Heath care Debate

There is no doubt that if you're reading this, you know of the debate that is taking place all across the country that centers around the issue of health care. This was one of President Obama's promises while campaigning, that he would reform health care. There are quite a few areas that are being looked at nationally, and I'm going to look at a few of them here.

The first topic we should look at is whether or not there should be reform. Lets call reform change, because reform sounds to me like Washington mandating something, and change can come from anywhere. I am of the opinion that there needs to be change. We in America spend way to much on health care as a dollar amount and as a percentage of GDP (Kudos Planet Money). This makes sense, because we have the most disposable income, after food, clothing, housing, etc. We also have the best health care system in the world. We have the best doctors, and the best hospitals, but for some reason we need reform/change.

For all the money we spend we aren't the most healthy people. Nearly 2/3 of American Adults are overweight or obese. We don't have the longest life expectancy, which I would hope for, since we are spending the most money per person (by a lot). Therefore, we must have inefficiencies. Lets explore some of these.

Medical technology is great, but expensive. From anecdotal experience however, "best" technology may not be the most VALUable. (emphasis on value) One test may offer the best results, but if it costs 3 times the next option does the extra value pay off for the cost? This is not always taken into consideration. Here is why...

There is a gap of knowledge between the service providers and the patients. When my doctor comes in and makes a recommendation I really have to trust it. They are probably suggesting what they think is best, but do they consider what is the best value?

The second gap is from the doctors to the office manager, or whoever charges the invoices and bills the patients. Most doctors do not know exactly what a procedure, or a perscription costs so while they are perscribing what is in their opinion best, it may not be the best value. I know I keep bringing up that phrase value, but that is because in every other economic decision we make we consider what we are getting for our money before make the purchase. This is not always true in medicine.

The third gap is from the office manager to the patients. I know I have had procedures done and not known what they cost before I recieved the service. For example, I was rushed to a hospital for a phantom head injury. As it turns out, I probably didn't need an ambulance. At the end of the day the bill was north of 10,000! Had I known it would be that much for the ride in the big truck I would have just got a limo, and it would have been around $200. But seriously, if I would have known how expensive that adventure was going to be, I would have looked for another alternative.

The fourth gap is from the people paying for the serivce and the people recieving the service. Contrary to what you may have heard on the news, most Americans have insurance. We pay some out of pocket but for any serious event an insurance company picks up the rest. For most people, after the first 3-5k we pay a small percentage of the rest of the bill. This is a bit like when little Susie has daddy's credit card at the mall. The shoes are a NEED when she spending someone else's money.

These are the 4 main areas I see as a big part of the problem. The system we have now does not appropriately allow price to adjust our decisions.

I don't know how to fix the system, but I do agree we need change. However, if I can make a recomendation, it would be that we try and find a way to close these 4 information gaps between the parties involved.