Obamacare
was set up to have healthy people pay for the healthcare of sick people. It was
a bad deal for most Americans, so they voted for Trump. The US population is
325 million and the average cost of healthcare is $10,000 per year. The total
healthcare spending in the US in 2015 was $3.25 trillion.
50% of the
US population are healthy and only spend $264 a year on healthcare. They may
not even buy any health insurance or they might set up a pre-tax medical
savings account. They might buy a policy
that limits their exposure to catastrophic injury or illness, if it’s cheap
enough. They are happy to see the end of
Obamacare and look forward to cheaper insurance that is customized to fit their
needs. Obamacare was loaded with “one size fits all” unnecessary coverage and
nobody really needs that. Obamacare
The
sickest 1% of the population or 3 million people spend 25% of total healthcare
spending.
The
sickest 5% of the US population or 15 million people spend 50% of total healthcare
spending.
Medicare
was adopted because insurance companies couldn’t handle the high expense of the
really sick people and a lot of them are over age 65.
Medicaid
was adopted because insurance companies couldn’t handle the very sick who are
also poor.
Insurance
companies will have to return to offering policies for catastrophic coverage,
but the really sick folks will need to go somewhere. If they their premium
matches their medical bills, that premium could be $100,000 per year.
These are
the folks Congress is trying to figure out how to handle. These are the folks
who need to have their illnesses treated at a much lower cost. I would look at
the sickest 5% and put them in a reformed Medicaid program, cancel funding for
non-critical federal programs and transfer those funds to Medicaid block grants
to handle the sickest 5%. Many of these folks are in Medicare and Medicaid
already, but their treatment plans should be cost reduced.
There is a
lot of unnecessary costs in healthcare.
The healthy people don’t really need doctor’s visits and they don’t need
to get expensive screenings. Self-exams work fine.
Hospitals
are making an unnecessary fortune giving cat scans, MRIs, stress tests and
bouncing patients around to specialists. They do this as part of hospital
admission and don’t give patients a quote. Determining a diagnosis should start
with the cheapest test. Multiple diseases have the same symptoms.
Malpractice
lawsuits need to be replaced by complaints to County Medical Associations.
Defensive medicine needs to end.
Big Pharma
is gouging patients with unjustified costs of medicines needed for critical
care.
Pain
usually means inflammation and that is treated with anti-biotics. It makes more sense to get a doctor to
prescribe a $6 bottle of anti-biotics than it is to go to the hospital for
$40,000 worth of tests that don’t identify the problem.
Type II
Diabetes is treatable by the patient cutting meals in half to lose 30 lbs.
Hernias can be treated the same way by building up stomach muscles..
A
self-exam for breast lumps is cheaper than a mammogram. Taking eye vitamins is
cheaper than having cataract surgery.
Post-op
infections are common; they add to unnecessary costs and need to be prevented.
Non-targeted
radiation and chemo treatments have failed to save cancer patients. More
targeted treatments may work, but it’s too soon to tell.
The new
healthcare law needs to make providers quote the cost of treatment and quote
lower cost alternatives so patients can shop around.
Data Sources:
See Healthcare Cost Solutions, January 28, 2017 on this blog
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