Response to “Top 5 Reasons Healthcare is Broken” on ZDNet News

The current Healthcare Debate has the potential to be the most important issue of our generation.  For good or bad this legislation will affect all of us for the rest of our lives and the lives of the generations after us.  This post is a departure from our usual posts, however, I read a blog article by an online insurance broker writing on ZDNet News giving his top 5 reasons why our healthcare system is failing and given the timeliness of the issue I felt inclined to respond.  His points are in quotes and italicized.

1. “The current system is set up to reward sickness. Doctors get paid when you see them. And you only see them when something’s wrong, right? Hospitals get paid when someone gets injured or is sick. Pharmaceutical companies make outrageous profits when their drugs are prescribed (and they lavish gifts worth more than your annual salary to the doctors who prescribe the most…see #5). Insurance companies take in more money when there are more sick people to cover. Everything revolves around us being sick.”

The current system doesn’t “reward” sickness.  I can’t imagine a cancer patient feeling rewarded.  More likely they feel  grateful for the excellent care their insurance covers and the second chance at life.  Our current system, unfortunately does not reward good lifestyle choices (see #2).  The coverage for well visits is weak at best.  It is true doctors as well as hospitals get paid when we are sick. I don’t know of a single doctor that would not welcome the chance to consult with a patient regarding preventative medicine.  Preventative care saves a ton of money in the long run and improves the public’s productivity by keeping people well, out of the hospital and in the workforce or school, home, etc.

Who is to say a profit is outrageous?  Profits are necessary to fund future medications, medical devices etc. that solve health problems that treat your family, my family, everyone.  Without a profit a drug company has no money to fund research, donate their product to the needy etc.  Regarding lavishing gifts on doctors to prescribe their meds worth more than an average citizen’s yearly income is an inflammatory statement with no basis in fact that makes the public’s blood boil, and for good reason I might add, but it has no substance.  Many years ago I would not doubt some degree of this went on.   To say or imply that “pay to prescribe” is now or was in the past a common, everyday practice that most, if not all, docs were involved in is to irresponsibly inflame the debate.

2. “We are killing ourselves. Our choices bring on diabetes, heart-attack-inducing high blood pressure and cholesterol, obesity, chronic illness, and the like. We eat crap. We supersize it. We consider the walk from the parking lot to our office exercise. We only see the doctor when we get sick.”

I agree here, however, we don’t need to nationalize healthcare to solve this problem.  We need to reward people for making the right choices. We also need to educate people that the choices they make directly influence their well being and future financial health.  Heathcare costs could be cut tremendously through educated lifestyle changes.

3. “Tens of millions of healthy people choose not to pay for health insurance, putting the financial solvency of the system at risk. This leaves those that do pay into the insurance system paying more. The concept of insurance is to spread the cost so that when you need help, you are not buried under steep bills that you could not possibly afford to pay back. So those who opt out are cheating everyone else. Including, probably, their own family and friends.”

I’d have to agree here that when healthy people opt out it does make the premiums higher for everyone else, however this is America and they do have that choice.  What those individuals should not be able to do is should they find themselves in a health crisis and now expect the U. S. Taxpayer to come in and bail them out because they decided to go bare and not insure themselves or their family.

We need a true high deductible, insurance plan that people can purchase as a fall back option so that in the event a family or individual has a health catastrophe, that event does not bankrupt the family or force them to become a burden to the state.  I have found that there is not a wide enough difference in premium between the high deductible plans and normal insurance to make high deductible insurance a currently viable option for most families or individuals.

4.  “Big Healthcare, i.e. pharmaceutical companies, hospital networks, insurers and their support industries, spend hundreds of millions each year lobbying Congress to make sure there are not major changes to the business structure we call healthcare.”

Yes, every company in every industry lobbies Congress wishing to impose their view whether those views are for philosophical or financial reasons.  Nearly every organization from the NAACP to the NFIB (National Federation of Independent Businesses) is trying to influence congress.  Everyone is afraid of change, because we feel the change may be worse than the current method.  There are also many organizations that do not have a financial interest in this debate that are also trying to impart their will on this legislation.  Like or not this is our system and we should not fault companies, individuals or organizations for trying to get their voice heard.  Everyone wants to be heard and everyone has a right to be heard.

