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HEALTHPLANUSA. |
QUARTERLY NEWSLETTER |
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Community For Affordable Health Care |
Vol IX, No 4, January, 2011 |
Transforming the $3 Trillion HealthCare
Industry into Affordable HealthCare
By Utilizing the $2 Trillion
Information Technology Industry
Through
innovation by moving from a Vertical to a Horizontal industry
Thus
eliminating $1 Trillion wasted
Insuring
every American without spending the Extra $1Trillion Projected.
To purchase a copy of the business
plan, become an entrepreneur,
and changed the course of the healthcare industry, go to the bookstore at
www.healthplanusa.net/index.asp
In This Issue:
1. Featured Article: A Free and Prosperous New Year
by David Boaz
2. In
the News: The
proper
role of government in financing and delivering health care
3. International
Healthcare:
The Future Of
Healthcare
4. Government Healthcare: Obamacare
5. Lean
HealthCare: Changing Healthcare
Culture to Continuous Improvement
6. Misdirection in Healthcare: How to correct the
current misdirection?
7. Overheard on Capital Hill: America needs “Someone to
Trust.”
8. Innovations in Healthcare: All innovations may not be
improvements
9. The Health Plan
for the
10. Restoring Accountability in HealthCare by Moving from a
Vertical to a Horizontal Industry:
Have a Happy, Healthy, and Prosperous New
Year 2011
We wish each
and every one of you a Happy, Healthy and Prosperous New Year in 2011, as we
seek to restore the Private Patient-Centered Medical MarketPlace that will deliver
healthcare to all most effectively.
The Annual World Health Care Congress, a market of ideas, co-sponsored by The Wall
Street Journal, is the most prestigious meeting of chief and senior
executives from all sectors of health care. Renowned authorities and
practitioners assemble to present recent results and to develop innovative
strategies that foster the creation of a cost-effective and accountable
* * * * *
1. Feature Article: A Free and Prosperous New Year
by David Boaz
This
article appeared on www.cato.org/cato.org on
The sun
rises in 2005 on the freest and most prosperous world in history.
According to Economic Freedom of the World: 2004
Annual Report, the average economic freedom rating for 123 countries rose
from 5.1 in 1980 to 6.5 in 2002, on a scale from 1 to 10, with 10 representing
full economic freedom.
The
authors of the report, published by the Fraser Institute in
- The use of extremely
high marginal tax rates fell sharply. In 2002, not a single country
imposed a 60 percent marginal tax rate on personal income; in 1980, 49 did
so.
- Exchange-rate controls
were liberalized substantially. In 2002, there were only four countries
with black-market exchange rate premiums of 25 percent or more compared to
36 countries in 1980.
- Tariffs were reduced.
In 2002, the mean tariff rate was 10.4 percent compared to 26.1 percent in
1980.
- Controls on both
capital markets and interest rates were relaxed.
Over
the past 25 years, several factors have contributed to the growth in economic
freedom. The collapse of the
All
those trends should continue. On Ronald Reagan's 93rd birthday last February,
Countries
compete more than ever to attract businesses, investors, and citizens. High tax
rates, capital controls, and excessive regulation drive investors away, so many
countries have been trying to cut taxes and regulation. "Tax
competition" helps protect taxpayers from their own governments.
But
there are powerful forces that resist the call for less government. The
European Union started as a free-trade area -- it was first known as the Common
Market -- but today it is largely a giant cartel for high taxes. Its leaders
try to "harmonize" tax rates by pressuring member countries with low
taxes to raise them.
President
Vladimir Putin has been tightening restrictions on press freedom in
The
Bush years have been a mixed bag for economic freedom in the
We
must not forget the real importance of economic freedom. Besides the value of
freedom itself, economic freedom leads to economic growth. And growth is not
just an abstract concept. It means that women have running water, rather than
having to carry water from a well that may be miles away. It means enough food
for children. It means medical care and dramatically lower rates of infant
mortality.
The
hurricanes that devastated
For
those of us who want the poorest people in the world to have better lives, the
challenge is to continue the spread of globalization, resist tax cartels, and
give more people more opportunity to own stocks, bonds, and other real assets.
