I don’t know about you but I have heard too many times that our healthcare system is broken. Everyone has their own ideas and I would have to believe they aren’t too far off. Basically, if the system fails to meet our needs and expectations regarding both care and cost, then there has to be a problem. There’s one thing I do know. There’s no simple cure for the healthcare system. I believe there are a bunch of little problems that just compounds the issue. However, healthcare does need a cure.
Before I get into many of the specifics of my findings, I have to say a major underlying problem of the system is greed. Everyone wants to make a good profit. Doctors want to make money. Hospitals want to make money especially if they went public. Stockholders need to see a profit, otherwise, they wouldn’t have invested. Insurance companies both healthcare and malpractice have to make money. Then there are lawyers, who just sit back and profit on the mistakes of others. Some are legit but some are questionable. Here’s a funny thing about lawyers. Have you ever seen a lawyer sue another lawyer? I know they can and do but when do you ever hear about it? It really isn’t easy to do. Just read this article.
The problems started many years ago. Many will blame Reagan because he was the President that deregulated healthcare in the 1980’s. I totally agree that deregulation played a major role in our problems. However, prior to Reagan, Nixon started the problem when he signed the Health Maintenance Organization Act of 1973. This allowed insurance companies, hospitals, and even doctors to operate as a for-profit business instead of the service organizations they were intended to be. To further complicate things, the law Nixon mandated included clauses that encouraged medical providers to NOT CURE afflictions but to PROLONG them by only treating the symptoms. The attitude was that “there’s no money to be made in curing sickness. Let that sink in for a minute. With all our technology, how come there haven’t been many cures.
So onward with my findings and thoughts.
I drive a hotel shuttle for some hotels and the majority of their guests go to a major producer of medical software for training. Their software is used in Doctor’s offices, labs, and hospitals. To use their software, users need to be trained and certified in the modules they use. This ensures the users of the system know how to use it.
As a shuttle driver, it is my responsibility to drive hotel guests to and from the airport and back and forth to Epic on a daily basis. The majority of these people are either doctors, nurses, or I.T. (Information Technology). I have had many conversations with all three principles and they each have a unique idea as to how things need to be improved.
Let me start by saying that electronic medical records were created for the sole purpose of maximizing the billing process. They wanted to ensure that they could bill everything they could. Over time these records have been updated to help with all the regulations that must be followed. However, these systems were never developed with the physician in mind. But the good news is that they are slowly migrating to aid the physician. But it has a way to go.
I point this out because I discovered that most doctors dislike the system. Most I.T. personnel will tell me that Doctors are the worst to train and they feel the system isn’t too friendly. They actually count the clicks when they use it. They want it to work as an iPad with very few clicks. Many times doctors do a cut and paste instead of adding new notes. This causes problems because at times the notes do not make sense.
Have you ever noticed that when you call a doctor’s office, many times they want to see you instead of giving advice on the phone? There’s a reason for that. Unless you visit the office, they can not charge you. One doctor actually told me that he and others are advocating for insurance companies to pay the doctor a specific amount to take care of you for a year with your typical call-in issues. Now, they are willing to help you more without an office visit. The Telephone Care Service is a potential solution to this problem.
I believe the VA system works well. As a Veteran, I am assigned a team to help. It consists of the doctor, nurses, and pharmacist. I can contact anyone on my team. I found out a system like this already exists in Canada and a nurse from there told me it works quite well.
I’m not sure if I believe in socialized medicine but I do know the government started this mess with changes to the law and allowed healthcare to run as a for-profit business. Only when they regulate the profits will this problem start to improve.
As you can see, I’ve listed a few problems. I have more that I will explore in another post. I’m sure you have your own thoughts. I implore you to send me your thoughts either as a comment to this blog or as a guest post. I look forward to your side of the story.
One thing for sure, healthcare needs its own cure.
Having read this post several times, I believe it covers several issues very well. There certainly is an element of greed in the healthcare industry. That greed has led to fraud and most of it is in the traditional Medicare arena. There are too many reasons for this to recount them in a comment. From a hospital provider side there is only about a 1-3% profit margin and sustainability of smaller hospital is in jeopardy. A lot of the problems in healthcare are related to the vendors including pharmaceutical companies who charge enormous prices for their products, including the electronic medical record companies as one was mentioned in this post. It cost millions, yes millions, for their implementation and updating of these systems. There is not an EMR company that I know of that is not making record profits. Drugs, in this country, are many times more expensive than they are our side. Hence, greed is not just in provider side. The commercial payer industry is also a huge part of the problem. Not sure why they are called “payers” because they deny payment for services inappropriately. I could go on and on but this is just a comment, not a diatribe.