There has been no shortage of ink spilled arguing how we fix our broken US health care system so today I will use the spoken word instead. Fundamentally, we all want the same things from the system: Quality care, Affordable care, and Access to care. The real question is how do we move from here to there? Are there people who have fixed these problems even on a small scale that we can use as guides to work things out? Finally, should we look off shores for solutions to our woes? I feel that there are a few fundamental problems within our current framework that need to be recognized as the problems so that we can focus our solutions appropriately. The large problems are: 1) a lack of transparency on costs, 2) regulations that impede access to affordable care, and 3) a disconnect between the patient and the person and/or entity providing care. In my view, it is not reasonable to look to adopt systems and solutions from other countries as there are too many differences between our cultures, demographics, wealth, and economic infrastructure to expect the adoption of other countries' health systems to work in the US any more than our way of life would work in those countries. It is also not obvious how much we should spend on the care we receive. In that, I mean to say that there is no ideal GDP figure that we should target because you have to spend money on something and who is to say what the right amount is? We spend significantly less on feeding ourselves now than in the past which has freed up money to pay for other products and services - some of which are health care. I certainly don't mean to imply the amount we spend on care is correct right now but simply that using a random GDP per centage should not be a gauge for success. If we spent 30% of our GDP on health but we lived healthy and productive lives to age 150 thanks to gene therapy no one would think we were overspending. However, with that said, it is clear that we are not getting value for what we spend on care. By that token, we are paying too much for what we are getting and need to find ways to achieve the goals set forth above. I believe we have actually been shown some solutions that are already working that don't require significant legislative action and can be implemented today that will improve health, lower costs, and improve access. First, primary care could be delivered through the direct care model. Even specialized care could be administered this way. Physicians have shown that they can radically reduce the price of care to patients and provide them superior care than through traditional insurance third party pay plans. Second, we could switch from a third party insurance system to measures that control costs and put patients back in control of the shopping of services with health sharing or HSAs. Finally, we could move for a decreased regulatory burden on pharmaceuticals allowing patients to get medications from anywhere in the world and reduce the testing required by the FDA on efficacy (which would reduce the time and cost for new products to come to market.) These ideas simply provide a framework for changing the landscape of health care but are proven to work and would certainly put us on a more rational path while freeing up resources to take care of those who are unable to pay. Eric Larson is the host of the Paradocs. show notes
Episode 10: Mary Ruwart describes how changing the FDA would free our market
Episode 12: Dr. Keith Smith tells us how his full price transparency lowers the cost not just for his patients but patients everywhere.
Episode 34: Dr. Lee Gross explains how direct primary care is a proven game changer in the lives for those without much money and is providing better care than expensive health plans.
Episode 48: Matthew Bellis of Liberty Health Share goes over how health sharing ministries provide an affordable option for those seeking health coverage.
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