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