Sick Care, You Get What You Pay For (Part 2)

Healing the American Health Care System

Fellow Mature Market Experts, last week we agreed that we have a sick care system that rewards those who treat us rather than heal us or keep us healthy. So how do we convert a sick care system to a health care system?

Let’s go back to the beginning, “you get what you pay for”. We must devise a system where those who have superior outcomes and truly keep us healthy are rewarded, not those who simply provide care. Naturally this assumes we can measure outcomes and that’s where we have to start.

First and foremost America must put into place a comprehensive, secure, central database that would enable all of our medical information to be stored, organized and searched. Ultimately this would allow us to determine which providers are truly enhancing health and not just treating sickness.

Once we have quality information (see Tom’s previous post on this subject and Google) it could be made public and used by patients to seek superior care. This information would also be used by insurers to determine appropriate reimbursement. Clearly people who keep you healthier should get paid more! I’ve always said that it takes you five minutes to decide if you like your doctor and at least five years to know if he’s any good.

Last week I admitted a patient into a hospital whom I had never met. After taking her medical history and examining her I was pretty certain I knew the correct diagnosis. I felt she had a viral GI syndrome, but something did not sound right. Her recollection of certain key historical facts did not add up.

Since there was no easy way to check her medical history on the internet I spent 45 minutes tracking down her paper chart at another hospital. I found that she had been admitted there with a similar story but ultimately was found to have a flare of Crohn’s disease which was successfully treated with IV steroids. This dramatically changed my treatment plan and saved the patient some unneeded tests and treatments.

Naturally I was thrilled but I received the same payment from Medicare that I would have if I had not spent the extra time and effort. Physicians want to do the right thing and go the extra mile but as with all other professionals they need to be rewarded when they do so. Doctors are human too!

And as consumers we must also take responsibility to have a lifestyle that leads to health and not sickness. Despite the significant number of Americans without health insurance, the majority of us does have insurance and pay a very small part of the premiums. Most of the costs are paid by employers or the government in the case of Medicare and Medicaid. Generally speaking, people don’t value what they don’t pay for; and you have to wonder if people would take better care of themselves if their insurance rates reflected these efforts.

My grandmother always used to say “if you have your health, you have everything.” Well, we need to honestly look at our system of care and decide if we want to have our health or have the growing beast of our current sick care system. Fortunately it’s not about money, we’re spending plenty. It’s about the commitment to focus on long term outcomes rather than short term revenues.

Ultimately those of us who have committed to heal will be more professionally satisfied and will be better compensated because Americans will really get what they paid for and will sincerely appreciate it.


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