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It’s now or never: Fixing Healthcare with Common Sense

Fixing HealthCare with Common Sense

What it will finally take is anyone’s guess. Our candidates for public office are great at talking a good game, and oh what a show Wednesday on ABC promises to be, but what ultimately it will take is a combination of “Common Sense” (written in 1776 from Founding Father Thomas Paine*) and a return of major corporate ethics, with effective, consumer driven oversight and simplified regulation.

Assuming we keep a private, free enterprise system, lets finally put the consumer in charge, just like with other types of insurance. Lets simultaneously expand HSAs and FSA programs and benefits to further breed responsible healthcare consumption.

It is likely the best solution, easiest to implement without burdening us with bigger government. I say let companies like Geico, Progressive and others that market auto insurance direct to consumers into the ring. Let consumer choice drive them to cut costs by uncoupling dollars from non-benefits payment. Give them simple rules to follow, nationwide, exempt from state lines. This could be huge, and would not take any dismantling of our major delivery systems.

Remember, Medicare runs on 4% administrative overhead, but currently private health insurers are closer to 25%. Much of this goes to the questionably ethical profiteering of extreme proportions, exorbitant salaries for executives and contributes to ridiculously poor provider reimbursements.

And, how about adding return of premium benefits to reward the healthiest while not penalizing the seriously ill. This is a tremendously powerful idea that would reap huge benefits for the consumer. It’s already done with disability and some other types of insurance and mutual insurance companies regularly pay dividends to payees. So, Lets make sure that some of insurance premium dollars can be returned if consumers stay healthy.

Lets also finally de-link health insurance from employers and employment benefits once and for all. This has been an absolute catastrophe. Even the Boston Globe recently acknowledged this. The extreme burden on US businesses of all sizes from health care premiums is well known. The trickle down benefits to business, like the automakers, municipalities and others could also be a huge economic stimulus.

Uncoupling health insurance benefits from employment would make consumers ultimately more fiscally savvy and responsible. This could quite likely increase their wages simultaneously as employees would now purchase all benefits outside of their work. Uncle Sam can help with deductibility and tax exemptions, maybe larger in the beginning to help foster the transition.

I also believe that there should be real consumer dollars available for CAM (Complimentary and Alternative Medicine) that can be used in the treatment of our most common and non-life threatening disorders especially if the consumer does not utilize more expensive traditional pathways for the same condition. Back pain and headaches are two very real examples that both happen to be still the most common reasons for doctor’s visits, and are at least in part linked to stress and unhealthy lifestyles.

This mechanism alone would foster consumer education to choose their own healthcare pathways with taking an additional financial hit in addition to premiums.

Any effective system must simultaneously provide equitable reimbursement and other incentives to all licensed doctors of all disciplines as well as ancillary providers for our society to keep great healthcare providers in the system.

This must include simplified reimbursement schedules, equal across the professions for identical procedures. I strongly favor a diagnosis-based system with utilization review only for those cases outlying the norms. This could be a technological piece of cake with a national electronic healthcare database for all Americans.

Of course, there are other issues that need to be simultaneously addressed. These include malpractice provisions (some experts suggest in a separate healthcare “court” in addition to capped awards). Better awareness of poor outcomes vs. malpractice by society at large would really help as well.

Drug costs, competition and widespread availability of tested alternatives to prescription drugs all need to be handled. Again, a consumer driven Wal-Mart type of distribution may be what already does it.

So, how can we help? Lets make sure we educate ourselves first and foremost as to what’s wrong with our current system and push our lawmakers toward better consumer choices. Take a real hard look at their differences on these topics when you vote and support any politician, as some are huge. Let your patients know who these consumer friendly elected officials are in your area are too.

Utilize cost effective preventive screenings in your practice, and advocate the same for our families. Lets make sure we teach our kids and our patients all the rewards of better health choices like non-smoking, stress management, diabetes prevention, relationship choices including illicit drugs and sexual behavior, and permanent weight control.

How it will all turn out is anybodies guess. I continue to be as vocal about these issues with my patients and community, and urge you to do the same.

Not Unlike Thomas Paine did over 200 years ago.

(*Society in every state is a blessing, but Government, even in its best state, is but a necessary evil; in its worst state an intolerable one: for when we suffer, or are exposed to the same miseries BY A GOVERNMENT, which we might expect in a country WITHOUT GOVERNMENT, our calamity is heightened by reflecting that we furnish the means by which we suffer.)

Really Looked at your marketing campaigns lately?

Missing real leadership in tougher times is driving responses to an entirely new set of on-line ads, that 1 year ago were almost irrelevant. It will tell you what people really want, and need right now.
The same is true off-line.
Really.
I recently took a hard look at what on-line ads are pulling the hardest.
Boy, has that changed!

How many businesses and practices are oblivious to this?

It also explains why private practices, lead by true integrity continue to support the community and are themselves very healthy.

Fixing HealthCare with Common Sense

What it will finally take is anyone’s guess. Our candidates for public office are great at talking a good game, but what ultimately it will take is a combination of “Common Sense” (written in 1776 from Founding Father Thomas Payne*) and a return of major corporate ethics, with effective, consumer driven oversight and simplified regulation.

