Health Care Solutions

I am no expert on health care. But I recognize that there is tremendous waste and inefficiency in the current system that we have. My wife- Amy- has endured a rough 5 years of various health problems. During that time, she has been diagnosed with a degenerative neurological disease- Charcot-Marie-Tooth.

She has had 5 surgeries. I have lost count of how many MRIs, scans and doctor visits. We have been blessed to have had an insurance safety net- which we pay large premiums for through the Texas High Risk Pool because no other insurance company will cover her. Our total health care expenses have been over $200k in the last five years. Unfortunately, too much of her time is spent fighting with insurance over what expenses we are responsible for and what expenses insurance will cover.

Any family that has experienced health challenges can relate to this. Doctors have to practice defensive medicine because we live in an over litigous society. This defensive medicine leads to testing that is probably unnecessary. But who can blame the doctors? If I was in their shoes, I would do the same thing.

After some reading, thought and going through Amy's health challenges, I have some ideas for some solutions to our current health care mess. I don't think a universal health care plan adminstered by our government is the answer. That may be where we are headed. I think the solution needs to be a system that combines the free market innovation that our country excels at with sufficient regulation to make sure the incentives are in the right place.

I have 7 ideas. Many of these are borrowing some ideas that I read elsewhere.

1. Raise the annual limits on health savings accounts to $5k for singles and $10k for families and encourage their widespread use. Every family with under $200k income would receive a $5k tax credit that could be used for establishing a health savings account. All health savings contributions are tax deductible.

A family would be required to pay out of pocket for any health expenses incurred in a year that were $10k or less. A high deductible insurance policy would cover all expenses over $10k per year. The money to pay the $10k per year potential expenses comes from the health savings account. Any unused money is carried over to the next year. The health savings account becomes a supplementary retirement account. Lots of education will be needed. But I am confident that when people see health care expenses like they see any other expense, it will force competition and less waste.

2. Law requiring price lists of medical services. Don't get me started on this one. I find it ridiculous that you know what you are paying beforehand for everything you do except medical costs. You should know exactly what the costs are before you visit a doctor, order a test or have surgery.

I realize that costs may escalate if more is required than originally thought. But it makes no sense that medical pricing is so lacking in transparency. Where there is a lack of transparency, you have great potential for fraud and waste.

3. There should be a national health information system that centralizes medical information. I have read that over 60% of medical costs are due to administration. I have talked to medical professionals that are frustrated with how much time is devoted to filling out forms. Every new doctor that you see requires a new set of paperwork. This is wasteful time for the doctor and the patient.

There should be a centralized system that eliminates this. A new doctor could have your records with a few clicks and your consent. My wife's doctor gives her medical records on a jump drive that she can carry on her key chain. There has got to be a better way. Surely, we could save billions here if someone gets this right.

4. Radical changes in prescription drug distribution. One idea that sounded good to me was to develop a no-patent government drug research and development facility. Drugs are cheap to produce. What makes them more expensive is the large amount of failures for every one success. Pharmaceutical companies spend huge dollars on research. The 17-year patent process protects pharmaceutical companies but doesn't serve the public interest as it should.

What would happen if there were some facilities that were devoted to research where collaboration was encouraged worldwide to find cures for diseases? File sharing has brought huge improvements to our lives in the tech world and brought down costs. Something similar has to be possible for health care. The incentives are all wrong. I am sure many prescription drugs are necessary. But we need to have a system geared towards wellness and not profiting from creating dependencies on prescription drugs.

5. Revamp medical malpractice law. In the financial world, lawsuits are heard by an arbitration panel of 3 knowledgeable industry insiders versus a jury who may or may not have the background necessary to make wise decisions. I would be an advocate of a similar system in medicine.

There should be the establishment of some facilities that are lawsuit-prohibited. This would be a much lower cost option for consumers. Doctors could practice medicine without worrying about covering their butts all the time. Consumers could decide if some services are worth signing a waiver that releases medical staff from any potential liability. We do that for bungee-jumping, white water rafting, sky-diving, etc... Plenty of people still do those things.

Costs go way down when you eliminate the potential lawsuit issue. And you don't have to be subject to lots of unnecessary tests because the doctor is overly defensive in their treatment plan.

6. Scalable medical diagnostic testing. This is not far off. A few years ago, Andy Kessler wrote about these trends in the End of Medicine. There are some exciting possibilities. Probes that are in pills that can be eliminated safely. Low cost strips that can be used for urine samples. If something needs to be examined further, the strip changes color or gives a positive symbol similar to a pregnancy test.

There is also the possibility of a low cost mri device that you hook up to your personal computer. This device could alert you if there is something that needs further examination. If multiple millions are produced and sold, the cost falls to something that rivals any electronic device. Imagine how many lives would be prolonged and saved if early detection of cancer and heart disease was the norm. Imagine how much money this would save our health system?

7. Reorganize education requirements for doctors and allow some medical functions to be performed by trained nurses or physician assistants. Doctors spend over $150k and 12 years to become a physician. There has got to be a way to train them effectively that doesn't require so much time and money.

I would rather see a doctor with 8 years of experience and 4 years of education in a field than 8 years of education and 4 years experience. We need an overhaul of our education system. But this is a topic for a future blog. There are many functions in medicine that law requires a doctor to perform that should be delegated to a trained professional where the cost of a 12-year education is not being passed on to the consumer.

I am extremely optimistic that many of these changes are coming. There is no cure for high prices like high prices. Energy, education and health care reform have the potential to revitalize the US economy. All three areas could see dramatic price decreases if technology, innovation and wisdom are embraced. This will provide relief to so many families who need the relief.

Looking forward to a perfected, resurrected body where these issues become moot,

Ashley Hodge