Well it’s a good thing I have all of 10 visitors to my blog daily. First it keeps me humble – I really have to write for myself if I’m going to post because I’m not letting any fans down, and second it means that the external pressure to produce is not that strong.
So here it is, Tuesday, and I’ve not been able to complete my thoughts on what makes sense to me in healthcare. The truth is, there hasn’t been enough good analysis of systems already in place worldwide (Atul Gawande did one for the New Yorker, but that was just one piece), nor have I seen some trustworthy, fact based examinations of the different solutions being offered from what I consider non-partisan sources. We can throw around claims of bias and partisanship for all media outlets, but the best journalists attempt to overcome their personal bias in their writing. Rather than starting from one side and working to a conclusion that stays on that side, they recognize where their leanings are, and attempt to subvert that in their examination of the facts.
It’s a reason that I enjoy reading long-form journalism such as is in The New Yorker and The Atlantic and similar periodicals. The writers are able to spend time with the subject, which allows bias to be more clearly seen.
But that’s not what I’m attending to say with this post. Truth is, I just don’t know what steps make sense to solve healthcare. And that’s ok in that it’s not up to me to save healthcare, but it is frustrating as someone who is trying to educate themselves and have an informed opinion about the subject. The problems are systemic, complicated, and to truly repair they require sacrifice, something Congress avoids when passing bills. Rather than delay gratification to solve problems, we always end up spending our way out of them. And then have to revisit the issue a decade later.
In all my reading and all my admittedly amateur and haphazard researching, there have been two, maybe three solutions that begin to repair the healthcare issue but do not represent a system-wide fix. Here they are in brief:
1. Enact a system nationwide similar to what Maryland has in place
Every year a state commission sets the prices in Maryland for all medical procedures. This is the price that everyone has to pay – large Insurers, small Insurers, uninsured citizens. This reduces variance of medical costs, and (according to those who support the system) forces healthcare providers AND insurers to compete not on price but on quality and other benefits. But the other benefit is that we can get a handle on medical costs – medical providers are forced to operate under the prices they can charge and this can theoretically curb the ridiculous yearly increase of healthcare costs.
2. Standardize billing and record keeping for all healthcare providers
Right now a great deal of your insurance dollar (estimates are that it is over 30%) are spent on administrative costs – billings and records keeping. If you go to a different doctor or move to another state, there is no standard way for your records to be transferred nor are healthcare providers required to keep them in a standardized form. Surely in America someone or some group is smart enough to figure out this problem and to solve it. Normally I would be inclined to wait on a free market solution, but what motivation does the market provide to this? It seems that it needs to be motivated by someone else.
That’s it. That’s all I’ve found. Really, just two simple solutions that don’t at all get to the heart of the issue. So I guess what this means is, for now, I have to keep reading and keep digging to find out more about the proposed solutions, to see if they do make sense and will be able to help. And anyone who tries to convince me using political party propaganda will be summarily dismissed and blacklisted.