Seeing past political ideology
Many of us grew up believing that private health care was a form of ‘personal responsibility’. Middle class people should not sponge on the government, right?
Others have always been convinced that it’s the government’s role to step in and provide public-funded healthcare.
People devote a LOT of time arguing about private versus public health care services. Some of these arguments even split families and break up friendships.
I see these political arguments as being a red herring, distracting us from the real issues.
The face is, there will be no healthcare for any of us in the future, unless we control exploding costs.
And the chronic flow of easily avoidable hospital errors need to be stopped, permanently.
Despite spending more on healthcare than any other nation (close to 18% of GDP), Americans have the lowest life expectancy in the Western world.
Despite health costs that double every decade, Australians receive ‘appropriate’ treatments in only 57% of the times they see a Doctor.
In healthcare, there is no relationship between the amount of money you pay and the quality of the service you receive.
Getting to the root cause
What makes medical services fundamentally different from other industries?
In healthcare, you DON’T get what you pay for. Whether you are a public or a private patient.
So what are you actually paying for?
The majority of your health dollar is going towards an army of clarks, middle men and lobbyists. They are supposed to purchase, manage and deliver all your healthcare services.
Are they doing a good job of this? Are you getting value for your money? Are they doing a better job, than you could do on your own?
Read the following. Then decide for yourself.
- Up to a quarter of health care budgets in advanced health systems are being wasted on administration
- Resistance to new technology is a widespread problem in the health industry. For example, the hospital you go to may be using antiquated technology such as DOS (a 40 year old computer system). Others are still clinging to paper drug charts, pagers and faxes.
- 12% – 18% of the private insurance bills that Americans pay out, go on administration of health services.
- In both America and Australia, computer systems often don’t integrate with different providers. Instead they form thousands of ‘information silos’ where patients data gets trapped and even lost
- Funding for patients treatment is fragmented across dozens of providers, public, private, not for profit. Many of these companies and organisations do not share data with each other, or a centralised government authority.
- Nearly 50% of American spending on brand medications go on middle men like health insurers and pharmacy benefit managers.
- Australia’s federal Department of Health employs 4500 non-clinical staff at an average salary of $222 000 each.
- A third of Australia’s 150 billion a year health budget is being wasted on over servicing, or unnecessary tests and treatments.
- 1 in 6 dollars in the American economy flows through health care. 75% of the lobbyists in Washington represent the health industry.
- The focus on health bureaucracy rather than ground floor health services even has its own name! It’s called the “close a bed, open an office” syndrome.
Doctors sit at the far end of this wasted money trail. They receive a minority of the money that was originally set aside for health services. And out of that, they have to pay university fees and medical indemnity insurance.
Meanwhile patients can’t access information about costs or quality of health providers. They are not allowed to publicly comment on quality of their treatments.
Despite the fact that libraries of data is collected every year on hospitals performances, data is hidden from taxpayers.
Does all this sound like a bad deal?
That’s because it is.
So how do you cut medical bills while getting a better service?
First, take an inventory of your health. Imagine you are a property inspector walking through a house, checking off lists. Or a car mechanic examining a vehicle that’s come in for a service.
Do you have any know medical condition? High blood pressure? Diabetes? Were you prescribed any medications for these conditions? And if so, are you still taking them?
Are you currently taking pharmacy medication (over 50% of the population)? Why? When is the last time you had you condition and medications reviewed? Are you over 60 and taking more than 5 separate medication (36% of the population).
Are you overweight (67% of Australians)? Do you have difficulty sleeping? Are you anxious or depressed? Do you take illegal drugs (approx 15% of the population)?
Don’t be emotional. Try to remain pragmatic and clear headed.
What are your most pressing problems? What are related to a medical condition? And what do you think, are due to lifestyle issues?
Healthcare is actually a very practical field. Medicine is about identifying problems then trying to solve them. Nursing is about keeping people comfortable and supported.
Go to my directory, where you can look up the specialty that covers your disease or condition. Then scroll through the international list of health technology services. These products are recommended by medical technology commentators and reputable health technology magazines.