It is likely the best solution, easiest to implement without burdening us with bigger government. I say let companies like Geico, Progressive and others that market auto insurance direct to consumers into the ring. Let consumer choice drive them to cut costs by uncoupling dollars from non-benefits payment. Give them simple rules to follow, nationwide, exempt from state lines. This could be huge, and would not take any dismantling of our major delivery systems.

Remember, Medicare runs on 4% administrative overhead, but currently private health insurers are closer to 25%. Much of this goes to the questionably ethical profiteering of extreme proportions, exorbitant salaries for executives and contributes to ridiculously poor provider reimbursements.

And, how about adding return of premium benefits to reward the healthiest while not penalizing the seriously ill. This is a tremendously powerful idea that would reap huge benefits for the consumer. It’s already done with disability and some other types of insurance and mutual insurance companies regularly pay dividends to payees. So, Lets make sure that some of insurance premium dollars can be returned if consumers stay healthy.

Lets also finally de-link health insurance from employers and employment benefits once and for all. This has been an absolute catastrophe. Even the Boston Globe recently acknowledged this. The extreme burden on US businesses of all sizes from health care premiums is well known. The trickle down benefits to business, like the automakers, municipalities and others could also be a huge economic stimulus.

Uncoupling health insurance benefits from employment would make consumers ultimately more fiscally savvy and responsible. This could quite likely increase their wages simultaneously as employees would now purchase all benefits outside of their work. Uncle Sam can help with deductibility and tax exemptions, maybe larger in the beginning to help foster the transition.

I also believe that there should be real consumer dollars available for CAM (Complimentary and Alternative Medicine) that can be used in the treatment of our most common and non-life threatening disorders especially if the consumer does not utilize more expensive traditional pathways for the same condition. Back pain and headaches are two very real examples that both happen to be still the most common reasons for doctor’s visits, and are at least in part linked to stress and unhealthy lifestyles.

This mechanism alone would foster consumer education to choose their own healthcare pathways without taking an additional financial hit in addition to premiums.

Any effective system must simultaneously provide equitable reimbursement and other incentives to all licensed doctors of all disciplines as well as ancillary providers for our society to keep great healthcare providers in the system.

This must include simplified reimbursement schedules, equal across the professions for identical procedures. I strongly favor a diagnosis-based system with utilization review only for those cases outlying the norms. This could be a technological piece of cake with a national electronic healthcare database for all Americans.

Of course, there are other issues that need to be simultaneously addressed. These include malpractice provisions (some experts suggest in a separate healthcare “court” in addition to capped awards). Better awareness of poor outcomes vs. malpractice by society at large would really help as well.

Drug costs, competition and widespread availability of tested alternatives to prescription drugs all need to be handled. Again, a consumer driven Wal-Mart type of distribution may be what already does it.

So, how can we help? Lets make sure we educate ourselves first and foremost as to what’s wrong with our current system and push our lawmakers toward better consumer choices. Take a real hard look at their differences on these topics when you vote and support any politician, as some are huge. Let your patients know who these consumer friendly elected officials are in your area are too.

Utilize cost effective preventive screenings in your practice, and advocate the same for our families. Lets make sure we teach our kids and our patients all the rewards of better health choices like non-smoking, stress management, diabetes prevention, relationship choices including illicit drugs and sexual behavior, and permanent weight control.

How it will all turn out is anybodies guess. I continue to be as vocal about these issues with my patients and community, and urge you to do the same.

Not Unlike Thomas Payne did over 200 years ago.

(*Society in every state is a blessing, but Government, even in its best state, is but a necessary evil; in its worst state an intolerable one: for when we suffer, or are exposed to the same miseries BY A GOVERNMENT, which we might expect in a country WITHOUT GOVERNMENT, our calamity is heightened by reflecting that we furnish the means by which we suffer.)

Talking Trash About Success

Talking Trash About Success

It’s a fact; politically self-serving agendas have been a part of history for centuries. Even back in Ancient Rome and Greece, elders warned about the expansion of self-perpetuating plutocracies.

Right now though, in the midst of an economic meltdown, the constant injection into the media is fear from politicians who we entrust to be leaders.

Rather than reassurance this trash talk about the wealthy is destructive, and controlling. Too often, the very criticisms our politicians hurl at others, mirror habits that exist in their own lives, a fact too many of their constituents and certainly the paparazzi ignore.

It’s the deeper message though, most recently not so hidden, that in my opinion is the most dangerous to private healthcare, especially for our student doctors.

That message is that being wealthy and ultra successful is somehow bad. That because you did well through your own efforts, your results must now be penalized.

Never has such a more dangerous notion been put forth with unquestioning by the mainstream media.

Its NOT wealthy successful people that brought the economy to it’s knees, It’s now many years of bad decisions and top down government and corporate corruption that transcends political parties and international boundaries, fueled by incredible greed. Unfortunately, these basic facts are too often conspicuously absent from the daily media banter.

