Physician-lawmaker offers health care reform suggestions
Rep. Doug Cox, an emergency room physician, has come up with his a top-10 list that Congres should consider as they prepare to tackle health care reform. Cox, R-Grove, in preparing his list, today urged federal lawmakers to rethink health care reform and shift their focus to improving price and care instead of simply subsidizing coverage.
“There is no doubt that our health care system is broken,” Cox said in a news release. “And while I applaud President Obama for making this issue a priority, I am concerned his plan misses the mark. The reason health insurance costs so much is that health care costs so much. To simply try to subsidize insurance coverage without addressing the root problems in our system will place an undue burden on the American taxpayer and push our great nation to the brink of bankruptcy.”
Cox said his suggestions would generate cost savings without sacrificing quality; estimates the average office call in rural Oklahoma for a low-complexity visit could be reduced from $78 to $45.
Here are his suggestions. What do you think?
Problem 1: Physicians and hospitals are middle-men between insurance companies and patients, requiring a large number of personnel that are not involved in patient care, thus driving up the cost.
Solution 1: Insurance should be a contract between the insurance company and the patient with the patient responsible for the bill. Information on the physician/hospital statement should contain all information needed for a patient to file a personal claim and be reimbursed.
Problem 2: Access to test results between offices or office-to-hospital is limited. If a patient undergoes a test and winds up in the emergency room later, the results of that previous test may not be available to the new location. As a result, the test may be repeated at additional cost.
Solution 2: All medical test results should be kept in a central electronic repository, available to all physicians and hospitals.
Problem 3: Physician shortage.
Solution 3: Fund expansions of medical school facilities to handle larger classes, and fund post graduate training programs (residencies).
Problem 4: Physicians need to be more aware of the actual costs of the tests and treatments.
Solution 4: Provide for transparency in pricing, accessible to all.
Problem 5: Excessive consumer demand.
Solution 5: Establish clear treatment protocols that will decrease liability, educate consumers, and ensure physicians are using the most cost-effective treatment methods.
Problem 6: Defensive medicine – ordering excessive, expensive, and often unnecessary tests to provide an extra layer of insulation from lawsuits.
Solution 6: True lawsuit reform that gives real protection to physicians who practice medicine following “evidenced-based protocols.”
Problem 7: Insurance policies and mandates vary greatly from state to state.
Solution 7: One agency to regulate insurance companies nationwide.
Problem 8:Self-induced illness (such as diseases related to tobacco use and obesity).
Solution 8: Incentivize healthy life styles and healthy habits.
Problem 9: The present system prevents doctors from granting special rates to people on hard times.
Solution 9: Insurance companies and Medicare need to allow doctors the flexibility to adjust charges down for poor people without penalizing the physician.
Problem 10: Uncoordinated medical care. Patients self-referring to multiple specialists can result in fragmented care with no continuity and increased costs.
Solution 10: Americans should have a “medical home” with a primary care physician to manage their overall care, with an emphasis on prevention and specialty referral when indicated.
- Michael McNutt, Capitol Bureau
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Comments
As to solution #1. Let’s apply that same rationale to auto insurance. Let’s say I drink a fifth of Jack Daniels, hop onto the closest interstate cross the median, accelerate to 90 MPH, turn off my headlights and let go of the steering wheel. I (quite predictably) have a head on collision with one of your loved ones, causing grievous injuries or death.
Under Representative Cox’s regime, aside from the definite criminal liability I’d face, I wouldn’t be responsible for the probably $1million or higher damages I caused through my reckless and wanton behavior. That’d be all based on the insurance contract between the victim and her insurer.
These ideas are dangerous. They encourage the worst doctors in the United States to practice in Oklahoma. Instead of encouraging “defensive medicine,” which is a myth, this regime would encourage reckless medicine. Finally, doctors could concentrate on what really matters — profit. The patient? Whether they live or die? Whether the doctor screws up and kills the patient? So what? Not their problem.
The rest of this stuff is no big deal, even great. But allowing and encouraging doctors to practice negligent and reckless medicine is a dangerous idea which would kill people if implemented.
This idea ( proposal ) is for cutting cost and providing better care for Medicare and Medicaid recipients. I see this idea benefiting those of us outside Medicare, Medicaid by maybe stabilizing and possible lowering our tax rate in the future. I believe the best and quickest bet for now, tort reform. Along with my idea.
We have ( We the people ) Social Security Offices, Welfare offices……
I propose we build our own Medicare, Medicaid, Hospitals for our Medicare, Medicaid recipients in each and every County, Parrish, and District..
There are about 3114 Counties Parishes, Districts ect….. in the United States.
If we could build a forty five bed 15,000 square foot Medicare, Medicaid Hospital at 200 dollars a square foot. It would cost three million dollars for one Hospital. Now add another three million to complete it. Our Medicare, Medicaid hospital with 45 beds would come in at six million dollars. We could build a Medicare, Medicaid Hospital in every county in the entire United States for 18,684,000,000 Lets call it Twenty Billion with the leg work. One architect, one low cost design.
Now some counties will have more population than others. I’m aware of that. So for fun let’s double the number of Medicare Medicaid Hospitals and spread it out later. We now have 30,000 Square foot and ninety beds per county. Cost to build, Forty Billion Dollars. Perhaps we could use some of that Stimulus Money to put people to work building for but a short time.
Now I don’t know what the true average cost for nightly care in a public hospital or what we might be paying for it is. But I know this. If we saved 400 dollars per day per patient per room with our Medicare, Medicaid Hospital we would save 40,917,960,000 That pays for our Hospitals in one year. Do the math. That’s Forty Billion return in one year.
Now lets build our own manufacturing plant in say Michigan? We build our own Hospital Beds, Wheel Chairs, Walkers, ect. We now ship them to our Medicare, Medicaid Hospital to distribute and be returned when no longer needed. We just did away with rental costs and who knows how much fraud.
We could have our own diagnostic equipment and pharmacy right there in our own Medicare, Medicaid Hospital. No more paying two, three times the cost.
Now about staffing the thing. How many I wonder have the gifted IQ to become a physician and not the funds. My idea would be to give free education along with room and board. Same goes for the nurses. You can quit us only with all educational and boarding moneys up front, in full, and with interest. For now we staff it best we can.
All in all Medicare Medicaid Reform can be had here.
Medicare, Medicaid nursing home anyone?
Dale Stoltz
Jacksonville Texas.
American.
I like the idea of the first solution. That is how the offices were run in the past. This would have a couple of benefits, first the patient would see how much their health care costs by actually having to pay money for their care. It would start to eliminate the idea that health care is free. This mindset has grown through the years, and is not true. This would force the patient to seek medical care when needed which should bring down costs. Secondly, it would relieve the physician offices of expensive personel and wasted time chasing down money that they deserve. By reducing doctor overhead, that will offset the decrease in payments that are inevitable with healthcare reform. It is a good start, but only the beginning. The truth is congress is trying to move so fast, they won’t make it better, but actually make it worse.