health care debate

It's sort of amusing (and more than a little disturbing) to listen to what's being discussed. Why don't we start with easy, low-hanging fruit:

  • Go back to forbidding direct-to-consumer drug advertising. This direct advertising, last I heard, was responsible for about 40% of the steadily-increasing cost of medical care. Consider that those drug companies are spending more money on those ads than they are on R&D.
  • Allow medicare/medicaid to bargain as an entity for drugs. The price will go through the floor on drugs for people in those programs, with almost no effort.
  • Require insurance companies to standardize paperwork. Right now the paperwork attendant with insurance is absurd. Duke University's medical system has, according to its web site, 1241 doctors. According to its director (heard on NPR a couple of weeks ago), it has about 600 people processing insurance paperwork (down, recently, from 900).
  • Start a public plan, or, if the will for that is lacking, require availability of a non-profit (or maybe not-for-profit) insurance option across the country. This would not offer, for instance, access to cosmetic surgery (except, I suppose, for cases like mastectomy "repair" (man, there's gotta be a better term for that)). This would just be a no-frills thing for basic and urgent care.

None of those should really be all that difficult to implement, and would vastly improve costs across the system.

Another issue that I see is that, it seems to me, medical schools are turning out way too many specialists, and too few GPs. Unfortunately, I have no clue how to attack the problem.

The reason, of course, is that specialists make so much more than GPs do. As always, follow the money. Maybe that public plan could reduce that by cutting down on the price premium for seeing a specialist? This is something I can only speculate on.

Hmm... more to discuss on this, but that's it for the moment.

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