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* * * * *
2. In the News: The proper role of government
in financing and delivering health care
Ten
Principles of Health Care Policy By:
Joseph Bast
Published In: Legislative
Principles > Health Care Policy > 06/01/2007 Publisher: The
Heartland Institute
The proper role of government in financing and
delivering health care is one of the hottest public policy issues of our time.
Some experts call for more regulation and more subsidies, while others call for
less. All levels of government in the U.S. are coping with rising spending on
health care for their own workforces and rapidly rising spending on programs
for the poor and elderly.
This booklet is designed to help state legislators
find solutions to health care problems by first identifying their causes and
true extent--which often are not as they are reported in newspaper stories or
touted by special interest groups--and then by presenting 10 principles that
ought to guide reform efforts. Read
more . . .
Do we really spend too much?
It often is assumed at the outset that “we spend
too much” on health care in the U.S., but who is “we” and what is the “right”
amount? Individuals, not nations, earn income and choose how to spend it.
When adjusted for inflation, per-capita health
care spending in the U.S. today is about 10 times what it was in 1950. By
itself, this statistic is not evidence of a problem. Data from around the world
show that people tend to spend a bigger part of their incomes on health care as
they grow wealthier (OECD 2004). Health is what economists call a “superior
good,” which means spending rises faster than income.
Spending on health care in the U.S. totaled $1.9
trillion in 2004--an average of $6,430 per person, almost one-sixth of the
nation’s gross domestic product (NCHS 2006). No doubt some of this increased
spending has produced good results. Higher spending on health care is
responsible for some part of the significant increases in lifespan and reduced
disability during the past half century. Most spending today is on treatments
that were unavailable at any cost in the not-so-distant past (Cutler 2004,
Gratzer 2006). Health care providers in the U.S. provide a higher level of care
than is available in most, and perhaps all, other countries (Brase 2000).
Reasons we spend so much
Spending on health care in the U.S. often is
compared unfavorably to spending levels in other countries, but there are some
good reasons having little or nothing to do with public policies that help
explain why health care in the United States costs more than it does in other
countries. Among them:
·
We invest much more in saving prematurely born infants
and extending the life of our elderly. Other countries withhold care and stop
treatment (Wesbury 1990, Wennberg 2006).
·
Pregnancy, birth, and abortion rates among girls aged 15
to 19 are higher in the U.S. than in other developed countries (Singh and
Darroch 2000).
·
The portion of the U.S. population aged 15 and older that
is obese is nearly double that of Canada and substantially higher than in other
wealthy countries (Anderson and Hussey 2000).
The need for health care reform
Even knowing that a high level of spending on
health care is not necessarily a bad thing, and that there are reasons why we
spend more than consumers in other countries, we might still conclude that we
spend too much on health care in the U.S. In fact, we should come to this
conclusion.
Waste and inefficiency are easily identified in
our hospitals, government programs, and private insurance markets (Meier
2001b). We see it in the number of people who lack health insurance, the lack
of price transparency in much of the health care system, the high rate of
medical mistakes in hospitals, and the massive transfers of income--often from the
poor and uninsured to the well-to-do and insured--that the current system
generates.
A “good health care system” wouldn’t employ armies
of “gatekeepers” to intrude in the relationship between doctors and patients,
wouldn’t require lawsuits to ensure that victims of malpractice get adequate
compensation or that incompetent providers lose their licenses, and wouldn’t
ration access to life-saving drugs. . .
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entire report from Heartland . . .
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* * * * *
3. International
Healthcare: From
the Stockholm-Network of Think Tanks
FUTURE OF HEALTHCARE
Paul Healy,
senior researcher of the
Healthcare systems today
are more adept than ever at keeping patients healthier for longer. Since 1961,
life expectancy at birth in the OECD has increased by over 11 years on average,
which means that a person born in the OECD can now expect to live beyond 80
years of age. . .
More accessible healthcare
Modern consumer habits mean
that today’s patients are much more demanding of easy-to-access healthcare
treatment. No longer are patients willing to accept long waiting lists for
operations, time-consuming booking systems for family doctors or an inability
to access medical opinion at the touch of a button. This inclination is not
necessarily because patients are unacceptably insistent today but because they
recognise that such obstacles are no longer necessary. . .
