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Cheerio Part 4: How to improve Healthcare in the U.S.

7/31/2019

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  Having studied economics academically in undergraduate and graduate courses, then living and helping clients through the economics of U.S. Healthcare system through many surgeries and healthcare issues, I would offer the following adjustment to the U.S. Healthcare system.
  1. Everyone would contribute to a Health Savings Account (HSA) of at least $5,000. maximum each year for each individual (adult and child) up to a maximum of $25,000. for a large family. These accounts would be mandatory and would be tax deductible and tax free. There would be tax deductions for anyone making matching contributions to these HSA accounts, including corporations that now contribute to health benefits. These accounts could “roll over” the balance of the accounts every year and into retirement. These monies out of the HSA accounts could be utilized for not only current post health care but also preventive care and “well-being” items (smoking cessation, weight loss help, gym memberships, etc.) These accounts could be invested in conservative or balanced investments only after 50% of the account stays in cash.
  2.  Make health insurance only “catastrophic care” and kick in only when a healthcare cost is above $5,000 per person or $25,000 per family per occurrence. All smaller costs would be paid with an HSA debit card and at discounted fees/prices by the healthcare provider. All costs would have to be posted and given to each patient before any care. This way patients could “shop” and “compare” costs for minor health care issues (sinus/allergy issues, vaccines, annual medical exams, etc.)
  3. All minor health issues could be completely handled by a Physician’s Assistant who doesn’t have to attend medical school as long or as expensive as a full medical doctor.
  4. No health procedures, except emergencies, could go forth without a full declaration of cost before the procedure is started. The patient must be included back into the cost equation as many health issues are not life threatening and should be shopped and compared.
  5. Competition must be added back into the equation of healthcare decisions. When was the last time you knew how much a non-emergency procedure, major healthcare process or hospital stay cost before you had that healthcare procedure? Cost and value should be put back into healthcare.
  6. Quality of care, along with cost, must be quantified and qualified and published for all potential patients before they need healthcare. A uniform rating system must be instituted for all facilities and healthcare providers. This should not be kept by a government or government agency instead it should be policed by a combination of patients, consumers, and healthcare professionals. 
  7. “Transparency” and simple messaging must be the keys to all healthcare from now on.
  8. Proactive healthcare must also be key. There must be incentives, both positive and negative, for individuals to pro-actively improve their health. If I am overweight, which I am, I should pay more for my healthcare insurance than someone of my same age that exercises frequently, diets and keeps their weight in check better than I do. 
  9. A new Certified Healthcare Cost Analyst could be paid by any patient to help with complicated cost benefit analysis. This specialist would have to be a fiduciary and work only for patients not insurance companies. Their fees could also be paid out of the patient’s H.S.A.
These are only a few suggestions. And there are no perfect plans or ideas, but we must continue to seek out new ideas to improve overall healthcare. However, I am adamant and have studied and experienced that a monopoly in healthcare, such as a single payer system like the government, would be the most inefficient idea possible. This would hurt all patients and healthcare providers both, but the end user, the patient, must be placed back in the forefront of decision making when it comes to their healthcare. No government, nor insurance company, should supersede the patient.
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