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    Here’s the answer to fixing healthcare

    Editor's Note: Welcome to Medical Economics' blog section which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with Kumar Yogesh, MD, a practicing independent physician in Dresden, Tennessee. He is join in this blog by his daughter, Niti Yogesh, PA-S, a physician assistant student at Bethel University. The views expressed in these blogs are those of their respective contributors and do not represent the views of Medical Economics or UBM Medica.

     

     

    to come up with any meaningful changes in Obamacare. Honestly, it does not break my heart because I'm very much doubtful that the new law would have made any difference anyway. Basically, what they were trying to do was an insurance reform (not a healthcare reform) which is a quagmire created by politicians themselves.Dr. Kumar Yogesh

    America is the most powerful and free nation in the world. It is a fact that our doctors are the best in the world and our nurses are the most competent and caring group of professionals in the world. The quality of healthcare that every American receives is unmatched anywhere else in the world.

     

    RELATED READING: Is healthcare a collective right or individual privilege?

     

    Despite these facts, why is our healthcare system being mismanaged?

    There are two answers:

    1)    Involvement of the government and insurance companies.

    2)    Ourselves. Including the people and physicians.

    The three most important groups involved here who have the most to lose or the most to gain are:

    1. Patients: This group includes all 325 million of us in America. Democrats, Republicans, independents, moderates, Libertarians and all others.

    2. Doctors: Approximately 800,000 or more. Democrats, Republicans, independents, moderates, Libertarians and all others.

    3. Nurses: Approximately 2,500,000 or more. Democrats, Republicans, independents, moderates, Libertarians and all others.

    4.  

    IN CASE YOU MISSED IT: 'Willful neglect' of Obamacare is unsafe and unacceptable

     

    I have been told by senior physicians that in the early 1900s until the mid-1960s, doctors were very well-respected community members and medicine was truly a noble field. Since the mid-60s, with the inception of Medicare and the American Medical Association-created CPT system, things went downhill. Maybe we did allow ourselves to be commercialized and be controlled by the government and insurance companies rather than remaining true custodians of our patients.

    Next: "We have failed by being so passive"

    Kumar Yogesh, MD
    Practicing physician at Dresden Family Clinic for 24 years. Owner of practice, self-employed physician, medical director.
    Niti Yogesh, PA-S
    Physician Assistant student, Bethel University, anticipated graduation May 2018.

    6 Comments

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    • [email protected]
      The fundamental problem to healthcare is three-fold: 1. getting someone who needs healthcare (usually not that difficult), 2. getting someone to provide that healthcare (given schooling, facilities, regulations, etc. a much-more difficult situation, but one we've mastered), and obtaining the medium of exchange (usually money, seemingly the most difficult part). Insufficient money is causing the healthcare problem. Lacking money (disposable income), we get the argument "healthcare is a fundamental right". It is a right in so far as you have a right to be treated for a medical problem; you cannot be refused, a priori, healthcare. But, the patient lacking sufficient money to pay for treatment means compelling someone ELSE has to pay. It's really that simple. Since compulsion has become a common currency in politics and governing today, the logical solution to the delivery of healthcare services is to compel all parties who could potentially provide these services to provide them ... free. Should the people who could provide these services resist, we will need to accompany each patient requesting healthcare services - who can't (or refuses) to pay - with an armed healthcare agent who will see to it that the services are appropriately offered and delivered. This would be a faster, more efficient method than attempting to institute costly, confusing and unreliable insurance systems funded by unwilling and evasive taxpayers way down the revenue chain. You may have a "fundamental right to healthcare", but, you do not have a "fundamental right" to compel ME (or anybody else, or the Government) pay for it. Until healthcare,the ethical problem, is solved, healthcare, the political problem will never be solved. Steve Reade.
    • UBM User
      I definitely agree that insurance companies should NOT dictate what doctors should or should not do. They dictate this by paying the payers. They are getting wealthier and wealthier because they depend on corruption for their business. Definitely, the fee for service is excellent; the problem patient cannot afford it. Insurances should not be the ones to dictate policies, even though they are the payers. Also, there are any business prople, not physicians, involved in the whole medical fields. Their objective is only one thing "to get wealthier and wealthier", on the expense of the poor patients who cannot afford treatment. I still want to have the government involved, specially for those unfortunate and poor civilians who cannot afford treatment. I had a 40-year old in my office (I am an employee), who could not afford the insurance given by the employer. She had breast cancer, and I worked hard to get her assistance from the government. Thus I think the government has a role, but insurances should NEVER have a role or to dictate how physicians should practice medicine. We still can use the ICD and CPT, though.
    • [email protected]
      I agree with Pogo: "I have met the enemy and he is us." I have watched the degradation of the medical profession over the past 35 years. I have always been involved in organized medicine and ongoing contact with my elected representatives over that time span. I believe the third party must be removed from my examination room. If what I do now adds no value to the patient, it needs to go. I agree with the suggestions in this article. I would add direct pay practice, where I work for the patient, not a government or insurance company bureaucrat.
    • [email protected]
      I totally agree. So much of the cost of healthcare is spent on policies not likely to improve healthcare, but rather to enrich insurance companies, government bureaucracy and the pharmaceutical industry. As a result, we have to jump through hoops just to be reimbursed at a ridiculously low "negotiated" rate. The reimbursement idea presented in this article is excellent and simple. It is time we physicians stepped forward and demanded an end to the present highly inefficient system.If we do not help ourselves who will? Also, we must insist on being referred to as physicians as had been the case for centuries and not "providers.
    • [email protected]
      I totally agree. So much of the cost of healthcare is spent on policies not likely to improve healthcare, but rather to enrich insurance companies, government bureaucracy and the pharmaceutical industry. As a result, we have to jump through hoops just to be reimbursed at a ridiculously low "negotiated" rate. The reimbursement idea presented in this article is excellent and simple. It is time we physicians stepped forward and demanded an end to the present highly inefficient system.If we do not help ourselves who will? Also, we must insist on being referred to as physicians as had been the case for centuries and not "providers.
    • UBM User
      My idea is to put control into the hands of those who deserve it: the patients and the doctor of their choice. Services would be priced by free market forces. A single payer system would reimburse services at a cost-based minimum. The physician would then be permitted to charge above that level on case by case basis whatever supplementary fee required to keep up with demand. Physicians can and must have the necessary autonomy to advocate for themselves by providing high quality services to the people they advocate for - the patients. This reasonable arrangement would be driven by freedom of choice. Price discovery would be based on reality, not fantasy. Alconcerned Americans should demand high quality medical services at ther true cost and not arbitrarily determined by the machinations of solely profit driven elite. We can restore fair and affordable health care if we continue to demonstrate why the current system is bad for the health of this country. That there is a health and financial alternative to the current system of wealth stripping that the business and political elite have imposed upon us. Their goals are The usual: wealth and power. The more they take from the people the more they will suffer. They are not interested in anyone's health, their own likely included. These special interests have failed the people si we must continue to press for really meaningful change. Otherwise our nation will be bankrupt- and unhealthy.

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