More personalised healthcare
If eHealth can be rolled
out further then this would certainly fulfil another demand of patients: the
desire for more personalised treatment. No longer do patients want to be
treated as a homogenous mass, primarily because they have realised that medical
evidence proves that they in fact are not all the same. Whilst one-size-fits-all healthcare can have
its advantages in areas of public health, such as immunisation, the reality is
that most diseases are much more complex.
Semashko healthcare systems
during the Cold War, which were entirely socialised, proved woefully inadequate
in dealing with individually treating patients and life expectancy, as a
result, lagged far behind Western healthcare systems by 1990. . .
On average, current health
spending per capita in the most developed countries is 19 times the amount that
it was in 1970. As a percentage of
Conclusion
So it becomes increasingly
obvious then that healthcare systems are likely to change. Whilst it is
encouraging that such developments are going to be designed to keep people
alive for longer, such progress will inevitably come at a cost. Therefore,
policymakers should be looking to pre-empt changes in healthcare and aiming to
install reforms that will better accommodate such changes.
The best way to prepare for
more accessible, effective and personalised treatments would be to implement
reforms now that make the current healthcare system more accessible, effective
and personalised. To do this, patients need be empowered.
In financing healthcare,
there needs to be a greater balance between private and public funding,
allowing for more flexibility and choices. Furthermore, there needs to be a
reform of the relationship between patients and their health services, which
could turn the emphasis towards what patients want. Last but not least, further
competition in health services will increase accountability of such services to
patients.
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Government medicine does not give timely access to
healthcare, it only gives access to a waiting list.
Euro-Care is beginning to recognize the economic
value of patient empowerment and private care.
* * * * *
4. Government
Healthcare: Obamacare - This Cannot
Stand
Consumer
Power Report > 2011
> Health Care
> Consumer
Power Report
Written
By: Benjamin
Domenech Publisher: Consumers
for Health Care Choices at The Heartland Institute
Welcome to the first Consumer
Power Report of 2011.
This New Year has brought an
influx of new Congressmen in Washington and new state legislators and governors
across the country. For many, the first topic of conversation when they enter
these halls of the republic concerns health policy and entitlement reform. Read more . . .
In the next few days on Capitol
Hill, we’ll see the first major vote to repeal President Barack Obama’s health
care law. This is a vote that must happen, and ought to be politically easy given the
jobs numbers involved – it’s a sign of commitment to the reason
many of these new members got elected. What’s more critical is a vote that will
come later, one that some observers and pollsters will declare must not happen
politically – a vote that will offer America a clear choice about our budgetary
future under the leadership of Budget Chairman Paul Ryan (R-WI).
. . . So often in prior
congresses, conservatives could not sway their hand-wringing colleagues to take
firm stands in favor of balanced budgets, entitlement reform, and an approach
to health policy reform that empowers individuals within open markets. We’ve
seen the consequences of this failure: a budget picture that is growing worse
with each passing day, a health care system in desperate need of reform, and a
deficit graph line that expands with the entrance of the Baby Boomers into
Medicare like a pig in a python.
This cannot stand, or we will
reap the consequences. . . new
legislators in Washington should take their cue from the boldness of the
states, where it’s far more difficult to play shell games with budgets. This
honesty breeds defiance, and I expect we will soon see governors, Democrats and
Republicans, banding together to demand more flexibility from Washington as
they await the outcome of the court challenges.
Every week I talk to more state
legislators asking what they can do to battle back against Obamacare. Grace-Marie
Turner has written an excellent column for Health Care News
describing nine steps, which I strongly recommend as a starting point. Not all
these votes will be politically easy – but it’s those votes, after all, that
you were elected to make.
-- Benjamin Domenech
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Government is not the solution
to our problems, government is the problem.
- Ronald Reagan
* * * * *
5. Lean HealthCare: Changing Healthcare
Culture to Continuous Improvement
On the Mend: Putting culture change at the heart of
a lean healthcare transformation
Originally presented:
Part
case study, part manifesto, this groundbreaking new book by a doctor and a
healthcare executive uses real-life anecdotes and the logic of lean thinking to
make a convincing argument that a revolutionary new kind of healthcare — lean
healthcare — is urgently needed and eminently doable. Read more . . .
