HAPPY NEW YEAR: HEALTHCARE DEFORM

It is New Years day and I am sitting in the ICU room of Ed’s 62 year old mother.  She has multiple tubes and I.V.’s in her body.   Luckily she is asleep and pain-free at this moment.   Last New Year’s Day no one could have expected that she would be here today- which makes the proposed health care reform bills in front of Congress even more relevant…and even more of a disappointment.

Many of you know that during 2009 I passionately advocated on CNN’s Campbell Brown Show in favor of health care reform.   Unfortunately, what has been structured in Congress is not health care reform…but health care DEFORM.   It will not solve the problems of our ailing health care system.  The process became all about politics instead of doing what is best for this country and its citizens.   In the homestretch, the politicians compromised any purpose they originally may have had, so that they could appeal both to their constituents and to their party.   Shame.  Shame.  Shame.   You and I suffer the consequences…again.

Here is how I would have tackle health care reform.   I would begin by clarifying the goal.   Is the objective to insure every citizen?   This narrowly defined statement does not tackle what I believe our main objective should be -  ensure that every American is able to live a longer healthier life.    Having insurance does not guarantee this, especially since most people use insurance only after they are sick, not to maintain good health. 

Therefore, the ten things that I would include in “Dr. Jorge’s Health Care Reform Bill” are:

1. Every American should have health insurance.  There should be a competitive government option along with private insurers providing multiple tiers of service.  There should be a basic coverage for everyone, but with different tiers that provide greater expediency and less hassle, but not greater coverage.  If you have worked hard all your life  and want to pay for a private clinic as opposed to using the basic coverage, why not?   Choice is the American way.  Competition is the American way.   Everyone should be able to drive a drive a car; but not everyone has or wants leather seats.    Let the best plans win.  Let people choose the level of coverage they want or can afford.
2. Deny no one health insurance because of a pre- existing condition.  What is the point of health care insurance otherwise?
3. Incent Americans to become or stay healthy.   In the long run, healthy Americans are less expensive to the health care system.    Anyone who has ”registered” with a family physician can qualify.   The physician must verify that this person has been under their care for at least a year and has had their yearly physical examination.   Apply a federal tax rebate toward health care insurance costs for every American who…
   1. is of a good, healthy weight (BMI less than 25)
   2. has a normal blood pressure, with or without medication.
   3. has normal cholesterol, with or without medication.
   4. Has a normal diabetes test ( HgbA1C), with or without medication.
   5. performs the recommended cancer screening when appropriate (mammograms, colonoscopies etc.)  This way we can help control the risk factors for heart disease, cancer and diabetes.   Together these diseases account for approximately one million deaths a year and hundreds of billions of health care dollars.)  Prevent, prevent, prevent.
4. Find a way to outlaw or decrease the use of cigarettes.   (We don’t make drinking cyanide legal do we?)
5. Decrease the amount that plaintiff lawyers can receive from a malpractice lawsuit.   When this was done in Texas the number of malpractice suits decreased by approximately 50% in the first year. Makes you wonder how many of the previous lawsuits were frivolous, doesn’t it?  The following year 18% more doctors moved to Texas to practice medicine     Of course, we must continue to make sure that doctors that are truly committing malpractice can be sued and have their licenses revoked.  
6. Invest in the future of American physicians.  There are too few college students going to medical school who want to become primary care physicians.   We need more Marcus Welby M.D.s and less Dr. McDreamys.   This can be done by mandating that any medical school that receives federal research funds must have 25% of their medical school class agree to become primary care physicians once they graduate.   Most importantly, the government will pay for those students’ medical school career in exchange for the same number of years of service as primary care physicians in underserved areas.   This would be like a “Medical Peace Corps”.   Once they have fulfilled their obligation they may return to become specialists if they wish.
7. Create medical center based clinics where those “Medical Peace Corp” doctors can treat people.
8. Do not decrease the compensation of physicians.   As distasteful as talking about physician reimbursement is, Medicare and insurance companies have decreased physician reimbursement by at least 30% over the past decade.  This is causing future doctors to seek out other professions and practicing doctors to retire at the highest rates ever.   Who is going to take care of us if this trend continues?
9. Invest in the future health of America’s children by providing billions of dollars of financial incentives to states that have mandatory physical education and health education in their school system.   Current trends in childhood obesity will cause heart disease, diabetes and cancer to sky-rocket in the future.   Make sure that the future generations are healthier than the current generations.   Healthy people leads to more productive people and a decrease burden in the overall cost of healthcare.
10. Increase the number of generic medications available to the general population.

Sure, there are a lot of other issues that need to be addressed.   These ten may appear simplistic, but they keep focus on making Americans healthier, not JUST making sure they can get into the hospital when they are sick and dying.  That is important too…but by then; it is too late to make much of a difference either in their overall health or in the cost of health care.

So in 2010 think about and take action towards getting and staying healthier.

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