. Centralized health care is like centralized medical ethics. It looks good on paper, but produces judgemental thinking that can be detrimental to your health and your children's future.

The best gun used for home defense is the one you don't have to use. The best health care is the one you don't have to use because you have taken the best care of yourself that you can.