In On
the Mend: Revolutionizing Healthcare to Save Lives and Transform the Industry
John Toussaint, MD, former CEO of ThedaCare, and Roger A. Gerard, PhD, its
chief learning officer, candidly describe the triumphs and stumbles of a
seven-year journey to lean healthcare, an effort that continues today and that
has slashed medical errors, improved patient outcomes, raised staff morale, and
saved $27 million dollars in costs without layoffs. Find out: Read more . . .
·
How lean
techniques of value-stream-mapping and rapid improvement events cut the average
“door-to-balloon” time for heart attack patients at two hospitals from 90
minutes to 37.
·
What ThedaCare
leaders did to replace medicine’s “shame and blame” culture with a lean culture
based on continuous improvement and respect for people.How the lean principle
of “building in quality at the source” broke down divisions among medical
specialties allowing teams to develop patient care plans faster.
·
Why traditional
modern management is the single biggest impediment to lean healthcare.
·
How the
plan-do-study-act cycle coupled with rapid improvement events cut the wait time
at a robotic radiosurgery unit from 26 days to six.
·
How the lean
concept of “one piece flow” saved time in treating ischemic stroke patients,
increasing the number of patients receiving a CT scan within 25 minutes from
51% to 89%.
·
How senior
leaders at other healthcare organizations can begin their own lean
transformations using a nine-step action plan based on what ThedaCare did — and
what it would do differently.
Toussaint and Gerard prove that lean healthcare does
not mean less care. On the Mend
shows that when care is truly re-designed around patients, waste and errors are
eliminated, quality improves, costs come down, and healthcare professionals
have more time to spend with patients, who get even better care. Get your copy
of this important new book today.
If you have questions or
comments for the authors of On the Mend, you can call 920-735-7213.
Purchase
the book, On the Mend . . .
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The Future of Health Care Has to Be
Lean, Efficient and Personal.
* * * * *
6. Misdirection in Healthcare: How to correct the
current misdirection?
The Conservative Way Forward on Health Care
By:
Richard Amerling, M.D.,
The landslide Republican victory, in taking the House
and electing some strong conservatives to the Senate, can be interpreted as a
mandate to rein in government spending, and specifically to repeal ObamaCare,
as these issues were clearly behind the large turnout. There is still a
very real possibility the Supreme Court will find the “individual mandate” to
buy private insurance unconstitutional. If this provision is thrown out,
it’s hard to see how the law survives, since the mandate is needed to finance
it.
Now is an excellent time to construct a conservative
alternative vision for true reform of our health care delivery system.
Since most current problems with the health care system stem from government, a
conservative plan should seek to reduce its role.Read more . . .
It goes without saying that the Patient Protection and
Affordable Care Act must be repealed since, like all the laws passed by this
administration, it does precisely the opposite of what its name
suggests. By massively increasing the health care bureaucracy at
the expense of actual providers of care, it will make care harder to access and
more expensive. Many physicians will take early retirement and the
already great physician shortage will be exacerbated.
The law is too large and complex to waste time
foraging for items to salvage. There is a great risk of leaving behind
hidden mandates and rules that will be harmful. Better to scrap the whole
thing. With Democrat Senators running scared for their jobs in 2012, it
is conceivable the Senate would also vote for repeal (Harry Reid
notwithstanding). But not even the most generous view of Barack Obama’s ideological
flexibility has him signing a repeal bill, and a veto override is out of the
question for now.
It may be possible, however, to enact affirmative
measures that make ObamaCare irrelevant. Here are some common sense, free
market proposals, many of which were proposed and discussed, but ignored by the
President and the Congressional leadership in the run-up to passage of
ObamaCare.
1. Transfer the tax deduction for health care spending from employers to
individuals. This would end the absurdity of purchasing health insurance at the
“company store,” a practice that limits individual choice and liberty,
nourishes a sense of dependency, and promotes overuse of care. This
policy, an accident of WW II wage and price controls, was the “original sin” in
health care financing; doing away with it would empower consumers to shop for
the best plan for their families, which will lower premiums.
2. Remove barriers to the interstate sale of health insurance. There
is broad agreement on this proposition. It would increase choice and
competition between insurers and drive down premiums by effectively ending
state mandates that drive them up.
