How would YOU fix our health system?

I am not well versed enough on the subject to say how we should "fix" health care, although it seems ridiculous to me how much profit the insurance companies are making and I seriously disagree with paying doctors less unless someone figures out how to decrease their cost of education.... I am also not a med mal or PI attorney but I don't think that you can blame the health care cost crisis on attorneys alone. They've got to make a living too and if someone wants to sue it's their job to take the case (and not all cases appear to be BS right at the beginning). I believe in tort reform, I think Texas does a great job with limiting the amount of damages awarded for non-medical injury and I recently heard a rumor that they are going to force attorneys who lose to pay the opposing counsel's attorneys fees in their entirety. Which I don't think is a good thing and I don't think it will completely eliminate frivolous lawsuits but it might be on the right track at least. I don't like "ambulance chasers" anymore than the next guy but I really don't think you can shift all the blame onto their shoulders when there exist much more deserving candidates. What about pharmaceutical companies? Shouldn't they take some of the blame too?

[DCJenn]

Blaming one entity for all of the problems is part of the actual problem-

The Federal Government is not evil, they do not inherently do things wrong and Medicaid is a state administered program. Any problems that happen both with the direct services recieved through either the Medicaid or the Medicare programs are on the states- the Feds give the money to the states to administer as they feel appropriate for their state- which is why until recently Texas was one of the only states that didn't treat substance abuse through Medicaid. Same thing w/ most entitlement programs- the feds gie the money directly to the states or provide a match to the funds that the states set up as with the Medcaid Waiver services for persons with disabilites.

Lawyers are not evil people who are out to make the almighty dollar at the expense of some small town doctor who made a mistake. Yes, there are ambulance chasers. There are also crappy doctors who injure people. Cutting off the wrong leg is sorta hard to fix...

Politicians are not evil people blindly sitting at the hands of the lobbyists and lobbyists are not evil people blindly being led by Corporate America Suits.

Dumbing down the problem into easy targets does nothing but insult the target and not fix the problem.

Let me share one example of how stupid the process can be: Texas just decided that it would be a lot smarter to treat indigent addicts rather than have them repeatedly go to jail (sending the drunk to the drunk tank does not make him stop drinking, it gives him clean clothes, a shower and a meal, and needed medical services he otherwise wouldn't get) or to the ER where he's passed out on a guerney better used by the lady having a baby...

So, in the treatment of heroin, Federal regulations require that the addict not be allowed take home methadone until they have met specific criteria- no other drug use, at least a year in treatment (for ONE take home dose), going to counseling, etc. If and only if the client has met that criteria are they allowed take home doses and only for 28 days at a time. In practical terms, that means that if you get your act together and do well, you can dose in the clinic once a month and take the rest of the medicaiton home with you. If you don't meet criteria then you come to the clinic every day and you drink your dose under observation of the nurses who dispense it to you.

The adminstrators of the Texas Medicaid program cannot figure out for the life of them how we're supposed to bill. Seems pretty clear cut, you'd think but they can't figure out how to bill for take-homes. It's never even occurred to them that there might be take homes. (obviously, they've also not ever spoken to the State Methadone Authority, any provider OR any of our neighboring states who currently provide this benefit through Medicaid) They've changed the billing requirements FOUR times now and we've only been able to bill since September. What is happening is that smaller providers and for-profit providers are saying to heck with it and deciding to not accept Medicaid- which is entirely their right. The Feds don't care what Texas does with it's Medicaid dollars, either.

I would estimate that in staff time alone, we've spent well over 100k dealing with the substance abuse medicaid roll out. It has now become 50% of my job and I'm completely administrative- I bring in zero revenue.

Multiply that by each different HMO and insurance provider, each hospital, each diagnosis, each region, each state, each town....?

I'm saying there is no ONE solution and there is no ONE entity to blame.

Jenn

[scrub-jay]

I'm saying there is no ONE solution and there is no ONE entity to blame.

This is what I was trying to get at. There are many issues, many many issues, it is not simply one bad apple.

[diggitydot]

The problem with allowing people to purchase health insurance across state lines is that each state has their own insurance board that regulates the industry. Some states are FAR less stringent about their laws and how they're implemented or enforced. Instead of inducing competition between insurers, we'd have droves of people flocking to cheap plans administered in states with lax supervision. Those cheap plans leave consumers with very little benefit or coverage and do nothing to improve health.

I think there are things that can (and should) be done to improve the state of care. However, I'm not sure we'll see serious changes until we as a society experience a massive paradigm shift in how we view our own health.

[SoonerTexan]

I was really excited about insurance cover children up to 26 regardless of school/marital status until I talked to my mom yesterday--her provider changed the rules so children are covered individually, not as a whole. Sucks for big families. (This is a private plan my parents were forced to buy for my mom and siblings and my dad works for a small organization with insurance that isn't any cheaper than a private plan)

Her deductible DOUBLED (5k to 10k) and I think she said they are paying about $500/month for it now--as a result of the legislation, they did add lots of "preventative" care that is fully covered--unfortunately my family wont use most of it, or it wasn't too expensive to begin with.