Fixing health care isn’t the unimaginably complex issue most people make it out to be. It isn’t easy to fix because of politics, not because there are no good solutions, it’s because it will meet resistance from politicians, health care lobbyists, hospital administrators, pharmaceutical companies and anyone else who benefits greatly from the system as it stands, but for the rest of us, change is critical.
Out of control costs for medical care
The primary problem is the out of control cost of medical care itself since insurance can’t be cheap when the covered costs are through the roof, but even more troubling is the simple fact that costs are unknown before the care is administered and can vary from patient to patient for exactly the same services. If a patient does not have insurance, they may be charged five or ten times what an insurance company will pay, and the hospital will accept. What this means is you are essentially forced to buy insurance or be threatened with potential bankruptcy which sounds suspiciously like legal extortion.
Price transparency is essential, know the cost up front
If you buy groceries, a new car or a house, you know what the price is before you make the purchase. If you walk into a doctor’s office, an urgent care center or an emergency room, there are no prices displayed anywhere. If you ask what certain services cost before you agree to them, you’ll be asked what insurance you have. Why?
If your car is damaged in an accident, you can get an estimate of repair costs from several body shops, take the best one and either pay out of pocket or submit it to your insurance, but you know the price beforehand and it’s the same no matter who pays.
Medical bills, however, are a surprise, they usually arrive long after the service, trickling in from the hospital, a doctor’s office, maybe a radiology group, a lab of some sort and who knows where else, with long lists of charges sometimes described in cryptic language or often in uninformative abbreviations. You may see a price charged by the hospital negotiated down by the insurance company to a small fraction of the original cost, but what if you’re not insured? If the hospital writes it down for the insurance company, why not for you? Why not make the price they accept for the insurance company the price for everyone so you can pay out of pocket if you choose? Why not display those prices for everyone to see on the hospital’s or doctor’s web site and at their location so hospitals and doctors can compete on price and why do you have to choose from a limited list of in network providers, why not not just a doctor or a hospital of your choice?
What’s necessary to fix health care is already in place
While most everyone complains about these aggravating and opaque methods and requirements, few question the reason for their existence when, in fact, everyone should. Pricing, billing and insurance are not medical care, they’re the business side of a service industry that is allowed to function in ways that would put companies in any other industry out of business and likely result in fines and imprisonment for more than a few. U.S. Code, Title 15 Chapter 1, takes a dim view of what the health care industry considers standard operating procedures. Why do they get a pass? These laws either apply to everyone or to no one, if they’re going to be ignored here, then they should be ignored for every business in every industry. Unfortunately, legislators from both parties seem unwilling to simply enforce the law.
New legislation can be brief yet comprehensive
As an example of what could be done, here are two proposals, a quick, one sentence bill dealing with the high cost of care for the uninsured and also a detailed bill to permanently fix the health care crisis as well as the skyrocketing price of drugs. These bills can be read and understood by any reasonably intelligent person and the result would be a dramatic correction to a problem that many believe is un-fixable. (The effects of these changes even fix the budget deficit!)
They’re hard to summarize without covering all of the details, so just read the bills yourself at the links provided. Each point in the comprehensive bill is a couple of sentences with a short explanation of its purpose and how it works. You’ll find the clarity of the various points refreshing in contrast to every other “solution” you may have seen and you’ll discover what many in the health care industry would rather you not know or even think about.
Go ahead and check them out, they’re only a few pages in total, and definitely worth your time. If you like them, forward them to your friends and legislators. These are solid ideas, see if you agree.