Healthcare: we're missing the point
The problem with the healthcare conversation in this country is the way we make presumptions about what it is and should be. First and foremost, medicine has become a profit center for large corporations and the super rich.
I heard a political pundit last Sunday suggest it's a problem that sick people are showing up at the doctor's office without healthcare insurance. There's never even a remote possibility that the patient might pay for services rendered. And that's a new dynamic that took hold in my lifetime.
In 1958, when my mother gave birth to my oldest brother, the doctor and hospital bills combined equalled two weeks' of my dad's salary. That reveals two major changes in medicine in the last half-century: costs have tremendously outpaced inflation and the patient-as-the-payer model is dead.
Secondly, health care professionals have resisted modern technology that would improve both the quality and accessibility of health care.
In the tech and statistical realms, we understand that the higher the granularity of collected data, the higher the resolution of the system or model.
There is no shortage of devices that can collect and store a patient's vital signs. Heartrate, blood pressure, respirations, temperature and other diagnostic information can easily be collected and studied by a patient (or family & friends of the patient) by devices and appliances that can and should be widely available to consumers.
The collection and storage -- and subsequent analysis -- of this data is not a complex thing, yet the established routine remains a personal visit to your doctor's office to establish these.
Imagine that. Someone under 50 years old sees a doctor maybe annually, and usually much less than that if he's a man. We rarely know what our heartrate is at any given moment and may only see blood pressure readings at the Walmart pharmacy while playing with their sphygmomanometer.
From a statistical standpoint, that's a pretty awful data sample.
With today's technology, people could potentially increase their awareness of their state of health to levels never before seen. I don't mean merely increasing vitals collection to monthly or weekly, but minute-by-minute.
Imagine pulling out your phone and opening your health monitor to see idiot-proof gages and alerts and trends based on your vital signs. Add the ability to to take high-resolution photos of areas of concern, sonograms and personal observations -- all over a period of time (showing changes) and you can begin to predict with much more accuracy the internal workings of a person's body.
This would undoubtedly modify one's behavior -- and provide invaluable diagnostic data to a health care provider, who now has access to a gold mine of information from which to assess and treat ailments. Together, between the patient's input, the collected data and the doctor's observations & expertise, a patient would then have the best possible chance for a positive outcome.
But today, we needed a President to tell the health care industry that they suck at record keeping and overall patient care. It takes a Supreme Court case to expose just how broken the health care industry is today. It takes people of a certain age to remind the country that it hasn't always been this bad.
I've always said that if Apple was in the health care business, everyone would carry a health monitor capable of managing their own health -- cheaper and more reliably.
Doctor's would always have an established baseline from which to judge the meaning of tell-tale changes in vitals. Patients would always be able to glance at the monitor and make more informed and objective decisions about their own health care needs.
There's a wealth of knowledge about the human body available to all of us and there's no good reason the health care industry should shroud this critical information and medicine-as-a-profession behind enormous pay-walls and bureaucratic bullshit.
How did this system get so badly broken? Easy. We let insurance companies transform medicine into a profit center. And they did so insidiously and gradually. Big Hospital and Big Pharmaceutical leveraged Congress to advance health care in a way that restricts access to only those doing business with the big pockets of big insurance.
It's one of the country's worst morale failings since slavery. Withholding medicine except to the highest bidder is legalized extortion, and the only ones that can stop it are too busy engaged in partisan bickering or playing video games.
If we use common sense and follow the money, we usually find out it's about money and greed. This case is no different.
I said that there's no good reason to shroud the health care system behind paywalls and bureaucracy, but there is a reason nevertheless. It's much more profitable to extort money from sick people, a dynamic facilitated by the insurance companies' promise to pay the bills for us.
Along with that promise comes sacrifice and a lawyer-rich environment.
We continue to see Washington trying to fix symptoms of the health care system, one of which is the litigious nature of the business and subsequent limits on lawsuits called tort reform.
There wouldn't be a need for tort reform if there wasn't this enormous pool of money from which to draw million-dollar settlements commonly referred to as "deep pockets".
You're starting to see how the insurance companies are at the center of the healthcare problem and issues surrounding it. Litigiousness is the symptom of the problem and the fix isn't restricting meaningful lawsuits. Washington politicians and lobbies know it, but none of them will ever want to talk about it.
