Pardon the expletives, I have been wanting to share some thoughts and frustrations about healthcare that I have seen arise over the last few years.
The United States healthcare system is completely broken; it has become a huge money pit, with insurance companies, pharmaceutical corporations and greedy lawyers at the bottom filling their pockets. Mind you, I do not blame the practitioners or their staff, because they do an exceptional job, even when they are sleep deprived from working doubles.
Is our health a commodity?
Healthcare is a strange commodity. If you are starving, you can’t walk into a restaurant and demand a hamburger, and you certainly can’t walk into a steakhouse and demand a ribeye. If your water gets shut off, you can’t walk into a gym’s locker room and demand a shower and use of their shampoo.
If you can’t afford a cell phone, you can’t bust up into a Sprint store and demand to see Dan Hesse the CEO. But in healthcare, if you think you need care, regardless of actual physical acuity (severity), you can go to a hospital and they have to give you the best care they can provide, by law, and for FREE!.
Without making a value judgment on that fact, you have to admit that devising a system that both capably serves its clients and doesn’t bankrupt its providers is a tenuous ordeal, at best.
UPDATE: Check out Part 2 – Another 11 Reasons Why Our Healthcare System is So $&@%#! Up, for the follow up story.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
11 reasons why healthcare is broken
Today I’m going to talk about 11 reasons why I think healthcare has been down in the gutter for so many years.
1. Insurance companies – In a short-sighted view, insurance rates are a big problem. They cost so much that people outside of large business plans cannot get coverage unless they’re in perfect shape, under 40, and have no family history of medical problems. Which, given that last qualifier, discounts pretty much everyone. However, simply saying insurance rates are the problem is like saying inflation is the reason things cost so much; you’re actually only describing an effect of a larger system of problems, not the problem itself.
Just like the solution to keeping ice from melting isn’t inventing ice that stays frozen at a higher temperature, making insurance more affordable isn’t necessarily done by demanding insurance companies to lower their premiums.
The fix is to improving communications between providers and insurance companies that would result in less wasted tests, long wait times between care and approvals, (which result in health problems getting worse, which cost us more) Right now most insurance companies use paper fax to authorize treatments and sadly many of these are lost in transit or take many days or weeks to process. Get with technology guys!
Thanks to dailyinfographic.com for image.*See the full infographic here
With insurance premiums on the rise again, we seriously need to get our insurance companies on the right track so we can afford to die healthy.
2. Excessive regulation – Not saying all regulation is bad, but, for example, the criteria for becoming a medical practitioner is way too strict. There is no reason why I should need eight years of schooling to say, “Hey, you have an ear infection. Take this for a week.”
Probably half the nurses at most hospitals could handle a lot of the GP work that gets done, but they can’t, because the government doesn’t allow them to. When it takes a couple hundred grand in education costs to become a doctor, doctors are going to demand a $%#! Ton of compensation for their services.
When doctors demand a %@#! Ton, it drives the cost of health care up. If we opened up certain branches of healthcare to people who can do the work even without all the schooling, it would drive costs down for at least some forms of healthcare. I mean, I can help design a bridge that, should it fail, will kill dozens of people without all that schooling, but I can’t tell someone he has a cold?
3. Shortage of Doctors – Studies show that there will be a shortage of doctors for the American patient in the next 15 years according the Association of American Medical Colleagues. But what they do not quote in the WSJ article is that number 2 above is the real reason why there is the lack of people wanting become doctors. If you have gone through the rigorous medical schooling, or know someone who has, you know how tough it can be.
4. Medical advances – We’re learning how to treat more and more ailments, and these new treatments are pricey. Once upon a time, if you got a certain illness, you just sort of quietly died. Now medical advances are not a bad thing, they just cost a lot more during the first few years of their launch.
Now, you instead rack up a hundred grand in treatments that are paid for by your insurance provider. The insurance providers pay through the nose, and they pass the costs on to you in the form of higher premiums and co-pays.
5. Paper – Please, stop using 50 year old FAX technology.
Did you know that providers need to fill out an average of 20,000 forms every year? And, 3 out of every 10 tests are reordered because the files are lost?
We also know that paper is the costly, killer of trees, hard to track, and easily misplaced, lost or misfiled…
So why most do doctors still use paper to communicate? Because till recently, it was really the only way for 2 doctors to communicate information, but thankfully that is finally changing with the advent of new applications that help manage the patient referral and insurance authorization process. Sorry for the little plug – Check out referralMD, it will make you and your staff’s live so much easier.
Want more stats? Check out the full healthcare infographic about American’s broken referral system, the stats are shocking.
6. Ignorance – Another branch of increased costs is ignorance, which I don’t mean in a derogatory fashion. Just the simple ignorance of patients or their parents not knowing how to treat something at home, or not even worrying about it and coming straight to the ER for care.
Ninety-five times out of a hundred (especially in children), the problem can be solved with medicine available at CVS for $6.99, but instead it now costs several hundred dollars in triage and physicians’ fees. As you can expect, many parents are more concerned with getting their children well than if they can actually pay for the service, and as a result do not pay the bill. They know they do not have to have money to be seen, and that’s all they need to know.
7. Choice to Die – I feel that we, as a nation, spend entirely too much money on the care of irrecoverably indigent patients, and that euthanasia should be a legal option if granted in powers of attorney and a Living Will. I’ve seen too many middle-aged or older people spend their entire savings keeping elderly parents on life-support for years beyond the point when recovery was medically viable. People with strong feelings on healthcare should have to spend time in ICU wards and nursing homes, watching withered old people sit paralyzed in their own feces, fed by tubes because their vegetative minds can no longer operate their contracted and atrophied hands.
It’s a hard thing to look at, but it’s even harder, for me, to defend the right to keep someone in this cruel condition, especially at the cost of the taxpayer. I have notices in my Living Will dictating the removal of life support in that situation, as do most of the people I know. And I think that’s the biggest thing about people’s thoughts on healthcare: a volume of experience changes you, and the longer you’re in the field, the more pragmatic you become.
8. McDonalds – Well any fast food for that matter. Some of us eat it daily due to it being cheaper, faster to eat, and more easily consumed from any location. The mentality of eating this type of food is slowly destroying our country. It causes American’s to gain weight, become stagnant, which in turn increases the risk for heart disease and other debilitating diseases. The overall effect is that these diseases are preventable and if kept in check, could lower the cost of healthcare premiums for everyone.
Will we change, probably not; will we get fatter and sicker? Yes…. So unless we make it illegal to eat badly, we will be drowning soon in our own disgust.
Read the remaining 3 Reasons Why Our Healthcare System is So M@#!&D Up on referralMD’s Blog here.
