Monday, February 25, 2013

How to Decrease Medical Costs

1. Decrease the number of people involved in delivering the service. Government, Insurance, For-profit Hospital board of investors all take their cut. Make hospitals non-profit, have them be county- owned and give them low/no-interest loans.

2. have doctor's focus their practice on caring for the sick and not "well checks". Let nurses or mid-level providers do well-checks when needed. "The whole hath no need of a physician but them that are sick".

3. If we stay with insurance, why do we shift insurance from private to government once a person retires. If a person has been covered and paid into insurance their whole life, then why shift liability to the tax payer after age 65?

4 . When a doctor changes 1$ the government amd insurance pays only 40 cents. Consequently, doctors charge more to get their 1$. Government then uses the artificial inflation of medical costs, due to their decreased reembursement, for political leverage.

5. Realize that mommies and daddies teach and practice preventative medicine and not doctors. If a doctor is telling you to exercize, eat right and loss weight; it's probably too late for most people.

6. Our current system makes it too easy for pain-pill and xanax-pill addicts to clog up the system. They take up way too much space for their chronic problems. These people may need their meds but they don't need to be taking up a doctor's time.

7. CLIA regulation and pharma have made many tests very complicated and impossible to perform in the clinic setting. Tests like a CBC, CMP, UA need to be simpler, cheaper and easy to do without needing a lab technician. Really, we should not be setting up a system were we need lab techs, resp techs, rad techs, etc. Technology should br symplified enough that doctors offices can perform them without needing a separate training degree. Blood tests could all be done on one micro-well chip. A scan could be just involve laying on a table and selecting what part of the body to image.

8. We all know that end-of-life care is where all the money gets spent. We don 't need death panels. But at some point, we can't keep prolonging the agony when our loved one has end-stage dementia, is in a nursing home. At some point it is probably a mistake to place a feeding tube, or start dialysis, or place them on a vent. But people do because they are spending her retirement or SS check and they need to keep her around for as long as possible.

If something is wrong, there is nothing wrong visiting the ED in the middle of the night. ED doctors make ourselves availible 24/7-365. But I think programs like Hospice and Palliative Treatment can be expanded. It doesnt mean we dont give fluids, antibiotics, nutrician or pain medicines: but we may not do other invasive and expensive things. Hopefully, if tests are simpler to do; nursing homes can diagnose amd treat their own UTI and not have to cause a hospital admission.

9. Why is there an age of retirement. Retirement isn't a biblical value. Are we not to "eat our bread by the sweat of our face all the days of our life?". I thinks its good to work less. Change the nature of work and take more time off. However, instead of retirement, we should just have disability insurace. We stop working when we become too disabled to work.

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