The fix is insurance reform and rule changes for doctors and hospitals.
To fix health care in this country is to reform risk pool management and to force health care facilities to become transparent with patients with regard to their business and medical practices and policies.
I'm appalled at the restrictions placed on frontline health care providers -- the truly good-spirited, kind and giving souls we want to see greeting us in our hour of need. Doctors and nurses and technicians are the heroes, but have given way to impositions that restrict their ability to provide quality health care. It's practically unheard of to see a doctor that isn't bound by government regulations that enslave him to large corporations, like Big Hospital, Big Pharmaceutical and Big Insurance.
There was a time when the most important insurance decision you had to make was deciding whether it was worth letting your insurance company know all your health issues in exchange for having them pay your medical bills. Now there's no choice whatsoever; it's no optional but assumed that you have a health insurance plan -- and they get to make all decisions about what care they'll pay for.
And the government seems to have it out for you and your doctor. The clinic is stifled under the weight of regulations that make it difficult at best, not to mention very expensive, to meet all the legal criteria imposed on them. All of these compliance measures mean more employees and third-party vendors who specialize in government compliance consulting, drives up the cost of health care -- and drives many smaller practices out of business altogether.
There's no way you can tell me that today's restrictive health care environment is better for patient care under the current set of rules. There would be less suffering through better access and higher quality diagnostic methods and treatment and medications if we were truly on a level playing field.
Medicine is a field that should be occupied by caring, generous individuals who want to do good, reduce society's suffering and serve their communities.
The corporate tycoons that are driven by greed, whose only concern is enriching themselves over the good of patients' health, should be sent packing on their Leerjets to their private islands to die a horrible and lonely death.
Finally, if you fix the culture in a way that embraces Silicon Valley, you'll see product development in consumer-targeted medical devices and instruments skyrocket, which will give doctors and patience an incredible advancement in diagnostic medicine that will transform health care -- and human behavior itself -- in unimaginable ways.
I heard a political pundit last Sunday suggest it's a problem that sick people are showing up at the doctor's office without healthcare insurance. There's never even a remote possibility that the patient might pay for services rendered. And that's a new dynamic that took hold in my lifetime.
In 1958, when my mother gave birth to my oldest brother, the doctor and hospital bills combined equalled two weeks' of my dad's salary. That reveals two major changes in medicine in the last half-century: costs have tremendously outpaced inflation and the patient-as-the-payer model is dead.
Secondly, health care professionals have resisted modern technology that would improve both the quality and accessibility of health care.
In the tech and statistical realms, we understand that the higher the granularity of collected data, the higher the resolution of the system or model.
There is no shortage of devices that can collect and store a patient's vital signs. Heartrate, blood pressure, respirations, temperature and other diagnostic information can easily be collected and studied by a patient (or family & friends of the patient) by devices and appliances that can and should be widely available to consumers.
The collection and storage -- and subsequent analysis -- of this data is not a complex thing, yet the established routine remains a personal visit to your doctor's office to establish these.
Imagine that. Someone under 50 years old sees a doctor maybe annually, and usually much less than that if he's a man. We rarely know what our heartrate is at any given moment and may only see blood pressure readings at the Walmart pharmacy while playing with their sphygmomanometer.
From a statistical standpoint, that's a pretty awful data sample.
With today's technology, people could potentially increase their awareness of their state of health to levels never before seen. I don't mean merely increasing vitals collection to monthly or weekly, but minute-by-minute.
Imagine pulling out your phone and opening your health monitor to see idiot-proof gages and alerts and trends based on your vital signs. Add the ability to to take high-resolution photos of areas of concern, sonograms and personal observations -- all over a period of time (showing changes) and you can begin to predict with much more accuracy the internal workings of a person's body.
This would undoubtedly modify one's behavior -- and provide invaluable diagnostic data to a health care provider, who now has access to a gold mine of information from which to assess and treat ailments. Together, between the patient's input, the collected data and the doctor's observations & expertise, a patient would then have the best possible chance for a positive outcome.
But today, we needed a President to tell the health care industry that they suck at record keeping and overall patient care. It takes a Supreme Court case to expose just how broken the health care industry is today. It takes people of a certain age to remind the country that it hasn't always been this bad.
I've always said that if Apple was in the health care business, everyone would carry a health monitor capable of managing their own health -- cheaper and more reliably.
