- Health Care, Drugs & Insurance
Fixing American Health Care
Millions of people in America aren’t getting the healthcare treatment that they need. It can be because they either don’t have insurance, or their insurance providers deny them coverage to certain health benefits. As Americans are up in arms about the reason for the rising cost of healthcare, it should be known that what it all boils down to is money, and nobody can really blame one particular person.
The great irony is that while there are millions of people not getting the treatment that they need, others may be being over treated. For example, a man could walk into an emergency room because he isn’t feeling well. The doctor will order some lab work, probably an X-Ray, a breathing treatment, and possibly a CT Scan. How much of this testing is really needed to be done? And if all these tests come back negative, would a patient feel like they wasted their money? The reason the doctor has to order all of these tests is because they do not want to get sued. He or she wants to make sure that a patient doesn’t walk out of the emergency room with a disease, ailment, or injury that went undetected. With the cost of malpractice insurance at $209,000 a year in some places, physicians do not want that price to increase.
All of the tests come back negative. Here is a run down of what a patient might have paid to be told that they are fine:
$106.00 is the cost for the Emergency Room visit.
$50.00 per lab test done and they’ll typically run quite a few.
$1,354.00 is the cost of a CT of the Abdomen with contrast.
$1,216.00 is the cost of a CT of the Pelvis with contrast.
$197.00 is the cost for a chest x-ray with 2 views.
The cost for a typical emergency room visit is $2923, which most of the insurance company will cover. That’s only if the patient receives one blood test, which is highly unlikely, and the fee for the physician that sees the patient and the cost for medications aren’t even included. If a patient gets admitted to a unit, expect the price to be much, much higher as the physician will order more tests to follow up on whatever is troubling the patient.
So why are the prices of the tests so high? If it takes 10 minutes to do a CT scan, why do the prices need to be what most people make in a month? Most emergency rooms can not turn a patient away from a facility. More than likely, a patient without insurance is not going to be able to pay the cost of the bill to be treated. What happens to the money? The hospital has to eat the cost of it. The hospital provided a service to a patient, including medications, tests, equipment, and manpower and did not receive a dime from them. Now, in a similar situation, a patient with insurance comes into the hospital. The emergency room physician determines that this patient is in need of an MRI for back pain. The insurance company does not cover an MRI, so the hospital has to do the test anyways, and will eat the cost of it, again. They could do a different test, but the results could be less accurate, and the doctor does not want to risk being sued.
With the insurance companies are looking out for themselves, and the healthcare system is looking out for itself, there is no one looking out for the patient. Nobody wants to lose money. The patient falls right in the middle of a tug-of-war match between two companies, and nobody is looking out for them. The healthcare system is looking to drag every dollar it can muster out of the patient in the hopes it can make some money for a service it provided. The insurance companies fight good health care, trying to save a buck or two by not covering certain procedures. They will not cover pre-existing conditions, which doesn’t make sense at all. If a person is sick, that person has a right to be treated. Insurance companies pretty much make the argument “We’ll only cover you if you’re healthy.”
So what can be done about this? It’s fairly simple. In America, diagnostic equipment is much easier to come by than in other countries. It’s not uncommon for a hospital to have X-Ray equipment that can accommodate 10 patients at a time. A hospital could have 3-4 CT Scanners, or 2 MRI machines. The solution would be that everyone is covered. Everyone has a co-pay of a determined amount for a personal physician visit. Everyone has another co-pay of a slightly higher amount to visit the emergency room. Everyone has access to all the medical attention they need. It doesn’t matter what kind of equipment that is used on the patient, everything is covered. Also, private practices that work in certain health-related duties could open up. For example, a physician could open up a mammogram station where women could come in, pay their $15 co-pay, and walk out with a mammogram. There would be no scheduling of appointments. The same could be done with other diagnostic equipment and preventative medicine. A man could walk into a men’s preventative health center and get a prostate exam and walk right back out. Insurance companies would have no reason to even exist, and no loops would have to be jumped through to get certain tests ordered for patients who need them.
People could argue that this process would cause hospitals to lose out on a ton of money. In a way, that would be true. But they could more than make up that money by opening preventative treatment centers across cities. If patients have access to areas to prevent disease, there would be fewer trips to the emergency room and more trips to the family doctor. Hospitals would waste less money on unnecessary testing, as patients could come in and already be diagnosed. Physicians can go straight to treating the patient instead of figuring out what is wrong with them.
It’s much more efficient to get a patient to pay $15-50 here and there than to charge them thousands of dollars up front. With the health care system fixed, Americans could have the right to a healthy life, liberty, and the pursuit of happiness.