What Obamacare 2.0
Friday, April 19, 2019
Might Mean for REAL Health Reform
Part 1 of this post explored three things Obamacare fails to do that would empower patients to be smarter consumers of expensive and often dangerous medical services. Part 2 explores how these and related measures would help us get a better handle on healthcare spending that virtually everyone agrees is “unsustainable”.
It would require going beyond the “low-hanging fruit” of Medicare fraud and abuse to the obvious but obstinate cost-drivers in order to not just “bend the curve” in medical spending increases, but to actually have a shot at keeping medical spending growth at or below the rest of the economy on a sustained basis.
This radical notion – if refusing to pay for things we don’t need that also endanger our lives can be considered radical – would indeed slow the medical component of our economy. But replacing unproductive medical spending with more productive spending elsewhere in the economy is essential to getting it back on sound footing.
And that’s what individuals and companies could do with their savings from a more aggressive approach to cutting medical spending. Because our exorbitant healthcare spending is a net drain on America’s economy, hampering the global competitiveness of American companies and suppressing the wages of American employees – wages that have been stagnant for the past decade.
Here Are Some REAL Reforms
What are some of the radical ideas that would help accomplish this perfectly sound – and not the least bit radical – goal? Here’s a brief listing of items previously discussed here and in Our Healthcare Sucks with the most potential for reducing our medical spending:
“Soft fraud” – Banning completely physician self-referrals to facilities and services in which they have a financial interest;
Excess hospital payments – Reducing payments to hospitals to national averages (with appropriate adjustments) and prohibiting the ridiculous 1,000+% mark-ups of our most egregious hospitals;
Specialist compensation – Reducing payments to sub-specialties with the greatest rates of over-treatment;
Defensive medicine – Combining limited caps on patient compensation when evidence-based practices are employed with stronger informed consent and patient education efforts;
End-of-life care – Mandatory end-of-life counseling that includes videos of ICU end-of-life care and hospice alternatives; and
Patient safety – “Zero tolerance” for failure to wash hands and follow other proven patient safety measures by hospital personnel.
Saving More Than Money
What would this translate to for the United States?
Cutting current wasteful medical spending could save about $500 billion a year, every year. That’s not the half of current spending that’s considered wasteful. It’s not even a quarter – it’s more like 18%, which reflects the reality that we’ll never succeed in removing ALL of our wasteful medical spending. Over a decade, that’s $5 trillion and about half of that would be taxpayer dollars – perhaps the single biggest impact possible on our record-level federal debt;
Cutting current medical errors by half would save over 50,000 lives a year – more American lives than are lost every year on our highways or to homicides and suicides combined…
Cutting unnecessary hospitalizations by half would avoid over 2 million hospitalizations every year and the associated risks of hospital-induced disease – including cognitive decline – and their expense.