Real Health Care Reform

The health care business in the U.S represents 16% of total GDP
The highest health care costs in the world, the lowest life expectancy and the highest infant mortality among developed countries. Health care is big business and those that are reaping the benefits of the system are not going to support any change that would impact their bottom line. Let’s look at some of the real reasons behind these appalling statistics.

Overuse of prescription drugs
Ninety percent of all television advertising during prime time news is for prescription drugs. Note that these products are targeted toward people who cannot just go out and purchase them. Obviously, the pharmaceutical companies want the viewer to ask their physician to prescribe them. The physicians are more than willing to do so as their revenue stream depends on it. As a result, Americans are over-drugged. Some seniors take ten or fifteen different types of medication, some of which cross react so as to cause harm to the patient.

The answer:
1. Ban all advertising of prescription drugs.
2. Ban payment of commissions or fees from drug companies to physicians based on prescriptions.

Unnecessary and often harmful testing.
MRIs, CAT scans and other tests are expensive, often unnecessary and sometimes harmful. Cost of testing provide a large percentage of the industry’s revenue stream. It is in the best financial interest of the medical provider to order as many tests as possible.

The answer
Establish accountability for testing. Track the cost/benefit

Fraud or billing errors
Personal example. I had a minor horse accident in which I received a bump on the head. At the urging of friends I went to the emergency room at the local hospital. The physician administered several standard tests for pupil dilation, cognition and balance and said I appeared to be OK. This took no more than five minutes. He recommended a CAT scan “just to be sure”. I declined the scan and was asked to complete a form stating that the doctor’s recommended a scan and I elected not to have it. I signed the form and left. Some weeks later I received a statement indicating that Medicare had been charged $1500 for the visit. Obviously the can had been billed. I wrote a letter to the hospital advising them of the error but did not receive a reply. How often does this occur across the entire country?

The Answer
A percentage of billings to Medicare and the insurance companies must be audited and penalties imposed for improprieties.

Bad protocols
Cancer is a good example. Physicians have a “cookbook” that they reference to treat cancer patients. Quite simple really: surgery and chemotherapy. The problem is that the success rate for these treatments is dismal. Chemo treatments are ordered without regard for their efficacy for the specific cancer. As a result, some patients are suffering the debilitating side effects of a costly treatment which has a nearly zero chance of improving their condition.

The answer
Promote integrated protocols which are based on departures from the “cookbook” and are tailored to the individual condition.

No pay for alternative therapies
The pharmaceutical companies and the medical establishment make sure that alternative treatments are not paid for by insurance companies. Patients are denied protocols that are more efficient and less debilitating because of the financial impact it would have on the pharmaceutical companies, medical device makers and physicians.

The answer
Encourage insurance companies to recognize legitimate alternatives to conventional treatment including herbalists, acupuncturists and other health care practitioners.