Doctor's would always have an established baseline from which to judge the meaning of tell-tale changes in vitals. Patients would always be able to glance at the monitor and make more informed and objective decisions about their own health care needs.
There's a wealth of knowledge about the human body available to all of us and there's no good reason the health care industry should shroud this critical information and medicine-as-a-profession behind enormous pay-walls and bureaucratic bullshit.
How did this system get so badly broken? Easy. We let insurance companies transform medicine into a profit center. And they did so insidiously and gradually. Big Hospital and Big Pharmaceutical leveraged Congress to advance health care in a way that restricts access to only those doing business with the big pockets of big insurance.
It's one of the country's worst morale failings since slavery. Withholding medicine except to the highest bidder is legalized extortion, and the only ones that can stop it are too busy engaged in partisan bickering or playing video games.
If we use common sense and follow the money, we usually find out it's about money and greed. This case is no different.
I said that there's no good reason to shroud the health care system behind paywalls and bureaucracy, but there is a reason nevertheless. It's much more profitable to extort money from sick people, a dynamic facilitated by the insurance companies' promise to pay the bills for us.
Along with that promise comes sacrifice and a lawyer-rich environment.
We continue to see Washington trying to fix symptoms of the health care system, one of which is the litigious nature of the business and subsequent limits on lawsuits called tort reform.
There wouldn't be a need for tort reform if there wasn't this enormous pool of money from which to draw million-dollar settlements commonly referred to as "deep pockets".
You're starting to see how the insurance companies are at the center of the healthcare problem and issues surrounding it. Litigiousness is the symptom of the problem and the fix isn't restricting meaningful lawsuits. Washington politicians and lobbies know it, but none of them will ever want to talk about it.
The fix is insurance reform and rule changes for doctors and hospitals.
- Absolutely no risk pool should ever be used as a profit center under any circumstance whatsoever
- Malpractice insurance should be abolished to eliminate frivolous litigation
- All risk pools should be tightly regulated and monitored by the state.
- All financials should be reported to the public on an ongoing basis, down to the individual claim (identified by number known only to the insured).
- There can be no criteria for coverage and absolutely no personal medical information can be supplied to a pool manager (insurance company).
- No health care provider can use coverage as pricing measure and all pricing must be published in clear and plain language, accessible by any prospective patient.
- Patient information is owned solely by the patient and cannot be released to any third-party or face imprisonment.
To fix health care in this country is to reform risk pool management and to force health care facilities to become transparent with patients with regard to their business and medical practices and policies.
I'm appalled at the restrictions placed on frontline health care providers -- the truly good-spirited, kind and giving souls we want to see greeting us in our hour of need. Doctors and nurses and technicians are the heroes, but have given way to impositions that restrict their ability to provide quality health care. It's practically unheard of to see a doctor that isn't bound by government regulations that enslave him to large corporations, like Big Hospital, Big Pharmaceutical and Big Insurance.
There was a time when the most important insurance decision you had to make was deciding whether it was worth letting your insurance company know all your health issues in exchange for having them pay your medical bills. Now there's no choice whatsoever; it's no optional but assumed that you have a health insurance plan -- and they get to make all decisions about what care they'll pay for.
And the government seems to have it out for you and your doctor. The clinic is stifled under the weight of regulations that make it difficult at best, not to mention very expensive, to meet all the legal criteria imposed on them. All of these compliance measures mean more employees and third-party vendors who specialize in government compliance consulting, drives up the cost of health care -- and drives many smaller practices out of business altogether.
There's no way you can tell me that today's restrictive health care environment is better for patient care under the current set of rules. There would be less suffering through better access and higher quality diagnostic methods and treatment and medications if we were truly on a level playing field.
Medicine is a field that should be occupied by caring, generous individuals who want to do good, reduce society's suffering and serve their communities.
The corporate tycoons that are driven by greed, whose only concern is enriching themselves over the good of patients' health, should be sent packing on their Leerjets to their private islands to die a horrible and lonely death.
Finally, if you fix the culture in a way that embraces Silicon Valley, you'll see product development in consumer-targeted medical devices and instruments skyrocket, which will give doctors and patience an incredible advancement in diagnostic medicine that will transform health care -- and human behavior itself -- in unimaginable ways.
