At some point in time–hopefully before the Social Security System becomes bankrupt–our lawmakers and leaders have to accept the stark reality that a continuation of the same healthcare system that we have been accustomed to in the past is NOT going to work in the years ahead. The system must be totally reformed--restructured in a way that incentives for providers to provide more and more service, whether or not it is medically necessary, have to be removed. Reimbursement must be denied for referral of patients by physicians to entities in which they, the physician-providers, have a financial interest: entities such as laboratories, imaging centers, day surgery units, hospitals, home health agencies; or to entities from which a physician receives a stipend in return for referrals. Joint ventures between hospitals and physicians must be scrutinized thoroughly and should always be transparent insofar as the public is concerned.
If the cost of health care is ever to be contained, the concept that more is better must be abandoned. Likewise, the health insurance industry must abandon the policy of ignoring over-utilization of services by healthcare providers and subsequently raising the premiums, deductibles, and co-pays--to be paid by the insured--when the cost of health care escalates from the medically unnecessary over-utilization of services. The health insurance industry should be mandated to focus on appropriate utilization and quality, instead of on loss ratios.
Basic Healthcare is a right of every person in this country and it should be affordable, available, and accessible. No one should be left uncovered. There should be no denial of benefits based on pre-existing conditions. If anyone is economically underprivileged, healthcare should be available through special federally funded programs. Individuals who elect to avail themselves of unlimited services over and above Basic Healthcare--without concern for whether or not those services are medically necessary--should be privileged to purchase health insurance for that purpose, without compomising the cost of federally funded Basic Healthcare for every resident in the United States.
How do you define Basic Healthcare? It should be rich in practice guidelines for all health care providers to follow in their care of patients, and its structure should reflect a consensus of input from all providers--physicians, hospitals, ancillary free-standing entities, nurses, and ancillary service providers, all of which must be held accountable for the expenditure of the taxpayers' health care dollars.
Is any political candidate or lawmaker brave enough to ignore the overpaid lobbyists and make those changes? If not our broken healthcare system is doomed to self-destruction.