Wednesday, January 27, 2016

Controlling Health Care Costs

HEALTH CARE COSTS

I believe the only way we are going to control health care costs is to put cost control in the hands of the patient.  “How can we control costs when we do not medical knowledge, the patient will ask?” The question is quite appropriate, but put your self in the doctor’s position.  He/she wants to please the patient and take good care of the patient and have a good reputation.  He will take more care in the ordering of tests and procedures if he knows the patient will have increased out of pocket expenses for whatever he orders.  Therefore the patient should tell the doctor that he wants to him to order whatever tests and procedures he thinks absolutely necessary, but to use his good judgment in the necessity for any test.  That information will be placed in the patient’s chart in case he is sued for failure to order certain tests.  I began medical practice in the 1960’s  before extensive insurance and Medicare.  I recall debating whether to order a $5 blood test because I knew the patient would have to pay and I wasn’t sure it would help in his care.

The  Government and the insurance companies thought they could control costs in the 1970’s by controlling hospital costs.  The patient would come in and say “hospitalize me Doc, my insurance will pay for it.”   Is that any different than saying, “order the test doc, Medicare will pay for it.”  When the patient does not have a role in controlling costs, costs will certainly increase.   

The Wall Street Journal published an article in the January 23, 2016 issue titled “Instead of ObamaCare :  Giving health care power to the people.”  The article was written by two independent investigators from reliable institutions located on both coasts.  The gist of the article was basically putting cost control in the hands of the patient through several different approaches.  Their suggestions are based on ObamaCare requiring all persons to have health insurance or be penalized by higher premiums if they do not have coverage.
To be continued on next blog



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