It’s the wealthy and most successful (not the greedy and corrupt) that pay the bulk of taxes already. It’s the wealthy that are the philanthropists and benefactors in a free society.

For those younger than I, this attitude is nothing new. The problem is, in our current world, this trash talk about success is today again everywhere. This only serves to perpetuate dangerous myths, especially to our young and inexperience citizens.

In fact, the greatest minds in history have warned about the dangers of unbridled political banter.

So what can you do?

First of all, have the guts to acknowledge media BS as just that.

Don’t focus and dwell on what’s wrong with the world.

Instead, focus on improving it, one patient visit at a time.

Yes, a lot has changed in practice! It’s changed in your patient’s lives too. And some have been enormous.

So, what have you done lately to help deal with their changes and how they utilize your care, or not?

And what about their own fears and concerns? Are you like a deer in the headlights, or a pillar of community strength?

When is the last time you and your team took actions that can make their days brighter, and their futures even healthier? The possibilities for practice expansion with this one are huge!

But, most importantly, make sure your daily actions and decisions are ultimately putting you in charge of your life. Take full responsibility for your own results.

Work a little harder, maybe a whole lot smarter to develop your own future choices and flexibility.

Always remember, no matter how ineffective prior decisions may have been, or how bad things may have been this is a brand new day.

Completely new opportunities abound.

But only if you decide to be fully engaged.

Tough economy or not, there is no better time to make your mark than right now.

I would also assert that is this the very best time to refocus, and reorganize. Learn new systems. Invest in your business skills development. Reorganize. Rebuild if you must!

Be sure you are limiting your media exposure. Focus on your new business and personal goals. Plan now to be reaping the rewards, without guilt.

Almost 100 years ago, Wallace Wattles warned those aspiring to make better lives for themselves to ignore the politicians.

To focus only upon your desired outcomes with continuous gratitude being your dominant thought.

Doing everything with the utmost care and attitude of devout service.

He called his big idea the “Certain Way”.

I believe he was right.

The Most Important Advantage of All

Life is Difficult.

This is the opening line of a landmark book by M. Scott, Peck, MD, The Road Less Traveled.

Dr. Peck had a wonderful insight into the human experience and especially our related behaviors. And for millions of people, his passing is still mourned. If you have not read his works recently, I suggest you do.

As many doctors do, he drew many life lessons from his experiences with patients. But way beyond that, he had an uncommon knack of distilling the key reasons why some people remain extraordinarily happy, especially in times of adversity.

You probably also know that one of the biggest reasons some doctors develop huge, successful practices, especially today Is their ability to regularly step back and look at the “big picture”, and then act, quickly. And if an action is somehow taken in error, or turns out not to be effective, they see to it that rapid corrections always take place.

In fact, one of the key skills to being a good doctor is that of making many rapid decisions and choices, often times for other people.

In our experience, the happiest docs set their entire personal and professional lives up so they are seemingly perfectly executed.
The reality is that their prosperity and fulfillment is due largely to their design. Living and practicing by design gives you huge advantages.

Just like professional athletes, superstar docs make it look easy.
The “Superstars” develop many skills sets and qualities. They are perpetual students. Marketing, clinical expertise, or technology upgrades. These doctors continuously learn, and develop new qualities.

But, what is the most important of all of these advantages?

Flexibility. Because the vantage point of flexibility gives you many more choices and options as time goes on.
Lets take a look at why this is so.

Lets take finances first. If you make a regular habit of saving money, and reducing debt, early in your career especially, this decision then gives you great financial flexibility later on. The ability to ride out an economic storm. The ability to take vacations and adequate time off, etc. A buffer against downturns due to regulatory changes and natural disasters.

Technological prowess also gives modern docs enormous flexibility. The tools and systems that are available today can help you not only with patient care, but research, marketing, and yes even a complete education in practice clinical skills, and management, growth and promotion.

The next big advantage is structural flexibility. An operating business framework of your choice that can accelerate you beyond any other practice in the area.

An entire team that is so well trained, that it can expand or contract at will. Patients remark on how you never seem to miss a beat. You hire no more staff than absolutely necessary, and add to the team as practice grows. Vacations or time away by a team member create new opportunities, not added stress on the practice.

Patient Care in these offices is thus based upon options, and letting patients know about all their choices. In healthcare, like many areas of modern life there are tiers of service. This is not a utopian world as some would have us believe about healthcare today. Given a chance, most people choose what’s best for them at any given moment in time.

It is in the honest presentation of these that the doctor serves his community the best.

The third and perhaps the most important is simply ownership and it’s inherent flexibility, that of being in charge. You call all your own shots. Hours, income, time-off, strategies for marketing, patients to accept or decline, yes just about everything.

For some docs, ownership can be overwhelming. Then the choice then becomes learn new skill sets or work for somebody else.

Now the good news, these are learned skills. When they’re applied to all areas of your practice and life, the result is a much more fulfilling experience.

And if not learned regularly updated and applied, practice can be a nightmare.

It’s all up to you.