Friday, March 13, 2009

About Healthcare Change

Anna Nicole Smith's lawyer/boyfriend and doctor are being held in criminal connection for her death by flooding her irresponsibly with prescription drugs.

Anna Nicole Smith

It's true that Smith could have avoided taking them, although perhaps that proved as difficult to control as her personal weight was as an issue, a challenge she finally won. She and her son, Daniel, and actor Heath Ledger have died within the last 2 1/2 years, all from lethal prescription drug mixtures.

These recent celebrity deaths could and should spark more national introspection into an improvement in the field of healthcare. Healthcare changes. It always does. It's always a topic in America and some changes to bring down costs while improving care coordination would be helpful. We all want that.

A medical doctor on CNBC this morning said that each person's healthcare should be followed from a health episode's start to finish. There are incentives to the way healthcare is paid for that favor invasive surgery, for example, when a less invasive method might work but doctors are paid more for the more aggressive surgery. The entire system needs to be replaced with one that is illness-related, so that drugs are properly administered, not repeated or mixed, and so that the best doctors follow the entire illness. Usually, a family doctor or internist now acts as a gatekeeper and stands back rather than coordinating doctor care when specialists take over a serious illness. Insurance companies choose to pay for care or not, and become de facto drivers of healthcare.

Karen Tumulty, National Political Correspondent with Time Magazine, on NPR radio on Wednesday noon talked about her brother's health issues as an example of the American problem with reimbursement for long-term disease or catastrophic illness. The issue of healthcare insurance is such that even if you are mostly covered, sometimes you aren't. Tumulty gave the example that if your health insurance is a six-month contract, and your illness becomes serious, your insurance might stop paying, even if you had the foresight and ability to stay with the same company, because your early symptoms occurred in an earlier six-month contract, and is thus treated as another contract. Each medical insurance contract is brand new, and until Tumulty filed a legal "complaint" her brother's heavy medical expenses weren't paid.

Other countries consider American medical coverage a nightmare, even if other countries have healthcare issues of their own. The sick already are forced to deal with quixotic harassing paperwork, exorbitant expenses and reliance on stronger relatives. There is the issue of the high costs for tests and surgeries and recoveries that are driving Americans abroad for procedures.

The toll on families of the sick is getting worse every passing year. Trouble is, the motivation to make a big change, to rethink the salaries and payouts to medical insurance companies, drug companies and doctors, is extremely controversial, especially socially and financially.

At the same time, most companies would be doing better if they weren't in such dire financial straits because of healthcare costs. In America, costs are threatening many companies and non-profits' survival within America. High healthcare costs are bankrupting the car companies and many small companies, who are already burdened with high taxes and shrinking revenues and internationally high competitive rates for loans.

It's time for changes in healthcare, to simplify it for all, improve quality by avoiding repetition and cover the entire population. It's the right thing to do for all of us, for business, for the already sick and for the remainder of us who will episodically need it.

Let's just hope that Jon Stewart, the comedian, doesn't blame the healthcare crisis on medical journalists the way he is faulting financial journalists for the economic crisis.

Maybe all of the above is just wishful thinking. Peter Navarro, in his investment blog says: "In the last few weeks, it has become abundantly clear that the Republicans are far more effective as the minority party than the Democrats. Because this is so, the Obama Administration can likely forget about any real reform in health care....." Sad comment. What will it take to achieve healthcare reform?

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