3. Deregulate and allow greater contributions to Health Savings Accounts.
These fabulous tax shelters give individuals more control over their health
spending, and, coupled with an inexpensive policy to cover catastrophic illness
(i.e., true insurance), are all most people need. By returning most
health care purchasing decisions to consumers, spending will immediately be
slowed and prices curbed. This is the conservative, free market,
already tested and proven way to “bend the cost curve down.”
4. Follow
the recommendations of the bipartisan Breaux Commission and give Medicare
beneficiaries a means-tested stipend to buy private insurance. This
solution came during the
5. Transfer (gradually) all Medicaid responsibility to the states. Federal
support for Medicaid allows much greater spending than would otherwise
occur. It forces frugal states to subsidize lavish coverage in
The latter two points would allow the mammoth Center
for Medicare and Medicaid Services to be mothballed, though Medicare could
retain a role as insurer of last resort for those with pre-existing, expensive,
chronic diseases.
6. Institute a “loser pays” system for medical malpractice to cut frivolous
lawsuits. The ability to launch a lawsuit (and this applies beyond
medical malpractice) with minimal financial risk is the reason behind the
explosion of malpractice litigation, with all the associated costs. Tort
reform at the federal level would require the Senate to override the trial
lawyers’ veto, which could be a problem. This reform should be pushed at
the state level.
7. Finally,
for true patient protection, let’s propose a constitutional amendment to
guarantee the individual’s right to privately contract for medical care.
This will eliminate for all time the threat to the private practice of medicine
and assure that, no matter what system is in place, patients will always be
allowed to spend their own money on care.
The above points are clear, simple and practical
solutions. They empower the individual and greatly reduce malignant government
influence and unburden the taxpayer. It is the conservative way forward
on health care.
Richard Amerling, MD is
a nephrologist practicing in
Watch Clip of Dr. Amerling at National Doctors Tea
Party
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Well-Meaning
Regulations Worsen Quality of Care.
* * * * *
7. Overheard on
Capital Hill: America
needs “Someone to Trust.”
Paul Johnson, 11.18.10,
Forbes Magazine December 06, 2010
What the midterm
elections proved is that the American people do not trust Barack Obama to lead
them. And trust, that magic five-letter word, is the most important element in
the relationship between a nation and its government.
Trust has been of
central importance in American history. During the long and exhausting War of
Independence the American people gradually learned to trust George Washington.
They subsequently were happy to have him preside over the process of governing
that led to the writing of the U.S. Constitution.
The more one reflects
on that wonderful document the more extraordinary appears its birth. Washington
felt this at the time, saying it struck him as "little short of a miracle,
that the delegates from so many different states . . . should unite in forming
a system of national government, so little liable to well-founded
objections." He further said: "It approached nearer to perfection
than any government hitherto instituted among men [and was] provided with more
checks and barriers against the introduction of tyranny . . . than any
government [previously devised by] mortals." He later concluded that it
came into being under "the invisible hand" of Providence.
The central reason
that the delegates were prepared to accept the Constitution and the states
subsequently ratified it was that Washington was in charge of the process. He
was the one man they all trusted. Read more . . . That
trust proved to be justified. During Washington's two terms as President he
showed that the Constitution was workable; he then stepped down--without
argument or fuss--and made way for another. By then the Constitution had become
a living thing, an organized part of America.
Trust is always the
best contract between a government and its people. It does not need to have a
constitutional basis or legal definition. But it needs to be felt in the hearts
and minds, the blood and bones. And it is reciprocal. A leader will never be
trusted until he or she shows, by attitude and conduct, that he or she in turn
trusts the people.
I remember feeling
this as a boy in 1940, when Britain was in danger of being drowned in the
rapidly advancing tide of Nazi military success. We trusted Winston Churchill
to save us, and he, in turn, trusted the British people to have the courage and
endurance and the intelligence and strength to make salvation possible.
I had a sense of déjà
vu at the end of the 1970s. Britain was in an appalling state, with militant
trade unions rendering elected governments impotent, while the economy was
sliding into bankruptcy. For the first time in our history we chose a woman to
be prime minister. Slowly the people's relationship with Margaret Thatcher
became one of trust--and was strengthened over the course of some nasty and
brutal attempts by the unions to overthrow constitutional government. The trust
was justified: After a dozen years under the Iron Lady, Britain emerged
strengthened and invigorated.
