Part 5: The Path to Reform – Competition, Choice, and Patient-Centered Care

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As this initial series concludes, there are some serious challenges facing our healthcare system. The Medicaid cuts try to stop a problem and halt the Obamacare Affordable Care Act that would get Linda Richman from SNL Coffee Talk Faklempt, as it was neither Affordable, nor Care nor an Act!

There is hope for a more effective, affordable, system that restores physicians to the practice of medicine and adhering to the Hippocratic oath over insurance company denials and hospital and Private Equity monopolies. The solution is not minor course correction but a fundamental shift that restores competition, patient choice, and rebuilding the physician-patient relationship that is free from burdensome administration, corporate interference and misleading social media. Without this shift and restored enthusiasm for the next generation of physicians, the addition of so baby boomers will be a cataclysmic event.

Refocusing Efforts to the Core Mission: The primary goal of healthcare must be to enabling physicians to utilize their skills and knowledge to treat patients without bureaucracy and administrative burdens. The current system is over-regulated, and has turned healthcare to an impersonal interaction like a queue for customer service at your cable company from the patient experience and a miserable "factory" for the doctor who is reduced to an assembly-line worker with patients as the product. It also stops the physician from utilizing deductive reasoning and thinking out of the box to treat on their experience rather than run tests to satisfy some formula for their hospital grading system. Before this factory method, diagnostic testing was based on the human interaction and tests were not the first step before patient interaction. This paradigm must be reversed to prioritize individual patient care. At the same time, the modern patient intake form has expanded and is focused on irrelevant information. Your sexual orientation is irrelevant for a broken arm but its on the form.

Competition Built This Country And Choice can Restore Healthcare: With the hospital as the only game in town and single providers, higher costs and less client care is the result with reduced quality. Health care solutions must actively promote competition across the healthcare spectrum to:

• Dismantle Monopolies: Antitrust laws must change to dismantle the real monopolies. Otherwise we will have further consolidation. Some of these mega-systems need to be dismantled.
• Empower Private Practice: Regulation and administrative reform coupled with private practice initiatives should encourage and support independent physician practices and other lower-cost providers. These necessary changes will allow them to thrive while creating alternatives to large hospital systems. The private practice, if restored, can reduce ER intake, even in lower socio-economic communities. Private Practices must be given the right to collectively bargain for their fees (this includes the right to strike against an insurance company) and not be forced to resort to acquisition by a hospital to make their practices profitable with the sacrifice of their independence.
• Encourage Preventative Care: Too much emphasis is on treatment versus prevention, and insurance is structured in this manner. This systematic shift to preventative care will reduce the cost of long-term treatments.
• Expose Healthcare Prices while Promoting Transparency: Requiring true price transparency for all healthcare services would empower consumers to make informed choices to lobby for alternatives while fostering competition among providers. This is especially true for the Provider Tax that subsidizes hospital care.
• Reduce Regulatory Burden: Government regulation is not an invisible hand. It is a crippling noose that has stifled innovation and added significant administrative overhead. A streamlined regulatory environment would allow healthcare providers to operate more efficiently, reduce administrative costs, and focus more on patient care rather than compliance. This also means re-evaluating the provider tax system, which currently functions as a hidden tax on those with private insurance. The same is true for the FDA and bringing new cost-effective and preventative care treatments to the forefront.
• Restore Trust and Autonomy: Physician burnout is real and must be addressed along with new excitement to attract new talent to the profession. Efforts must be made to restore trust in the medical community (by reducing internet misinformation). Physicians need greater autonomy in how they practice; the robot practice must be eliminated to foster stronger patient-physician relationships, and ensure fair compensation to incentivize patient centered care that reduces total healthcare costs over KPIs and other institutional metrics in the volume-driven hospital models .

These Issues Are Beyond Partisan Gamesmanship: Healthcare affects all Americans and this bi-partisan divide must be eliminated. Diseases do not discriminate between Democrats, Republicans, and unaffiliated voters; they all get sick and need healthcare. The latest obsession with a 2% "Medicaid cut" is the red herring to distract the public from the real healthcare problems and the epidemics of disease plaguing this nation while patients are adversely affected by an overpriced, over-regulated, and a misdirected healthcare system that is anything but affordable. Why have healthcare costs gone up with no increase in patient outcomes. Economies of scale with mergers was supposed to reduce costs, but it hasn’t indicating that a free-market does not exist in healthcare.

It is time to move beyond partisan rhetoric and embrace market-based solutions that prioritize competition, choice, and patient well-being to build a truly healthier future for all Americans. There is the way out to a new system that puts patients first.

There is Hope.

According to a survey of physicians conducted by the Doctors Company a Nation Wide Physician Owned Malpractice Insurance Company, doctors still like medicine for the following reasons:

• Helping people recover from illnesses or injuries that have negatively impacted them (70%)
• The ability to solve complex and challenging problems (55%),
• Getting to utilize skills and knowledge that I worked hard to develop (52%),
• Working a collaborating with people who share the same passions as I do (43%)
• Getting to form personal connections with patients and their families(40%).

If physicians could focus on being doctors, if patients trusted their physicians, if medical care became more cost effective, if doctors could choose how they practiced, were fairly compensated and the bureaucratic noose around the medical profession were lifted we would have a better healthcare system.

• Part 1: The Medicaid Paradox – Growth, Costs, and Misleading "Cuts"
• Part 2: The Unjust Burden – How the Current System Fails Working Americans, Middle Class, Self-Employed and Small Businesses
• Part 3: The Monopoly Problem – How Consolidation Drives Up Healthcare Costs
• Part 4: The Human Cost – Physician Burnout and Dissatisfaction
• Part 5: The Path to Reform – Competition, Choice, and Patient-Centered Care

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