For diabetes look at apps with algorithms that help predict future blood glucose levels.
For Parkinson’s Disease look at smart watches that continuously monitor tremors and help guide more accurate drug regimes.
For ventilator dependent people consider a service like Intensive Care at Home.
For many of these modern services you will need to pay cash. Neither government or private insurers are currently subsidising most modern health tech services. The good news is, they don’t cost much.
And this will also make you think ‘hey, what am I paying all this money in taxes and health insurance premiums for?’
The final step is really important. So listen carefully.
Take the time to seek out a family Doctor, that you can build a long term relationship with. Someone who will get to know you and listen to your secrets.
Someone you can talk to honestly about –
- Your sexual life
- Illegal drugs you or your family are using
- Family problems like divorce, abuse and fears of not being able to hold the family together
- Bullying at work or school
Why? Because the MAJORITY of general medical practice work, is of a non medical nature. It involves listening to people’s problems, following up their issues and giving them honest advice.
I want to make clear that when I talk about a family Doctor, I’m NOT referring consumer style walk-in walk-out clinics, such as –
- The Government funded 24/7 five minute tick and flick clinic – “Hello Doctor”, “Here’s a script”, “Goodby”.
- The teleconferencing app that is soooo convenient – click, select Paypal or Stripe, password manager – “Need”, “Script”, “😃”
Instead I’m referring to a Doctor who is financially independent from Medicare, Medicaid and private health insurance.
Someone with a reduced caseload of patients and who therefore has the time to spend talking to patients about their real and messy life issues.
Someone who will follow up on test results, checking up if patients are admitted to hospital, make sure their drugs don’t get changed unnecessarily and make sure they are not being pushed into tests and treatments they really don’t need.
In America and Australia, this is known as concierge medicine.
Once again, be prepared to pay out of pocket. Concierge medicine charges a monthly or yearly subscription service.
And once again, consider exactly what value your current taxes and health plans are providing you with.
For treatment that requires hospital visits, I suggest you demand as low a price, and as high a standard as you possibly can get.
Look for high volume hospitals (this means surgeons and medical specialists who treat a large number of patients every year). Yes, practice DOES make perfect.
If your country has some public healthcare, consider travelling into a large, inner city hospital.
If that’s not possible, consider flying overseas for medical tourism at an accredited hospital.
Medical tourism is currently worth 439 billion a year! There is a medical tourism association that accredits hospitals. Many Doctors have trained in Western Universities.
And Americans (with their insistence on good customer service) are a large clientele.
What health bureaucrats aren’t telling you is that they are paying for less and less of your medical bills.
You might have noticed that your private insurance covers less of your costs than it did in the past. Or that public hospitals are now asking you to pay more of your own bill.
The reason is, governments and insurers simply can’t afford skyrocketing health costs.
Health costs across Europe are expected to become completely unsustainable by 2040.
One of the biggest costs is hospitals. Modern day hospitals are filled with over paid bureaucrats managing a tangled mess of ever-changing government regulations, hundreds of thousands of billing codes, computer systems that don’t connect and fragmented payment systems.
An outdated payment system, resistance to using modern technology and inflexible work practices are keeping hospitals overpriced and inefficient.
And rather than tackle industry reform, politicians are taking the ‘quietly privatise’ rout.
Leaving you with higher costs and less services.
The bottom line?
Start taking control of your health services today.
Buy the latest in consumer health technology. If it’s been approved by the FDA (The Food and Drug Administration) or the TGA (Therapeutic Goods Administration) then consider it as safe as other product on the health market.
Monitor your condition continuously, understand your disease, drugs, triggers and patterns.
And consider joining a family style medical practice, where more time can be spent, discussing all your issues, and giving you the information you really need.
Staying out of hospital using modern health technology and concierge health services are cheaper in the long run.
In my opinion, they are also the future.
© Wikihospitals March 2020
Illegal drug use in Australia – 2001 – 2016