In the U.S. something
similar happened. The 1970s had also been a disastrous decade there, marked by
a collapse in the nation's self-confidence. When Ronald Reagan first emerged on
the national scene many dismissed him as a second-rate movie actor. Gradually,
however, trust built up. When Reagan was elected to a second term he secured
the enormous tally of 54,455,075 votes--nearly 60% of the total--carrying 49
states and winning 525 votes in the electoral college.
The processes of earning and granting trust are gradual and almost
metaphysical. So it is that a good leader, at some point, ceases to be merely a
politician, an officeholder; he or she becomes a trusted institution. And from
that point on the nation becomes healthier, more secure and thus happier. . .
As for the U.S., at
few times in its history has it stood in greater need of a leader it can trust.
The scars from the financial crisis are still raw and unhealed; unemployment is
a cruel scourge; and there are terrible threats to the country's internal and
external security, with the future overshadowed by emerging superpowers and
competitors. And there is no one to trust.
The U.S. has
all kinds of problems. But its biggest over the course of the next two years is
how to find a leader who will inspire through character and integrity, vision
and resolution, courage and judgment the belief, faith and confidence that
Americans have always warmly given to the right person--someone they can trust.
Paul Johnson, eminent British historian and author; Lee Kuan Yew,
minister mentor of Singapore; Amity Shlaes, senior fellow in economic
history at the Council on Foreign Relations; and David Malpass, global
economist, president of Encima Global LLC, rotate in writing this column. To
see past Current Events columns, visit [the] site at www.forbes.com/currentevents.
Read
the entire OpEd in Forbes . . .
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What are the President and Congress Really Saying?
* * * * *
8. Innovations in
Healthcare: All innovations may not be improvements
All innovations are not equal. At the
present time, there is considerable misunderstanding between digital medical
records, which I presume essentially all physicians that type their
consultations and medical reports using a computer word processing system
utilize vs a fully electronic system. The individualized local digital records
allow retrievable records across all office, group and clinic networks. This
allows any doctor on the network to access a patient’s medical record even if
the chart is temporarily misfiled or in another partner’s office. It also
allows for irregular patients or those seen infrequently in consultation to
have a continuous digital record when they do come in, even if five years after
the initial consult.
To have electronic ordering of tests,
x-rays, scans, pulmonary function testing, with the reading of this report on
the same interface, requires considerably more sophistication. There are many
opportunistic entrepreneurs who are selling doctors programs that allegedly can
do all these things. But over the past several years with all the government
meddling into medical records, many physicians have invested to their
detriment. They did not save money or time. They actually spent a lot of money
and experienced greater loss of valuable time, which resulted in being even
more costly than the investment.
This is not unique to health care, but
in all large programs. There is something about the word “computer” that acts
like a “soporific” –or at least tranquilizes the tension of being overwhelmed
for a short period of time. And then the crises hits—the programmers let out
reality thinking that the purchased program will not function as contracted and
cannot be altered to function as promised. There have been several departments
in
But most medical establishments don’t
have access to taxpayer’s money and cannot afford to make such costly errors.
Hospitals, which have access to taxpayer’s monies, sometimes can. In fact,
there is one hospital in
Thus it may be far better for most
private practitioners and small groups to be content with a digital record that
serves the group well and has easy access across several offices, for retrieval
of partner’s entries that can also expand as new developments appear. There are
small programs for prescriptions, ordering tests, retrieving test, sending them
out to the patient that fit very well with any digital system that a physician
or small group already uses.
Don’t be hoodwinked by politicians’ lack of understanding
of EMRs.
EMRs are not state of the art at this time or in the near future for small
practices.
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* * * * *
9. The Health Plan for the
There are a large variety of health plans in the
The insurance industry has obtained control of
patients through control of physicians and their practices. Nearly every major
test, procedure, consultation, and hospitalization has to be approved by the
insurance carrier. As Jerry Smedinghoff, an actuary, says in his addresses,
this just adds MUDDA to the system, a Japanese term of placing obstacles in the
path which decreases efficiency and increases cost, not the other way around as
is generally presented. Physician time in plotting a course around these Blocks
to Health Care is considered not being a cost—in other words a donation “to the
cause.” And this plotting a path around the obstacle is another administrative
challenge—how to block the detour. In fact, the various components of the
health care team no longer cooperate in helping patients get well—they are
essentially at war with each other—friendly as generally observed by outsiders.