5. “Doctors are rewarded for prescribing drugs. Big pharmaceutical companies are known to hand out “consulting agreements” worth more than your annual salary to doctors who prescribe their drugs like candy.”

Maybe in 1980 some docs were paid to be consultants.  I’m sure Big Pharma does employ some physicians as consultants that give lectures and those consultants must and should disclose that they are paid to consultant or lecture on behalf Brand X Pharma Company.  Even if the consulting docs let their consulting obligations influence their prescribing habits the number prescriptions these doctors write is minuscule compared to all of the prescriptions written by the tens of thousands of other docs.

Doctors prescribe the best medication for the patient.  We want a medication with the fewest side effects, lowest resistance and that promotes good compliance that will treat the patients problem quickly and effectively.

For this practice to be widespread it would have to be like the secret too big to keep.  Psst “did you know Dr. S is getting $60K per year from Brand X Pharma?  Yeah, I know his receptionist, she says he bought a boat with it”.  Big Pharma doesn’t have enough money to do this.

So there you have it.  We need reform of our healthcare system, without a doubt, however rushing to accomplish this rapidly, as is the current plan, will cause us to be saddled  with a suboptimal solution for which generations after us will have to deal with the circumstances.

3. “Tens of millions of healthy people choose not to pay for health insurance, putting the financial solvency of the system at risk. This leaves those that do pay into the insurance system paying more. The concept of insurance is to spread the cost so that when you need help, you are not buried under steep bills that you could not possibly afford to pay back. So those who opt out are cheating everyone else. Including, probably, their own family and friends.”

I’d have to agree here that when healthy people opt out it does make the premiums higher for everyone else, however this is America and they do have that choice.  What those individuals should not be able to do is should they find themselves in a health crisis and now expect the U. S. Taxpayer to come in and bail them out because they decided to go bare and not insure themselves or their family.

We need a true high deductible, insurance plan that people can purchase as a fall back option so that in the event a family or individual has a health catastrophe, that event does not bankrupt the family or force them to become a burden to the state.  I have found that there is not a wide enough difference in premium between the high deductible plans and normal insurance to make high deductible insurance a currently viable option for most families or individuals.

4.  “Big Healthcare, i.e. pharmaceutical companies, hospital networks, insurers and their support industries, spend hundreds of millions each year lobbying Congress to make sure there are not major changes to the business structure we call healthcare.”

Yes, every company in every industry lobbies Congress wishing to impose their view whether those views are for philosophical or financial reasons.  Nearly every organization from the NAACP to the NFIB (National Federation of Independent Businesses) is trying to influence congress.  Everyone is afraid of change, because we feel the change may be worse than the current method.  There are also many organizations that do not have a financial interest in this debate that are also trying to impart their will on this legislation.  Like or not this is our system and we should not fault companies, individuals or organizations for trying to get their voice heard.  Everyone wants to be heard and everyone has a right to be heard.

5. “Doctors are rewarded for prescribing drugs. Big pharmaceutical companies are known to hand out “consulting agreements” worth more than your annual salary to doctors who prescribe their drugs like candy.”

Maybe in 1980 some docs were paid to be consultants.  I’m sure Big Pharma does employ some physicians as consultants that give lectures and those consultants must and should disclose that they are paid to consultant or lecture on behalf Brand X Pharma Company.  Even if the consulting docs let their consulting obligations influence their prescribing habits the number prescriptions these doctors write is minuscule compared to all of the prescriptions written by the tens of thousands of other docs.

Doctors prescribe the best medication for the patient.  We want a medication with the fewest side effects, lowest resistance and that promotes good compliance that will treat the patients problem quickly and effectively.

For this practice to be widespread it would have to be like the secret too big to keep.  Psst “did you know Dr. S is getting $60K per year from Brand X Pharma?  Yeah, I know his receptionist, she says he bought a boat with it”.  Big Pharma doesn’t have enough money to do this.

So there you have it.  We need reform of our healthcare system, without a doubt, however rushing to accomplish this rapidly, as is the current plan, will cause us to be saddled  with a suboptimal solution for which generations after us will have to deal with the circumstances.

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