Woodruff wrote:Frigidus wrote:Nobunaga wrote:... Government assisted capitalism? You get that from your Social Studies teacher? How does that work? How will companies compete with an entity that has no need to produce a profit and can print as much of its own money as it wants?
The need to produce a profit is the entire problem with capitalist health care. Every health care system's primary motive should be to keep people healthy, not trim the populace's wallets as much as humanly possible and then try to skip out on care if they can find the right loophole.
Yes, I do agree. Capitalism really just doesn't "fit" a healthy healthcare system, in my opinion. I'm not necessarily in favor of universal health care system (I was in the military, so I know a bit about universal health care and its problems...), but I do know that when profit becomes MORE important than the healthcare product (and sadly, that really IS what capitalism has turned into), there is a serious problem. Capitalism is, in general, the right path...but it's not a fits-all paradigm, in my opinion.
I want to clarify that when I say competition could improve health care at upper levels, I am not strictly talking about profit.
I see the major problems as follows:
1. Too much time/energy wasted simply dealing with multiple insurance companies, forms and rules (including various government plans).
SOLUTIONS:
A. GREATLY simplify forms. At a minimum, agree on the basic information that will be collected. Better yet, have a semi-consensus of options available for various issues and illnesses.
B. Collect and compile information on effectiveness of treatments in various situations and do a better job of using that to create a basis for reccomended care. When people here this they often cry "but I want options". The REAL truth is that the only "option" people want in treatment is to be treated effectively as cheaply as possible. Geitner Health here in PA has a pilot program that does this. The idea is to track which treaments work best in which situation and then make that the "standard". Options exist when there is no real clear better treatment method (though particular hospitals or doctors might need to pick one), for special situations, to evaluate new treatment possibilities (studies), etc.
2. Payment is greatly increased for "doing procedures" rather than "thinking" or "communicating". However, those last 2 are far more likely to result in effective treatment.
A. allow doctors time to sit down and talk with patients.
B. TRAIN doctors to listen better to patients -- the more doctors listen, the fewer tests they often need. Also, the chance of missing something critical is actually far less.
C. Require and allow time for doctors to do "old fashioned" physical exams again. Like listening, these give doctors phenomenal clues on what is really wrong with a patient. This results in fewer bogus tests and reduces the chance of mis-diagnosis.
D. Pay more for time, rather than just "procedures". Why should lancing an infected toe pay far more than sitting and listening to a dying patient, explaining the options that are available and helping the patient and family better come to terms with what is happening. Why should it pay more than helping a newly diagnosed diabetic understand all the complicated life changes that will have to happen? Sure, the doctor needs to be paid for lancing the toe, but the doctor needs to be paid
more, not less for helping the dying patient or diabetic understand thier situation.
3. Change the way mistakes are dealt with.
A. define true criminality (intentional harm) and PROSECUTE it (few and far between, mostly done).
B. Hold hospitals/doctors responsible for any care needed to correct problems they create. This push is already happening. Geitner Health is a prime example. This right off eliminates a big reason why people are forced to sue.
C. Establish "no fault" malpractice insurance, patterned somewhat like auto insurance, that will pay living expenses, etc. for patients (and families when appropriate) who are injured or made sicker due to hospital/doctor error.
D.Reward doctors for finding errors, rather than penalizing them. If a doctor makes a mistake and "owns up" or discovers the error, then any penalty should be minimal. Doctors are not perfect , they make mistakes. The emphasis should be on finding ways to correct problems, not on penalizing doctors who err.
E.DO set better standards for recognizing negligence and incompetence. In some cases, retraining may be warranted, in other cases shifting to a lower-responsibility position. In others, maybe that doctor needs to retire. Because this is not tied to huge malpractice claims, the impetus to be honest will be greater. Certainly not perfect, but far better than now.
F. set up an independent board that will review ALL cases that meet certain criteria (the grossest errors or perhaps those most troubling situations, defined by the doctors/hospitals themselves), PLUS a stratified random selection of other cases. (that is, so many heart procedures, so many liver transplants ... etc... exact numbers and criteria will be formulated by doctors themselves). The goal here will be to find numbers of unreported errors and to better track how to prevent those errors.
There is more, but that is plenty for right now. Doing those things will go a LONG way to fix our health system, regardless of who pays.