But in fact, it can be rather vicious.
One insurance executive from a major health carrier
once remarked privately at the reception after his speech, “We could probably
save money if we just paid physicians the prevailing fees and fire the
‘oversight’ staff. But why would we want to give up our control of physicians?”
This can best be illustrated in the unpopular concept of
Concierge Practice. Concierge practices allow the patient to determine the time
they spend with their physician. This has been estimated at four to eight times
as much physician time for which they pay. However, studies have shown that
patients in a concierge practice visit ERs 65% less, see consultant physicians
50% less, be hospitalized 25% less and have 35% few hospital days and consume
50% less prescription drugs. These latter are very costly medical services
compared to concierge primary care. Thus the miner costs of having a concierge
physician is proven to be many times offset by the savings at the secondary and
more costly level. Access is increased and costs are decreased.
This can also be illustrated by adding a co-payment to
all services. This works only if the co-payment is a percentage of the charge,
not only of the professional visit, but also of each test the physician orders.
Thus, the greater the cost of a test or service the patient desires, the
greater is the cost to him. It the co-payment of outpatient testing is 30%,
then the patient will be motivated to be most cost efficient. A common request
is an
In either case it is the patient’s involvement with
the costs vs benefits that reduced the health care costs. This is the way it
should be.
The best health plan for the
This column,
HealthPlan for the
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* * * * *
10. Restoring
Accountability in Medical Practice by Non Participation in Government Programs and
Understanding the Devastating Force of Government
·
Medicine and Liberty - Network of Liberty Oriented Doctors, www.MedLib.ch/, Alphonse Crespo, MD, Executive
Director and Founder
Medicine & Liberty
(MedLib) is an independent physician network founded in 2007, dedicated to the
study and advocacy of liberty, ethics & market in medical services.
-
We support professional autonomy for doctors and liberty of choice for patients
- We uphold the Hippocratic covenant
that forbids action harmful to the patient
- We defend responsible medical
practice and access to therapeutic innovation free from
bureaucratic obstruction
- We work towards a deeper
understanding of the role and importance of liberty & market in
medical services
MedLib is part of a wide movement of ideas that
defends
- the self-ownership principle &
the property rights of individuals on the products of their
physical and intellectual work
- free markets, free enterprise and
strict limits to the role of the State
·
Entrepreneur-Country. Julie Meyer, CEO of Ariadne
Capital, (Sorry about the nepotism,
but her message is important) recently launched Entrepreneur
Country. Read their manifesto for information: 3. The
bigger the State grows, the weaker the people become - big government creates
dependency . . . 5. No real, sustainable
wealth creation through entrepreneurship ever owed its success to government .
. . 11. The triple play of the internet,
entrepreneurship, and individual capitalism is an unstoppable force around the world,
and that Individual Capitalism is the force that will shape the 21st Century .
. . Read
the entire manifest . . .
·
Americans for Tax Reform, www.atr.org/, Grover Norquist,
President, keeps us apprised of the Cost of Government Day® Report, Calendar Year 2010. Cost of
Government Day (COGD) is the date of the calendar year on which the average
American worker has earned enough gross income to pay off his or her share of
spending and regulatory burdens imposed by government on the federal, state and
local levels. Cost of Government Day for 2009 was August 12, a seven-day
increase above last year's revised date of August 19. With August 19 as the
COGD, working people must toil on average 231 days out of the year just to meet
all the costs imposed by government. In other words, the cost of government consumes
63 percent of national income. If we were to put health care into the public
trough, the additional 18 percent would allow the government to control 80
percent or nearly three-fourths of our productivity and destroy our health care
in the process. We would have almost no discretionary income.
·
National Taxpayer's
·
Citizens Against
Government Waste, www.CAGW.org,
America’s Taxpayer’s Watch Dog.
Since 1984, Citizens
Against Government Waste has been the resource that policymakers, media,
and the taxpaying public rely on for the bottom line behind today's headlines.
