The GOP Healthcare Bill - The U.S. Senate Version (Part 2)

The GOP Healthcare Bill - The U.S. Senate Version (Part 2)

Why can’t we fix U.S. Healthcare?

The biggest problem with the healthcare bill submitted by the Republicans in the U.S. Senate is that they have not tried to fix the same problems the Democrats were unable to fix in Obamacare.

They have all focused-on insurance – not cost, quality of care and/or price transparency. We in the U.S have only begun to scratch the surface on the use of technology. Plus, there is no patient or consumer influence in the healthcare marketplace – NONE!

Sky-high prices are what makes dealing with healthcare a national problem. This issue becomes more acute with tax-restrained federal and state budgets. The single largest state budget item in my home state of Florida is healthcare. Healthcare accounts for 32% of the entire $82 billion annual budget. You can forget public safety, education, infrastructure, etc.

The key buckets of healthcare costs are hospitals at approximately 32% of healthcare expenditures, physicians approximately 16%, other (which includes nursing homes, research, durable medical equipment, diagnostics, home care, et al) at 15%, and pharmaceuticals at approximately 10%.

The problems not being addressed are high prices, ineffective and inefficient care, and the lack of coordination between providers.

The Affordable Care Act (ACA) expanded insurance coverage primarily by paying for it directly and/or by the emergence of high-cost, high-deductible health insurance. Therefore, people have health insurance and access to care that they still can’t afford. Most people don’t have $5,000 to pay for unexpected medical emergencies. Sadly, healthcare cost is listed as the number one reason for most bankruptcies in the United States.

It’s not that we spend money to see our doctor; the facts show that we see our physicians less frequently than all other developed economies. Americans visit their doctors an average of four times a year versus 7.7 times in Canada and 6.44 times in France.

Our hospital admission does not vary much from those same developed countries; however, hospital cost in the United States is higher.

We are not advocates of price controls; we are very much in favor of free-market dynamics. These can and should include the bulk purchasing of products and services by government agencies such as Medicare and Medicaid. Additionally, we should be paying those same Medicare and Medicaid medical providers more to keep our citizenry well. Accountable care organizations or ACOs, as well as MSOs and PSNs are helping, so are managed-care companies.

For the 155 million Americans that receive healthcare coverage at work, and the 22 million Americans that have individual coverage, we need better solutions. Putting more control and demands in insurance companies alone is not practical, even though they know the most about controlling cost and improving the care to the members.

Without confronting costs and better allocation of medical and financial resources, we don’t believe there will be effective transformation in healthcare.

Healthcare can be fixed without higher costs by putting patient care first, taking advantage of the technology that is available to coordinate better care, improving patient control and access to their medical and financial information, and finally a relentless drive for a fully transparent healthcare pricing model. This is the only solution – not thinking we can fix healthcare by controlling healthcare insurance markets. Trying to fix healthcare by addressing insurance markets alone simply masks the real problems. We can either mask the problem or treat the disease.

– Noel J. Guillama, President