Simple Steps Toward Better Healthcare

This decade has been marked by a complete lack of real jobs.

Real jobs include health benefits.

Instead we have had an enormous rise in non-job jobs. Wal-Mart jobs are non-job jobs. Immigrant jobs are non-job jobs. Freelance jobs are non-job jobs. You can’t really live on a non-job job, only survive.

This is not because businessmen are bad people. They just can’t afford to offer health benefits under our present system.  In fact, I’m certain most businesses would love to offer real jobs, because real jobs offer stability, and let the business raise its stock of human capital over time.

Why are there no longer any real jobs?

Two words — preventive care.

Preventive care used to mean simple check-ups. No more. Now preventive care means pills, lots and lots of expensive pills. I, for instance, currently take three different prescription medicines to deal with a family history of hypertension and high cholesterol. None were available in my father’s time.  Where his "preventive" medicine costs were about $25/year, mine come to $80/month — and that’s just for co-pays.

We have wondrous medicines that can prevent many illnesses, and give relief for many conditions.  But they cost too much.

There is a second problem, of course. Technology, or the lack of it. The HIPAA Law, meant to improve patient privacy, has instead caused doctors to refuse technology. They won’t even use e-mail, fearing the liability. The liability laws also prevent use of new Always-On technology, for such things as  monitoring conditions, delivering medicine, alerting caregivers. The industry won’t touch this stuff — what if it breaks?

The ultimate solution is a single-payer health plan. But such plans, worldwide, are under incredible financial strain right now, because of the two problems I have just described.

So let’s address those now.

We need a more rigorous screening system for new drugs, one that is paid for by industry but controlled by government.

So let’s have one. Let’s have truly independent review boards, truly independent testing, so the drugs we approve for use are as bullet-proof as possible.  We can then agree to limit the drug-maker’s potential liability if there are problems, because we will have done enough testing to reassure people. The government can pay for it, but the industry must be charged for it, not in dollars but in drugs.

Newly-licensed drugs must be made available, at generic prices, sufficient to pay for their testing and approval.  These drugs can then be made available through government channels, starting with VA care and Medicare. This will greatly reduce the costs of those programs, improve their quality, and allow coverage of more people, removing risk from the private insurance system.

We need a national policy to mandate use of technology by medical professionals.

Every doctor must have an e-mail address. Every medical office must have a calendaring system for appointments, accessible by patients. Every doctor should have patient data available electronically, in real-time, when they see patients. And they should be constantly networked, so if any consultatation is needed, or any other back-up data, it’s there.

More than that, we need to encourage development of Always-On applications for medical monitoring. (That’s a roll of RFID chips, by the way, above.) We need to quickly approve applications that check on heart conditions for folks like me, on sugar levels for folks with diabetes, or mental conditions for those with dementia. Relatives need Always-On access to their loved ones, through video monitors, so folks can age in place, not in institutions. Without this we will be quickly overwhelmed.

Finally, let me address malpractice.

Punitive damages must not be insurable. Punitive awards cover deliberate, willful misconduct. Actual damages can be insured, those we expect to happen. But juries should be told that every dollar they assign to punitive damages will come out of the doctor or hospital’s own pockets, not some insurance company. I believe this will greatly reduce the amount of those awards, and take a lot of the current load out of the malpractice system.

These are just a few simple ideas which, I guarantee, will save billions-upon-billions of dollars and improve quality of care. Once costs are under greater control, then we can talk seriously about a single-payer system, because then it will be affordable.

But single-payer must be the goal. Without it companies will never offer real jobs in America again.