Posts Tagged ‘National Health Plans’

Questions America Must Answer to Fix Our Health Care System – Give Me Your Thoughts

January 8, 2009

FIXING HEALTH CARE

 

“50% or so of health care dollars is spent on advertising. What will you do to stop this waste. Health care providers should be like the police and fire departments, a necessary public service that does not advertise.”

 

“Would you support a steeply progressive and very high tax on advertising of drugs to discourage this practice? This would quickly reduce the cost of drugs as presently 50 % of drug company budgets are advertising costs. Or would you ban advertising?”

 

“Whether to do Phase 3 clinical trials of new drugs is decided by drug companies – encourages excessive costs by testing unnecessary “me too”  drugs with no benefit. Would you support FDA taking over this decision analagous to IL hosp plan commission?”

 

“Our veterans in chronic pain are thrown narcotics in high doses making them nonfunctional addicts instead of treating pain properly with multiple modalities (TENS units, therapy, muscle relaxants, meditation). Will you help them reclaim their lives?”

 

“Medical care at Cook Co. Jail & IL prison system is so inadequate inmates have had their leg amputated for lack of antibiotics & prisoners who were disabled lay on the floor in diarrhea for days unable to obtain water/care. Will DOJ investigate?”

 

“In Illinois Atty Gen Lisa Madigan, several Governors, and their corrupt accomplices fraudulently deny mental health care to those on Medicaid and wrongfully prosecute health care providers who are trying to provide this service. Will you investigate?”

 

“Will you acknowledge childhood obesity caused by fast foods and soda pop and ban soda pop and fast foods from schools & bring affordable food stores to poverty stricken communities? Inner cities have lots of fast food – little affordable food stores.”

 

“We save premature babies and children in ICUs, then fail to fund continuing care for severely disabled babies/children leading to poverty, divorce, family destruction, neglect of siblings, lost potential, and increased disability. Will you fix this?”

 

“Daschle has a reputation of being in the pockets of pharmaceutical companies. Is this true and if so will you make sure that pharmaceutical companies do not have undo influence over health care policy and do not rake in excess profits off our misery?”

 

“Will you help switch funding for care of severely disabled and dying children from institutions to home care? The choice to care for the child at home should be the parents not the state’s.”

 

“Haldol – antipsychotic is excessively involuntary injected in ERs and jails to quash free speech, curb dissent, and force behavior to change per dictates of others. Will you stop it? The Soviets used this method for dissidents – WE SHOULDN’T!””

 

“Half of health care dollars are spent for often futile end of life or beginning of life care (ultrapreemies). Much can be saved by putting limits on such and better funding and promoting more humane hospice care. Will you investigate this and fix it?”

Doctor’s Pay and HMOs – How to Fix HealthCare System

January 6, 2009

I do not believe that my colleagues who make 1 million dollars per year for doing open heart surgery deserve that amount of salary off of people’s misery. I do believe many are vastly overpaid – especially hospital administrators for “not-for-profit” hospitals that make $600,000+ per year. I believe physicians should be salaried like police or firemen. Then the incentive to see more than a hunded patients a day and move them through the “mill” will be gone and doctors will spend the time with you that they need to spend.

A VA like system could still use the existing health care networks.

An HMO style system where doctors are paid monthly per patient no matter how many times the patient sees them is very bad as the incentive is to have as large a panel of patients as possible to increase income and then to see the patients as little as possible, order as few tests as possible, and shortchange the patient by moving them through the office like a factory or mill.

The payment to the doctors should be totally disconnected form the Number of patients they see or the Type of illness they treat. Doctors who perform procedures like orthopedic and heart surgeons should not be payed obscenely more than doctors who talk to patients and counsel patients like psychiatrists and pediatricians. Talking and counseling therapy is as valuable and as difficult to learn as surgery.

We don’t need to add more dollars to medical care. We need to cut waste! Pharmaceutical companies spend half their money on advertising. Stop advertising and the cost of drugs will vastly decrease. Half of our health care dollars are spent on end-of-life futile treatments. We need to have clearer guidelines in this area. Instead of spending small amounts on preventive care, our citizens don’t get the care they need to prevent more expensive needed medical care. There are a LOT of areas where savings can be found and the money saved can be channeled into a more rational system.

A Message To Secretary-Designee Daschle – How to Reform Health Care

December 11, 2008

Health Care reform needs creative thinking. Policies and procedures of the past just won’t do. We can’t just copy Canadian health care systems. Nor should we just leave everything to the “free” market. Free market theory ASSUMES one is ABLE TO make a choice for the most competitive service provider.

