Using the Lessons from LASIK, (that I discussed in Part 1) the existing medical system must be redesigned so that it fosters competition, enables consumerism, empowers capitalism, and engenders compassion.
Our existing healthcare system is anything but competitive or consumer-driven. Doctors and hospitals almost never publish rates for common procedures and the consumer has no economic interest in demanding such information.
Today I spoke with a friend of mine who relayed a story about a man who recently spent twenty-four hours in an emergency room at an astounding cost of $45,000. When he demanded that the hospital justify the fees he was told, “Why do you care, you are not paying the bill!” That question just irritated him even more so he kept pressing and questioning the various fees until the bill dropped to $15,000, one-third of the initial fees. He found blatant errors and charges for services he never received. For example, he found that he was being charged $8 for each pill of Tylenol!
Folks, I believe that this same situation repeats itself over and over throughout our healthcare system. No wonder healthcare costs have risen at two times the rate of inflation.
Our healthcare system must be restructured so that it fosters competition, enables consumerism, empowers capitalism, and engenders compassion.
When an established system is restructured, the changes will affect every “stakeholder”--everyone who has an interest in the present system. Unfortunately, most of the stakeholders
will naturally want the present system to remain as is. Resistance to change is innate, especially when billions of dollars are at stake. Nevertheless, the patients, the true stakeholders and “constituents” must demand substantive changes that reinforce the four key principles outlined above.
Significant Change #1—The Creation of a “Medical Fiduciary”
If you experience a significant medical emergency, such as a car accident, there are quite a number of medical professionals that will come to your aid. The ambulance and its medical team take you to the emergency room where the staff admits you, nurses care for you, doctors
examine you, and lab techs take x-rays and run lab work. Very quickly the insurance company also becomes involved by reviewing the case and approving or disapproving treatments.
Within hours, literally, dozens of people from many different establishments become involved in caring for you and yet not one of these medical professionals is legally required to look out solely for your best interests. I am not implying that none of these people are caring individuals. Many doctors and nurses are very compassionate professionals. However, none of them are legally required to look out solely for your best interests. We have come to accept the fact that insurance companies, hospitals, hospital staffs, and even doctors, while they do care for the patient, are ultimately most concerned about their own profitability, not the patient’s care. In our healthcare system, no one is legally responsible for looking out solely for the best interests of the patient.
A fiduciary is someone legally charged with looking out for the best interests of someone else. For example, Trustees of 401(k) plans are legally charged with solely looking out for the best interests of the plan participants and no one else. The decisions the 401(k) Trustee makes, whether it involves the plan’s investments or various service providers, must solely be in the best interests of the plan participants.
The establishment of a Medical Fiduciary – someone legally required to look out for solely the best interests of the patient/client – will dramatically change medical care dynamics. I envision that such a Medical Fiduciary would be legally required to assist the patient in:
- Finding the best medical care at the best price,
- Evaluating the patient’s medical needs and treatments,
- Selecting the appropriate insurance coverage, and
- Challenging any unnecessary and wasteful procedures and financially sharing (along with the patient/client) in a percentage of the savings derived through such assistance.
Any Medical Fiduciary must of course have an extensive medical background and would need to be a doctor or a Physician’s Assistant. I believe that the person most naturally fitted to this position would be the patient’s Primary Care Physician.
The creation of a Medical Fiduciary would be revolutionary to our healthcare system; would constitute a potentially lucrative career; and would drive down healthcare costs while improving the healthcare of the patient/client.
But that is only the first of my recommendations.
To be continued…