Tuesday, November 19, 2013

Dr. Elaina George - A Practicing Physician’s Prescription For A Healthcare Fix

For all of the desperate attempts at distraction, demonization and outright lies about Obamacare the truth remains – having health insurance does not equal getting quality healthcare.

It is true that there are problems with the health insurance industry. If anyone had bothered to ask independent private physicians why they no longer take Medicare/Medicaid, or why many are opting out of insurance and moving towards a cash only practice in increasing numbers, they would tell you that they stopped because the game is rigged. It has become harder for doctors and by extension patients to access quality affordable healthcare. Obamacare expands and empowers the most expensive aspects of our healthcare system thereby dooming Americans to pay more money in the form of taxes and rationed care.

The proponents of Obamacare like Ezekiel Emanuel (the architect of  The complete Lives System ) and Paul Krugman are finally coming out and telling us the truth. Obamacare has always been about control of our healthcare system by centralizing the power in the government. The method to control costs will be driven by higher taxes and rationing (ie., death panels).

Unfortunately, the 30 million people who did not have health insurance will be exchanged for those who did and were not dependent on government handouts. Obamacare is not only a transfer of wealth from the young and the middle class to the government and its corporate friends, but as an astute individual commented – it is actually a transfer of health. Americans stand to lose their freedom to choose their doctor, and their freedom to choose how they treat their illness. For example, under the current law people can no longer use their health savings account (HSA) to buy natural remedies such as vitamins and supplements only brand name prescription drugs. How long will it be before we will be mandated to take vaccines or be placed on psychiatric medication against our will? Under this collectivist system the costs to the system will override individual freedom. There will be no anonymity within the national electronic medical record database.

 These are some simple solutions:
  • Change the tax code to allow private physicians to write off bad debt. 
Allow physicians to write off delinquent patient bills as bad debt. This would alleviate the need to send the  patient to collections and  remove healthcare costs as a cause of bankruptcy. It would also encourage medical care that is gratis because physicians could afford to offer it.
  •  Tort reform
Make patients who bring frivolous lawsuits responsible for paying all court costs. Consider caps on damages. Encourage doctors to give free care by giving them a discount on their malpractice insurance or waiving it if they provide a certain amount of free care per year.
  •   Allow Medicare and Medicaid access to cheaper drugs from other countries
Allow importation of drugs from Canada to decrease costs to both Medicare/Medicaid patients and the government.    
  •  Reform EMTALA (The Emergency Medical Treatment and Active Labor Act
This is an unfunded congressional mandate passed in 1986, that required hospital emergency rooms to treat all patients regardless of their ability to pay. The unintended consequence of this bill has led to increased costs that get passed on to patients who are able to pay.
Instead: Require that patients who present to the emergency room be triaged and treated for real emergencies only, and not problems that are best treated in an outpatient office, clinic or urgent care setting. e.g., common cold or ear wax removal.
  • Require insurance companies to honor the pre-certification process
 Require that if an insurance company pre-certifies (approves) a procedure then they have to pay for it. They cannot deny it after the fact and leave the patient on the hook for paying the bill.
  • Separate the triumvirate of the pharmacies, the insurance companies and the pharmacy benefit management companies (PBMs)
They are colluding to keep prescription medication costs high, while limiting competition which would lead to cost control through honest competition.
  • Do not mandate the licensure of physicians be tied to taking Medicare/Medicaid  or Obamacare
This will guarantee an exodus of physicians further exacerbating the doctor shortage.
If the government really wanted to expand coverage for 30 million people all they would have had to do was expand Medicaid/Medicare. It would have been a lot cheaper than the cost of blowing up the private insurance market. Empowering independent doctors instead of the hospitals, the insurance companies and Big Pharma would have been a much cheaper fix.