First we should analyze what is the meaning of health care. In America we have fire and police departments, public road maintenance, and other public services  where the employees provide services to the captive public for a salary. How well they do their work or how much work they do is not tied to their salary. When a burglar confronts you with a gun, or there is a fire at your house, there is no ability for the person in this “captive” market to shop around. I believe that Americans think that fire and police protection, garbage collection, etc are a right. 

These are not areas where there are super exorbitant  profits for those that supply the fire engines, police cars, and garbage trucks or who man the fire engines, garbage trucks, etc. Competition for services and supplies is somewhat limited. Therefore, the principles of the free market capitalist system just doesn’t work well.  

The questions is do Americans now believe that health care is a right and not a privilege as I do?  I don’t believe that exotic and futile health care however, is a right. Half our health care dollars (my estimate which may not be completely correct) are spent on futile health care at the end of life or the beginning of life.  We need clear guidelines as to when a  person at public expense will be placed under hospice care and taken out of the ICU and guidelines for other such end of life decisions. We cannot give every possible treatment to stretch out misery and suffering to the very last moment, nor keep brain dead people “alive” on ventilators at public expense instead of using that money to help those that can be saved!

If one believes it is a right then WHY do we allow pharmaceutical companies, high-tech health equipment and supplies manufacterors and suppliers the right to set exorbitant high fees without competition in a captive market? Executives of health insurance companies and HMOs, executives of “not-for-profit” hospitals, physicians who perform more procedures than others (heart surgeons, orthopedic surgeons, opthalmologists, etc.) bill exotic fees and make hugely outrageous incomes in the millions to tens of millions of dollars (in comparison to the President of the United States – $400,000, the average family practitioner or pediatrician $150,000, or the executive of other non-profit agencies) when the patients are a captive market who have only limited abilites to shop around. How can a person shop around when they are being taken to a hospital by ambulance for a heart attack and need bypass surgery?  A captive market is NOT a free market. The Milton Friedman model does NOT work with a captive market where people obtain life-saving and essential services. When only one company makes a PET scanner, how can a hospital shop around for competitive bids?

Pharmaceutical companies spend an estimated 50% of their expenditures on advertising. They convince doctors to prescribe marginally “better” drugs at great cost when the doctors could prescribe cheaper and just as effective medications. Yet we allow Medicaid and prisons medical facilities (who provide a LOT of health care in the US) to limit drugs in a ridiculously strict fashion that amounts to medical neglect. The disparities are astonishing in terms of availability of appropriate drugs and the use of unnecessary drugs.

We have 200 times (my estimate) the number of employees as countries with national health plans in the health care/industrial complex just to push around invoices for medical care and collect money from patients who can’t pay.  Hospitals charge 3 Xs reasonable fees to make up for the lack of payment from those who cannot afford to pay and are brought to their hospitals in dire straights unable to choose a cheaper facility.

Employers are expected to pay for medical care and our economy is driven into the ground by this when companies cannot compete due to this “benefit” package.

Lets be reasonable. We need the following and we need creative ways of obtaining it and a national dialogue about how much medical care is a right and how much profit should be allowed to be taken out by greedy people (executives, a minority of doctors, high tech product suppliers and manufacterers, pharmaceutical company executives and stockholders).

1 – remove health care from ties with employers so when you lose your job you dont’ lose your health insurance and to prevent employers from pushing out employees with chronic health conditions that make the companies insurance too costly,

2 – consider excess gradated taxes on advertising of drugs and high tech products to discourage inappropriate use of new expensive drugs, while increasing grants to pharmaceutical companies and research scientists to develop new drugs,

3 – consider either putting doctors and health care executives on a salary, a partial salary, or imposing a steeply progressive excess income tax (say 50% tax on portions of income over $400,000) or some creative variation of this, coupled with free education for physicians and nurses, which would be similar to free education for firemen – this will produce huge savings – why should the CEO of an HMO going out of business get $40 million in a golden parachute as the company goes under – these dollars should be used for health care and NOT TO ENRICH EXECUTIVES OF PHARMACEUTICAL COMPANIES, HEALTH INSURANCE COMPANIES AND HIGH-TECH MEDICAL EQUIPMENT COMPANIES, AND DOCTORS,

4 – regional health care plans instead of employer based plans, which would have to compete against each other,

5 – subsidies or tax benefits for companies that are very small and employ a lot of low paid workers, for the disabled, and the poor to help them pay any premiums,

6 – reduce paper and standardize electronic medical records so there is inexpensive access to information, so that disasters don’t wipe out records, so that services are not duplicated when results are lost, and so that erros are reduced – this will produce huge cost savings that can be used to fund the system instead of increasing taxes,

7 – a VA like health care system that people can choose instead of the private insurance companies,

8- don’t leave the decisions only to the legislators, the AMA, the powerful, and the elite, let those of us on the front line have a say – by being in every working group and on every board concerning any aspect of health care.


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