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I don't pretend to have the sure-fire fix for our national health system but have some suggestions to reduce the problems. Maybe someone like Franklin Roosevelt or Arnold Schwarzenegger can get them implemented.
First of all, here are some of the problems. The pricing of medical services is utterly insane. My bride recently had an ultrasound test performed in a hospital. They billed Medicare and our second-payor insurer $437. Medicare paid $82 and our second-payor paid $24. The hospital discounted the rest which they are apparently obligated to do if they wish to be an approved Medicare health provider. Another economic anomaly, capitation, is a system where an insurer strikes a deal with health providers to accept a small regular payment for every member in an insured group whether or not members ever see the providers. In other words capitation health providers can maximize their income by not seeing patients. These are examples of the wacky world of United States medical economics.
A couple of years ago I went on a bus tour of England. On the trip with me was Reno physician Mike Gainey and we talked a lot about the state of medicine. I posed this hypothetical: "If you had a magic wand and could mold the U.S. medical system any way you wanted, what would the result be?"
He thought for quite a while and finally responded, "Cash and carry." I'm showing my age when I reveal that cash was my family's medical plan until I enrolled at University of California where the then $104 annual tuition included medical care.
Imagine today trying to put our system back on a cash and carry basis. When hospitals bill four times the amount they expect to get paid, pity the poor uninsured patient who has to pay cash.
But if U.S. medical care economics are wacky, they are a model of efficiency when compared to many other countries.
During my tour of England the London Times reported that the government was conducting a poll to see if voters preferred new taxes or a lottery to rescue their socialized medical system.
I had dinner with the chief engineer of a New Zealand hospital who confided that their socialized medicine system is broken.
In Canada long waits for medical services are the norm. Many Canadians come to the United States for anything other than routine care because it's illegal to pay a private physician for services "covered" under their collectivist system.
And if Terri Schiavo were in Ottowa the doctor, not the family, would decide when to pull the plug.
To improve our system we need to:
1. Eliminate fraud and abuse. In 2002, 6.3 percent of claims were found to be fraudulent.
2. Establish best medical practices. The National Institutes of Health must research and report on which treatments work and which do not. Such data would set the standard for testing and treatment and should reduce waste.
3. Malpractice reform. We need to curb jury awards, restrict lawyers' contingent fee contracts and modify the doctrine of joint and several liability, which encourages suits against everyone in sight.
4. Adopt the English rule for law suits where loser pays the winner's legal expenses.
Maybe then it will be time for cash and carry medicine.
Jim Clark is president of the Incline Village/Crystal Bay Republican Advocates (formerly Republican Men's Club) and a vice chair of the Washoe County Republican Party. He also serves as chair of Independent Incline.
First of all, here are some of the problems. The pricing of medical services is utterly insane. My bride recently had an ultrasound test performed in a hospital. They billed Medicare and our second-payor insurer $437. Medicare paid $82 and our second-payor paid $24. The hospital discounted the rest which they are apparently obligated to do if they wish to be an approved Medicare health provider. Another economic anomaly, capitation, is a system where an insurer strikes a deal with health providers to accept a small regular payment for every member in an insured group whether or not members ever see the providers. In other words capitation health providers can maximize their income by not seeing patients. These are examples of the wacky world of United States medical economics.
A couple of years ago I went on a bus tour of England. On the trip with me was Reno physician Mike Gainey and we talked a lot about the state of medicine. I posed this hypothetical: "If you had a magic wand and could mold the U.S. medical system any way you wanted, what would the result be?"
He thought for quite a while and finally responded, "Cash and carry." I'm showing my age when I reveal that cash was my family's medical plan until I enrolled at University of California where the then $104 annual tuition included medical care.
Imagine today trying to put our system back on a cash and carry basis. When hospitals bill four times the amount they expect to get paid, pity the poor uninsured patient who has to pay cash.
But if U.S. medical care economics are wacky, they are a model of efficiency when compared to many other countries.
During my tour of England the London Times reported that the government was conducting a poll to see if voters preferred new taxes or a lottery to rescue their socialized medical system.
I had dinner with the chief engineer of a New Zealand hospital who confided that their socialized medicine system is broken.
In Canada long waits for medical services are the norm. Many Canadians come to the United States for anything other than routine care because it's illegal to pay a private physician for services "covered" under their collectivist system.
And if Terri Schiavo were in Ottowa the doctor, not the family, would decide when to pull the plug.
To improve our system we need to:
1. Eliminate fraud and abuse. In 2002, 6.3 percent of claims were found to be fraudulent.
2. Establish best medical practices. The National Institutes of Health must research and report on which treatments work and which do not. Such data would set the standard for testing and treatment and should reduce waste.
3. Malpractice reform. We need to curb jury awards, restrict lawyers' contingent fee contracts and modify the doctrine of joint and several liability, which encourages suits against everyone in sight.
4. Adopt the English rule for law suits where loser pays the winner's legal expenses.
Maybe then it will be time for cash and carry medicine.
Jim Clark is president of the Incline Village/Crystal Bay Republican Advocates (formerly Republican Men's Club) and a vice chair of the Washoe County Republican Party. He also serves as chair of Independent Incline.
