You will frequently hear the question “Is health care a right or a privilege”? I believe that health care is a right (yes, with some limitations to prevent fraud). It is providing health care that is the privilege. We seem to behave as if providers have the right to set up shop, and that seeing them is a privilege. We have the whole thing backwards!
First, a definition:
Providers are hospitals, physicians, rehab facilities and therapists, pharmaceutical companies, pharmacy retailers, device manufacturers, laboratories, surgicenters, imaging centers, dialysis and cancer clinics, ambulances, long term care facilities and product suppliers. In short, anyone who sells a product or service into the system.
It is a privilege to sell their services into this great market, but somehow we have to beg this sector to take our money! All $3 Trillion a year!
-Hospitals get tax breaks, physicians get educational assistance, pharmaceutical companies get tax breaks, many have some access to public grant and research funding, yet, everyone is allowed to pursue extreme profit.
-When physicians get into trouble, such as substance abuse, it is they and their careers who are protected, not the public.
-Americans spend far more than in other developed countries, yet we die younger. The dying part is a complex discussion, but the spending part is very clear. We are simply overtreated and overpriced, and we allow it to happen.
How do we straighten this out?
First and foremost, regarding the Affordable Care Act (Obamacare), if there is to be a government mandate, that mandate should fall on providers to accept all patients, not on citizens to purchase a set menu of benefits.
Specifically, providers, as defined above, should not have the right to refuse patients with Medicare, Medicaid, Obamacare, Tricare/ VA, ERISA plans or certified commercial plans, and they must accept the contracted rate as payment in full (plus contracted co-payments). If they do refuse, they should not have access to any government or commercial subsidies, incentives, research grants, performance bonuses, tax breaks or public institutional affiliations.
Second, providers should publish all prices and a standardized list of “performance metrics”.
Third, providers of products, including drugs, devices and supplies should be subject to price limitations (not strict controls) to prevent gouging.
It is only by changing this top-level dynamic- just who is it who has the privilege- that we can address the core problems with our health care system.
There’s more- lot’s more, but let’s start here.
What do you think?