To Save Healthcare We Need Big Compromises From Everyone

The following is a guest post, submitted by John from MeetingWave. John is competing to win a free ticket to the Web 2.0 Expo in New York and he’s passionate about  the need to reform healthcare. Enjoy.

In order to save our healthcare system, we need big compromises from everyone.

First, trial lawyers need to accept tort reform. I recall the NYT times editorial this past year that asserted that trial costs are “less than 5% of health care costsâ€� – First, that’s a really big number. Second, I think they ignored the cost of settlements, spiraling malpractice insurance and defensive medicine.

Second, insurance companies need to reduce administration costs and play more fair with patients. I heard you can get a masters degree in how to fill out insurance forms. Ever see all the different forms at a doc’s office? Give insurance companies one year to come up with a single form for doctors to use. I’d recommend a single payment system (doctors only interface with one form/system) rather then a single payor system. Moreover, we need better regulations regarding how and when they deny coverage. For example, if it’s a preexisting condition issue, let my current insurance battle it out with my prior insurer, not me. I shouldn’t need a trial lawyer to get the coverage I paid for.

Also, we’ll need rock solid regulations regarding privacy to avoid people becoming uninsurable based on unauthorized release private medical info- this is a growing concern with electronic records and companies who will screen your genes by mail (check out We want to encourage people to get such tests to allow any preventative measures so we should ensure obtaining such information is not penalized.

Third, customers should have co-pays and incentives to take care of themselves. No one should have an “all you can eatâ€� buffet-style healthcare. Consumer’s should be rewarded with take preventive measures (go to routine check-ups) and penalized (higher co-payments) when they don’t. We shouldn’t penalize people for who they are (bad genes), but rather how they act (bad habits).

Forth, doctors/health, they need to implement current information technologies. (FastCompany had an article several months ago outlining some of the major IT innovations in healthcare- it’s finally starting to happen – Welcome to the 90’s healthcare.)

On another note relating to the government being able to negotiate drug prices, we need to think through the impact this will have on innovation. That is, if the gov’t negotiates prices with pharmaceutical companies it will have enormous bargaining power, decrease the profit margins pharma can make and impact R&D efforts. If we move in that direction, I think could be an opportunity to better focus pharma’s R&D. For example, give them better bargaining (e.g., a “safe harborâ€� where the gov’t cannot use its bargaining power) for breakthrough drugs (e.g., cancer, aids, Alzheimer’s), but not for the many “me tooâ€� products they currently focus their R&D efforts to develop. Do we really need another Viagra or H-2 antagonist? There’s a guy at Harvard who wrote a great article about how big pharma doesn’t do beneficial R&D (I think it was in the NY Times).

I think we should give private health care a fighting chance. However, what’s described above are just some of the changes needed to make is work.

Regards, John


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