Monday Links

Posted on by John C. Goodman

Euthanasia in Canada: are doctors and health workers talking patients into it?

Japan to young people: drink more alcohol!

Hospitals say they need more money – their patients are “sicker.”

The federal government gave state and local governments almost $1 trillion to offset the effects of Covid. What difference did that make? Not much.

Stats from UK: Why are there so many non-Covid excess deaths? (They may even exceed Covid deaths.)

1 thought on “Monday Links”

  1. Most people want quality health care at a reasonable cost. I have a solution to high medical care costs. Have people pay directly for their medical care. Empower-Patient Accounts would allow people to do that.
    The government now forces us to buy all medical care through third parties, which is very profitable for third-party payers but makes health care expensive. Third-party payers come with onerous documentation requirements, extensive coding and billing expenses, and extensive regulatory requirements. This adds considerable cost and leads to provider burnout. Much of this would go away if people paid directly for their basic primary medical care.
    Larger systems can afford the fixed costs of regulation whereas smaller medical care entities cannot. This forces small clinics to merge into larger systems. Larger medical care facilities with regional dominance are then able to raise prices without fear of competition. Empower-Patient Accounts could reverse this inexorable trend by allowing patients to pay their primary care providers directly.
    Morra, D; Nicholson, S, et al in an August 2011 article in Health Affairs on what U.S Physician Practices Versus Canadians spend interacting with payers found that that the average physician spends an average of $82,975 interacting with health plans. A lot of this is through the expense of prior authorizations for drugs. Much of this cost would go away if people had Empower-Patient Accounts that allowed them to pay directly for drugs and primary care.
    Robert Kocher, in a 2013 Harvard Business Review Article, “The Downside of Medical Care Job Growth,” showed that from 1990 to 2012 medical care workers had increased by 75 percent, but 95 percent of that growth had been non-provider workers. The ratio of support staff in medicine had increased to sixteen support staff per physician. The median cost per doctor of non-doctor expenses averaged $823,000 per physician in 2013. Much of this cost would go away if people had Empower-Patient Accounts and could pay directly for their primary care.
    How could Empower-Patient Accounts (E-PA) be funded? States could fund basic E-PA, but it would be hard for states to fund them. My suggestion is that the federal government could give states block grants to help states fund E-PA for their residents. States could apply for federal waivers that by setting up E-PA so people could pay directly for preventive care and primary care.
    Direct Primary Care (DPC) is a way to give people unlimited access to primary care at reasonable rates. The E-PA should be funded so people could afford DPC, though people should not be limited to just paying for DPC. Some might use E-PA to pay deductibles. Others for low-cost drugs.
    I go over how this could reestablish a medical care market and drive health care costs down in my recently released book: Empower-Patient Accounts Empower Patients! This could start to remove the burden of the cost of health care from employers, reduce health and financial disparities, lower personal and national medical care expenditures, and might even improve people’s health behaviors.

    Reply

Join the conversation.