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    Here’s how to reduce healthcare costs

    The recent White House-Congressional fiasco epitomizes the lack of basic understanding regarding healthcare and healthcare reform. 


    Further reading: Cost, not access, is underlying problem facing American healthcare


    Obamacare (ACA) and the Republicans’ AHCA, each with its pros and cons, are more like “health insurance coverage reform” or “healthcare payers reform” rather than healthcare reform for patients. Offering “coverage” is different than offering “real access” to receive efficient, quality, compassionate healthcare in a timely manner. 

    Just because someone has an insurance, Medicare or Medicaid card, does not necessarily help him or her get an appointment for treatment in an efficient, timely manner. In addition, it does not guarantee the patient can afford the co-pay or deductible required before he or she is examined. The goal of our healthcare solution is to offer access at a sensible price.

    In 2004, the United States spent $1.7 trillion on healthcare.1 In 2008, we spent $2.3 trillion, or 16% of Gross Domestic Product (GDP). In 2016, we spent more than $3 trillion. It is not that we are not spending enough money on healthcare, the problem is that we are not spending the money wisely. There is wastage, redundancy, inefficiency, bureaucracy, and perhaps, even charging more than necessary in some sectors. We have to align the long-term incentives of insurers, payers, providers and patients. We need to restore trust between parties. Otherwise, we shall continue to be in chaos regardless of how much money we spend in healthcare. We are reshuffling the deck chairs on the sinking Titanic. 


    Hot topic: House Obamacare bill won't fix healthcare system, doctors say


    As Warren Buffett once told me at a dinner meeting, “each person comes to Washington to look for more money in healthcare; no one comes to Washington to reduce the unsustainable skyrocketing cost of healthcare.” This skyrocketing cost has already made us less competitive in the world economy. It is not necessary for finger pointing. If we all collaborate, it can be achieved without too much sacrifice from each sector of the healthcare industry.

    The following is a plan to reduce healthcare cost by 28%, making it much more affordable. This will make “healthcare insurance coverage reform” and “healthcare payers reform” easier.  Thus, a “replacement” or “improvement” of ACA can be achieved less acrimoniously.

    Next: Streamlining and expanding Medicare

    KJ Lee MD FACS
    K. J. Lee, MD, FACS is Harvard educated and taught at Yale.


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    • [email protected]
      This is one of the few articles that I have read on this subject that acknowledges that these bills are insurance bills and have little to do with actual health care. There is no one solution that is perfect, but you have outlined a number of good steps that would help. Unfortunately, the bills are written by lawyers, and have little input from the people it affects the most.
    • UBM User
      We are all bombarded daily with multiple news stories, correspondence from our medical societies, and editorials describing the "real" solutions to America's health care crisis. Unfortunately, these pundits either really don't have a clue or conveniently choose not to address the real problem and thus are completely off-base with potential solutions. This is the hard truth, from a front-line, solo, private-practice physician from "Mainstream, USA" who cares for the average Joe and Mary every day. The real problem in this country has everything to do with the amount of health care consumed, i.e., we have a consumption problem. Simply put, we require WAY too many health care resources. And Why??? Because we consume far too many calories, burn far too few calories - resulting in self-induced chronic illness and disease that, by far and away, IS THE MAJOR factor in American's health care crisis. Obesity and it's associated co-morbidities is, without a close second, the leading cause of medical expenditures in this country. We can argue whether access to quality health care is an American right - but it is a fact that one is NOT entitled to good health. That largely has to do with personal responsibility, hard work, discipline and making good health a priority. Unfortunately, the importance of these principles in today's society is fading dramatically. As long as the food industry is lining the pockets of the very people who have the ability to affect a change - and the drug companies, insurance giants, and large health care organizations are profiting hugely off the poor health of our country - change is not likely. It really is sad, but I firmly believe health in this country is in a rapid downward descent with no solution in sight. Who agrees? If not, how can this be disputed? 75% of adult Americans are either overweight or obese. At least 30 million Americans have type 2 diabetes. Guess what these numbers were a short 30 years ago? Has human physiology changed? I don't think so...
    • [email protected]
      I agree with what you are saying but one thing that no one seems to be considering is that when you add high costs patients to an insurance plan the shared costs of those patients most be born by other members of the plan. Unless there are a significant number of healthy patients the costs become unaffordable. In example I am a small businessperson who gets insurance for myself, my wife (both in our 50's) and a 25 year old daughter at a cost of over $2,000 a month. This is a plan with a $6,000 individual deductible and a $17,500 out of pocket maximum expense. In the federal employee plan a similar plan costs about $750 a month with a $500 individual deductible, and lower coinsurance rates. Why can't we open up the Federal Insurance Program to all who want to join it. This would raise federal employees rates but the numbers should help to offset the high costs of those currently in the ACA plans.

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