Political ideology versus hospital reality
For many of us, private health care was sold as a form of ‘personal responsibility’. Middle class people should not sponge on the government, right?
Others firmly believed that it’s the government’s job to step in and take control of every aspect of people’s lives. Only big government is tough enough to take on the big corporate bullies. Correct?
People devote a LOT of time arguing about private versus public health care services.
This is a red herring that distracts people from the real issues in healthcare.
The ‘dream’ many cling to is of being given individualised treatment by their private Doctor. Or free healthcare by an efficient public hospital nurse, dressed in a crisp uniform.
However ideologies can quickly evaporate, when people are faced with the reality of noisy and chaotic Emergency Departments.
You can pay all the private health insurance premiums you want and still end up with lost medical records, the wrong medications and hundreds of dollars in unexpected out of pocket costs, on your way out the door.
You can pay all the taxes you want to a public health system, only to end up having your serious condition ignored, be left waiting for hours then bundled out the door without being given any kind of health plan.
Despite spending close to 18% of their GDP on healthcare, Americans have the lowest life expectancies in the Western world.
Despite health costs that double every decade, Australians receive ‘appropriate’ treatments in 57% of the times they see a Doctor.
In healthcare, there is no relationship between the money spent, and quality of service received.
The root cause of the problem
The fundamental problem with healthcare is you DON’T get what you pay for.
You are not actually paying Doctors with your health dollar, public or private.
You are paying an army of middle men to ‘manage a Doctor’s treatment’ for you. Oh, and you also pay their wages, insurance, sick and holiday benefits, superannuation, supervisors, large inner city offices, heads of departments, CEO’s and IT departments.
And we haven’t’ even made it to the political lobbyists yet…
Canberra and Washington are called ‘swamps’ for a reason.
Consider the following facts
‘Up to a quarter of health care budgets in advanced health systems are wasted in funding a health administration sector’
12% – 18% of the private insurance bills that Americans pay out, go on administration of health services.
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.
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 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 upcoming out of pocket costs, individual hospitals success and failure statistics or how up to date hospitals technology is. They are not allowed to publicly comment on quality of their treatments or the amount of their medical bills.
Unknown to the public there is a vast library of data being collected on hospitals performances. It is all kept hidden from the very people who pay for health services with their taxes and insurance premiums.
Does all this sound like a bad deal?
That’s because it is.
So how do you cut medical bills and get a better service?
First, take an inventory of your health. Imagine you are a property inspector walking through a new property, checking off lists.
Be detached. And thorough.
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)?
The next step is really important. So listen carefully.
Take the time to search for a good quality family Doctor, that you can build a long term relationship with. Someone you can talk to honestly (about your sexual life, illegal drug use, family fights and bullying at work or school).
This is not the government clinic ‘5 minute tick and flick’ appointment. This is not the impersonal ‘I need a script from whom so ever is on shift today’ free service.
This is a private business (online or bricks and mortar), where the Doctor has a reduced caseload of patients and the time to spend talking with people talking about real life issues. And follow up their tests, come and see them in hospital, make sure mistakes don’t get made. And be honest with them when they pretend they are taking their meds, when in fact they are not.
For this, be prepared to pay out of pocket, either for one off visits or via a subscription service.
In America this is known as concierge medicine.
For all the rest of your medical treatments, demand as low a price for as high a standard as you possibly can. If you are not assertive, find a male in the family to advocate on your behalf.
You need to see a specialist? Have an operation? Or intravenous drugs? Either make the effort to travel all the way into a large inner city public 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. Doctors are often trained in Western Universities. Americans (with their insistence on good customer service) are a large clientele. And the nursing care is frankly better than at many Western hospitals, where patients can be left grubby and neglected, while university trained nurses spend their time at the computer.
Finally, go to my directory, look up the specialty that covers your disease or condition, and search for the best in health technology. Then contact the company and buy direct.
For diabetes look at apps with algorithms that predict future blood glucose levels or implantable devices that monitor glucose every 5 minutes and release insulin from an attached pump.
For stroke rehabilitation look at software that helps people learn to speak, virtual reality that helps them gain confidence and exo skeletons that helps them move their limbs again.
For stable but serious conditions consider an acute home nursing service like Intensive Care at Home or Chemotherapy at home.
What every your needs, I guarantee the health tech startup movement has created a solution. It’s just that most people don’t even know these services exist.
What politicians and bureaucrats aren’t telling you is that over priced hospitals, big spending government program programs and bloated insurance funds are on their way out.
The fact is, health spending is unsustainable at current rates. The combination of an ageing population, the collapse of many jobs to automation and artificial intelligence and skyrocketing health costs are a ‘perfect storm’.
If you start paying cash for healthcare now you will be ahead of the pack.
Start paying cash, for the services that you actually need now.
And I will feel that I’ve done my job.
© Wikihospitals February 2020
Illegal drug use in Australia – 2001 – 2016