based on having 2 kids, dealing with a few surgeries my wife has had, and a bunch of ER visits here are my practical ideas:
1. Remove stupid and costly ER policies
There is an ER by my house that has a policy that anyone that comes into the ER gets an IV automatically, unless you tell them no. Most people don't say no. How much does that needle cost, the bag they hook up, the nurse's time,etc. I'm pretty sure most people don't need a freakin IV.
2. Stop unnecessary procedures
There seems to be a C section epidemic in this country. As a witness to 2 natural births, and one at home, I'm pretty sure this C section thing is out of control. We have the highest C section rate of any industrial nation. Its really bullshit, and its not hard to figure out how it happened. Doctors and the hospital make a ton more money from surgery, than letting nature take its course. The human race has existed for at least 6000 years (probably more, depends who you ask), without surgery to get babies out.
I'm sure C sections are just one of a bunch of unnecessary procedures going on. I know in some cases they are needed, but shouldn't be more than 12-17%, not more than 50%.
3. Fix our diets and bad habits
Obesity, diabetes, heart problems, etc, etc, etc,. I blame is all on the corn lobby, we are addicted to high fructose corn syrup and processed foods. Its killing us.
I know this idea won't be popular but because we Americans want our cake and eat it too, but maybe premiums need to take into account your behavior and charge accordingly, much like auto insurance works. You smoke you pay more, you are overweight you pay more, you exercise you pay less, etc. There needs to be some personal responsibility for health, seems like a cost structure like this might go some way towards addressing the issue.
4. Stop charging for crap I didn't even get, or $40 for aspirin
We got billed for an episiotomy that wasn't even performed with our first daughter, and what's up with $40 aspirin when you are at the hospital.
5. Fix our medical schools or whatever they hell is culturally wrong with how we deliver care
I may have read one too many andrew weil books, but this guy makes a lot of sense to me. The way we treat people is just insane, we probably have a lot to learn from eastern medicine. No one is talking about how the doctors suck, its all about the insurance companies. But IMHO, most doctors suck. They often don't listen, want to just prescribe medicine, or surgery. The body is the best healer, the role of medicine should be to let the body do its job better. Really they need to get out of the way more often. Whatever happened to "do no harm". One procedure leads to another, one drug side affects treated with another. Its totally insane.
6. Remove the employer/employee thing in health care
Everyone wants choice right? Well lets stop letting employers make our decisions for us. I should get a pool of money from my employer in which I'm free to use with any insurer I choose. We should be able to shop around for insurance like we do for car insurance. This needs to be universal, no more gov't or unions or anyone negotiating special deals for their people. Everyone has choice. You want expensive plan for everything, fine you pick that. You want a program that specializes in preventive care or eastern medicine, fine you pick that. This would force the companies to be competitive beyond what any public option could do. It would also spur diversification in the insurance offerings out there and shitty companies that drop coverage when you are sick, or wont pay would go out of business, because people would drop them, instead of the other way around.
7. Force the medical community to either regulate themselves or somehow regulate them better
This would probably help with #1, 2, and #4. I've read 5% of the doctors are responsible for 85% of the malpractice law suits. So Tort reform maybe, but if we just get rid of the bad apples problem solved.
8. Put some incentive behind doctors actually fixing your problems
Right now the more procedures, tests, drugs, a doctor gives you the more they make. There needs to be some way to encourage doctors to actually address problems efficiently. I'm not really sure how this would work, I think single payer countries like France do it. There's got to be someother ways to do it without a single payer system.
Now I know I haven't addressed the un-insured thing, but I'll let the big boys figure that one out.
