In America today there are few things everyone can agree on regarding health care. However it is probably safe to say that the existing system is fairly good. It is unfortunate that there are the number of people in this country that do not have health coverage. Finally, it appears that the approach of passing one bill that contains sweeping health care reform will fail.
What is really wrong with the health care system? The problem is there are over 300 million different answers to that question. For what it is worth, here’s my version. Basically, doctors don’t have enough time to practice medicine any more.
I can imagine some are saying that my statement is intuitively obvious to the most casual observer and others are scratching their head (or something) wondering what I mean. In a variety of forms it is all tied to the existing insurance industry.
Malpractice insurance paid by doctors is too high. Why? One reason is the need to practice defensive medicine to avoid a future lawsuit. Another is the failure of our society to accept individual responsibility, our courts to throw out frivolous suits and the proliferation of lawyers eager to bring way too many malpractice suits in the first place. If malpractice lawsuits decreased, then malpractice insurance costs would decrease as would medical bills to the consumer.
This is a very hard issue to address since most members of Congress are lawyers and it is their nature to see any lawsuit as a good lawsuit. This is contrary to the view of most of the nation where a lawsuit is typically the least worst solution to a problem.
The other major failing of the existing insurance industry is the way that they control medicine these days. There was a time when a doctor and patient decided a course of treatment. Now the insurance company, in the interest of cost control and quality assurance, dictates how long any given treatment need be treated. Heaven forbid, you as a patient have other underlying issues that mean you do not respond according to their expectations. Treatment should be between the doctor and patient.
It is not that insurance companies have indecent profits. They have indecent overheads. This is not to say the problem is with executive compensation either. This is an issue nationwide and across many industries. What I mean is, what is the ratio of income to payments?
In the United States, the administrative costs of insurance companies are three to five times that of Medicare or medical insurance in other modern nations. It does not stop there. Hospitals and doctors then have to have additional staff and expend additional resources on billing to a similar degree. If the insurance company gets out of the medical practice end of the equation, that will greatly cut costs.
Certainly insurance companies are businesses and expect to operate at a profit. However, in recent years, a great deal more effort is being made by insurers to drag out and delay payments. Imagine what getting paid in six months instead of six weeks can do to your cost of doing business.
This is what I meant before about doctors not spending enough time practicing medicine. They have to spend so much time defending and justifying themselves, so that the patient and their wallet wind up being the loser.
It has taken decades for our health care system to evolve to where it is today. We do need more changes. Who among us really believes that Congress can slap together one bill, that can address all the issues that need to be in a way that is fair and effective? What we need is a series of smaller bills instead of one bill that no one understands.