Waste News is the first stop for reporters covering government spending. Members of the Media visit our media
page to sign up for email updatesor to set up interviews with CAGW policy
experts.
Porker of the Month
will introduce you to some of government's worst pork-barrel offenders.
"To advocate an efficient, sound, honest government is
neither left-wing nor right-wing, it is just plain right."–J . Peter
Grace, CAGW Co-Founder
·
Evolving Excellence—Lean
·
· Ayn Rand, a Philosophy for Living on Earth, www.aynrand.org/site/PageServer, is a veritable storehouse of common sense economics to help us live on earth. To review the current series of Op-Ed articles, some of which you and I may disagree on, go to www.aynrand.org/site/PageServer?pagename=media_opeds.
* * * * *
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joining the HealthPlanUSA network of 80,000 professionals that receive our
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and enter your email address. Stay tuned for the latest innovating thinking in
HealthCare and have your friends do the same.
Articles that appear in HPUSA may not
reflect the opinion of the editorial staff. Several sections are entirely
attributable quotes in the interest of the health care debate. We trust our
valuable and faithful readers understand the need to open the debate to
alternate points of view to give perspective to the freedom in healthcare
issues. We have requested permission and many of the sites have given us
standing permission to quote extensively from their sites and refer our readers
back to their site. Editorial comments are in brackets.
PLEASE NOTE: HealthPlanUSA receives no
government, foundation, or tax favored funds. The entire cost of the website
URLs, website posting, distribution, managing editor, email editor, and the
research and writing is solely paid for and donated by the Founding Editor (and
Friends of Freedom), while continuing his Pulmonary Practice, as a service to
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Contributions are welcomed but are not tax deductible since we ask for no
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HealthPlanUSA uses many standard medical terms considered forbidden by many spammators.
We are not always able to avoid appropriate medical terminology in the
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As readers use new spammators with an increasing rejection rate, we are not
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appropriate adjustments. To assure uninterrupted delivery, subscribe directly
from the website: www.HealthPlanUSA.net/newsletter.asp.
Del
Meyer
Del Meyer, MD, CEO & Founder
DelMeyer@HealthPlanUSA.net
Satyam A Patel, MBA, CFO, & Co-Founder
SatyamPatel@HealthPlanUSA.net
HealthPlanUSA,
LLC
www.HealthPlanUSA.net
Words
of Wisdom
The more the state “plans” the more difficult planning
becomes for the individual. –The Road to
Serfdom 1944
We have progressively abandoned that freedom in economic
affairs without which personal and political freedom has never existed in the
past. –Friedrich August von Hayek in The Road to Serfdom.
Some
Recent Postings
In The October HPUSA Issue:
1. Featured Article:
The
Forgotten Man of Socialized Medicine
2. In the News:
Discontinuing
Failed Drug Research is Expensive
3. International
Healthcare: The
Stockholm Network
4. Government
Healthcare: A
Growth Agenda for the New Congress
5. Lean HealthCare:
Healthcare is going ‘lean'
6. Misdirection in
Healthcare: What
Motivated ObamaCare?
7. Overheard on
Capital Hill: Benign
Dictatorship and the Progressive Mind.
8. Innovations in
Healthcare: Health Plan from the National Center for Policy Analysis
9. The Health Plan
for the USA: How technology reduces
health care costs
10. Restoring Accountability in
Medical Practice by Moving from a Vertical to a Horizontal Industry:
New
Years Day in History, the Day of Hope and Good Intentions
President Lincoln issued Emancipation Proclamation in 1863.
First issue of the Liberator, William Lloyd Garrison’s antislavery
periodical 1831
26 Nations signed United Nations Declaration in World War II in
Birthday of Paul Revere, 1735; Betsy Ross, 1752; General Anthony
Wayne, 1745
Always remember that Chancellor Otto von Bismarck,
the father of socialized medicine in
Thus we must
also remember that ObamaCare has nothing to do with appropriate healthcare; it
was similarly projected to gain loyalty by making American citizens dependent
on the government and eliminating their choice and chance in improving their
welfare or quality of healthcare. Socialists know that once people are
enslaved, freedom seems too risky to pursue.