Wednesday, February 03, 2010

If I were to fix the healthcare system...
  • Forget insurance for everyone.  Healthcare for everyone.  Affordable healthcare.  
  • Standardized billing codes.  They have standard numbers for produce, they can create nationwide billing codes for well child, well adult, pap smear, emergency stitches, UTIs, heart attacks, etc.  
  • Responsibility in the healthcare field.  Everyone makes mistakes.  Doctors and nurses are human.  But grown ups own up to their mistakes.  If a healthcare provider makes an error, they should cover the costs of fixing it.  Period.  That's the way it is in any other industry.  If they forget to run a B12 test when they draw blood, they pay to draw more blood.  If they cause an allergic reaction by inadvertently giving a medication containing a known allergen (for the individual) the individual should not bear the cost of treatment.  (within reason.  If they insist on a -cillin drug and know that they'll react, it's their own fault.)  If they remove the wrong mole, they should cover the cost to go back in and remove the right one.
  • Full disclosure.  All options should be discussed.  And if an insurance plan does not cover the cost of a chosen course of treatment, a payment plan should be implemented.  One that takes into account a person's financial situation.  In other words, income should not dictate your access to the best treatments.  
  • For non-medically necessary treatments and procedures, predicted costs should be readily accessible.  The patient's portion of a payment for a ct scan or laparoscopic surgery "just to see" should be part of a decision making process if the patient feels it is relevant.  
  • An extremely unsatisfactory office visit deserves a refund of at least part of the copay.  The patient is the customer.  They should be treated with respect, educated to their degree of willingness and interest, and should be a partner in their own healthcare.  If a doctor disagrees with a patient, they should free them to go elsewhere.  Doctors should be free to admit when they aren't comfortable treating a patient's condition and not willing to learn.  This would probably cut down on misdiagnosis, and overuse of the mental health system.  :P 
  • Not sure if this should be a healthcare mandate, but patients should be encouraged to use doctors wisely.  Perhaps a "good patient" benefit for not overusing the cold/flu visits?  Or for getting standard tests run prior to an appointment so that you can have the best use of your, and the doctor's, time.  (A doctor can request or approve a request for tests but insist the patient come to an office visit to receive results and discuss options.) This would encourage doctors to educate patients on managing their health, and encourage patients to take charge of their own health, and make wise personal decisions (wait and see if a low grade fever breaks within 48 hours)  Perhaps having a health nurse who can reccomend home treatments with the caveat that any patient wanting to be seen will be given an appt would work. 
  • Pharmacies should be required to release a prescription (print an electronic one) if the patient requests it.  That way if there is a disagreement between patient and pharmacist, the patient can go to a different pharmacy.  This would encourage the pharmacist to work with patients, as well as empower patients to self advocate when necessary. 
  • The process for applying for insurance should be fixed.  You should be able to get a quote before submitting estimated payments.  You should be able to get quotes from several companies.  And you should be able to regularly shop around while insured, without endangering your insurance.  If currently insured, there should be no "pre-existing conditions", even if you're switching from employee sponsored to self subscribed.  And self subscribers shouldn't have to pay more than employee-sponsored programs do.  

Just a few of my thoughts after spending a day arguing with our new "insurance specific" pharmacy about whether or not blue dye reactions are valid, and another entire day waiting next to the phone to talk to a doctor about migraines and dye and medication options.   I can see where this insurance could be good for someone without allergies or extenuating circumstances.  But, we have extenuating circumstances.  And I don't have the patience for them to learn on us, especially if they don't want to learn from us. 

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