Five ways to fix healthcare
Feb. 9th, 2009 09:39 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
ninevirtuesHere ya go, five modest proposals... comments?
1) Drug companies should stop advertising drugs and/or giving money to support groups or advocacy groups. Yeah, I mean like the ones for irritable bowel syndrome or fibromyalgia and other newly-minted ailments. We're all suggestible; how many of you have read about a disease and walked away convinced you had it? Yeah, that's what's going on here. Stop the advertising madness and we'll all be healthier.
2) We should stop prolonging life for the very old (or the terminally ill, or those in a vegetative state) when they have no quality of life. Someone has to sternly say that the end of a life is THE END. 90% of Medicare dollars are spent in the last year or so of life. Do not keep people alive when it would be much kinder to let them go in peace.
3) Emphasize prevention for chronic illnesses. I mean, spend some money on publicity so that every American knows how to eat right, how to get enough exercise, and what happens if you don't. (See above about not advertising newly-minted illnesses.) Make it easy, make it cheap to be fit: This could include: More money for bike paths, subsidizing vegetables so they are cheap cheap cheap to buy, redesigning cities so you can walk to a livable downtown. (This is one thing that Kaiser does right: They emphasize prevention.)
4) You should know how much a given medical treatment will cost you, personally, when the doctor suggests it for you. Or the physical therapist, actually. I mean the REAL cost to you, after the insurance company pays its share. So, for example, when the doctor says, "We could test you for X," and X is a remote possibility: You know exactly how much it will cost to satisfy your curiosity about that.
(For example, when you have low back pain, you can get an MRI for it. And, after age 30 or so, most of us have some joint degeneration or something that will appear on an MRI-- even though not all of us have back pain. However... no matter what's on the MRI, the doc will probably send you to physical therapy, because hey-- we're cheap and effective. Only in a very specific set of circumstances should you have surgery... and an MRI so the surgeon knows what he's dealing with before he cuts you.
5) Fix emergency rooms so that people with non-emergent complaints are routed to urgent care after being screened. Then find the 20% of remaining ER users who consume 80% of the ER resources. Assign them caseworkers and deal with their issues individually.
1) Drug companies should stop advertising drugs and/or giving money to support groups or advocacy groups. Yeah, I mean like the ones for irritable bowel syndrome or fibromyalgia and other newly-minted ailments. We're all suggestible; how many of you have read about a disease and walked away convinced you had it? Yeah, that's what's going on here. Stop the advertising madness and we'll all be healthier.
2) We should stop prolonging life for the very old (or the terminally ill, or those in a vegetative state) when they have no quality of life. Someone has to sternly say that the end of a life is THE END. 90% of Medicare dollars are spent in the last year or so of life. Do not keep people alive when it would be much kinder to let them go in peace.
3) Emphasize prevention for chronic illnesses. I mean, spend some money on publicity so that every American knows how to eat right, how to get enough exercise, and what happens if you don't. (See above about not advertising newly-minted illnesses.) Make it easy, make it cheap to be fit: This could include: More money for bike paths, subsidizing vegetables so they are cheap cheap cheap to buy, redesigning cities so you can walk to a livable downtown. (This is one thing that Kaiser does right: They emphasize prevention.)
4) You should know how much a given medical treatment will cost you, personally, when the doctor suggests it for you. Or the physical therapist, actually. I mean the REAL cost to you, after the insurance company pays its share. So, for example, when the doctor says, "We could test you for X," and X is a remote possibility: You know exactly how much it will cost to satisfy your curiosity about that.
(For example, when you have low back pain, you can get an MRI for it. And, after age 30 or so, most of us have some joint degeneration or something that will appear on an MRI-- even though not all of us have back pain. However... no matter what's on the MRI, the doc will probably send you to physical therapy, because hey-- we're cheap and effective. Only in a very specific set of circumstances should you have surgery... and an MRI so the surgeon knows what he's dealing with before he cuts you.
5) Fix emergency rooms so that people with non-emergent complaints are routed to urgent care after being screened. Then find the 20% of remaining ER users who consume 80% of the ER resources. Assign them caseworkers and deal with their issues individually.
