Health Care: Is there a solution?

06Oct09

Currently Medicare covers every senior citizen in the US, and medicaid covers those deemed impoverished. The Emergency Medical Treatment Active Labor Act mandates that any one having an emergency or in active labor must be treated.

If you query recipients of employer sponsored health insurance plans given the option of a PPO or an HMO most opt into the PPO plan. When asked why? Many will say that they don’t like HMOs (even though they may have never been in an HMO). Perhaps the knee jerk aversion to HMOs is that individuals do not want their freedom constrained. People by nature want the freedom to choose what they think is in their best interests.

Is there an answer to the US health care problem that does not stifle the freedom of choice?

As a board certified nurse practitioner who has worked in various settings ranging from inner city emergency rooms, homeless shelters, top 10 university academic medical centers, private practices, long-term care, military, critical care, trauma, home care, and occupational health I have been able to observe some of the very best and some of the very worst examples of health care.

In my opinion the answer to the health care problem in the US:

1) Deregulate the arbitrary rules that govern free market competition among health care. Human physiology does not change from state to state. Nurse Practitioners can practice independently in 15 states currently. NPs care for the sickest of the sick patients (the uninsured marginalized polysubstance abusing hospitalized patient). Study after study demonstrates that the care rendered by NPs is comparable to their physician colleagues. Any artificial argument that says this deregulation is not safe for patient care is not evidenced based.

2) Deregulate the artificial special interest rules that govern health insurance companies and allow open state boarder competition. Make the companies aggressively compete to insure patients and let patients hold the companies accountable.

3) Allow a similar contribution structure to HSAs (health savings accounts) as 401K and 403Bs. Incentive people to save for their health care just as we have create incentive to save for retirement.

4) A limit of medical expenses and lost wages should be placed on malpractice law suits. This will allow malpractice premiums to come down and allow more health care providers to practice in innovative care models which would decrease the cost of care to patients because there would be more medical providers. Medicine would be practiced in terms of best interest of the patient and not for the primary¬† purpose of reducing risk liability. If patients were connected to the health care dollars they spend I’m sure there would be less frivolous use (calling 911 for a ride to the hospital for non emergent problems, going to the ER for routine primary care, demanding advanced tests that are not clinically warranted) of the health care system.

Before we as a nation implement a sweeping change that may alter our individual freedom with respect to health care which would then spill over into anything that may remotely affect our health– Let us implement these conservative measures and assess the change. We can always become more liberal, aggressive etc.

In medicine we are charged to first do no harm, and then do good, and if you can’t do good, then at least do no further harm.

views expressed are those of Raymond Zakhari The Adult Health Nurse Practitioner Of New York, LLC. Taking the hassles out of going to the doctor, and empowering patients to make prudent health care choices.



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