Thoughts on Changing the Healthcare System – Part 2

For a healthy medical system, we need to establish universal health care without the insurance companies, or reconstruct medical care and insurance by controlling the profits

One of two health care systems is needed.

1) Establish universal health care without the insurance companies being involved at all. In this system, I propose that doctors MUST have their education paid for by the government, and a reasonable wage associated to the number of hours they work.  Universal healthcare cannot work without doctors and doctors must be paid fairly, or the existing physicians will retire and new ones will not choose the profession.

Or

2) Reconstruct medical care and insurance, controlling the profit of insurance companies and not the profit of the doctors who deliver medical care!  Education of the doctor would be covered by the doctor, but residencies would be required to pay the resident by the number of hours required per week working in the hospital.  Residency is a slave labor type of situation and we need to change it. Hospitals make money on the residents and they (the hospitals) should put some of their profit into the wages of the professional medical staff. In this system, insurance would only cover hospitalization, emergencies, and testing, leaving patients responsible to pay the balance of what insurance doesn’t pay, and Balance Billing (a system that allows the physician to set his bill above and beyond what the insurance “allows” and the patient chooses to pay the remainder.)  Under this system, the existing Medicare and Medicaid systems remain the same.  This is the only way to allow doctors to practice medicine as they were taught—with plenty of time to get a complete history and make a descent diagnosis! Medical insurance would be for ER, Surgery, and Testing and would be much cheaper than what is currently available.  Such a system of avoiding “rationing” by the “system” is the reason for the recent increased growth of Boutique Medical Practices. The people who can make the choice to avoid the massive system and obtain quality care are doing exactly that.

Other changes must be made in either system:

1. Medical Insurance would not be associated with employment, but would be required by US citizens.
2. Medical Insurance would cover those children living in their parent’s home or at college or graduate school without independent tax status.
3. Pharmacies and drug companies would have their prices set for a certain amount of profit and R and D. The requirements of the FDA for drug acceptance would be decreased. The length of the patent will be extended to cover the profit over more years to keep the prices down.
4. Government would negotiate the price of all drugs for their programs, and dispense from a central government-run pharmacy for Medicare and Medicaid.
5. Medical insurance would be required for those not receiving Medicaid or Medicare, and paychecks will be garnished the amount of the premiums (set by the government) if insurance is not purchased for a full year.
6. EMTALA (a federal law that requires emergency rooms to treat every presenting individual and issue irrespective of severity or ability to pay )must be rewritten-ERs are meant for emergency conditions only.
7. EMTALA must change to exclude non-emergent conditions to keep more ERs open. This can be by allowing referral to a clinic associated with the ER during normal office hours.
8. Buying drugs from other countries would be legal for both doctors and patients.
9. Governmental central purchasing or physician central purchasing that cover doctors and decreases their overhead.
10. Decrease the requirements of CLIA and HIPPA so doctors may deliver medical care have less over head and regulatory intrusion.
11. Qualify tele-medicine as a medical service that can cross state boundaries.
12. Unrestricted Medical licenses can be used in any state in the US.

My short term answer to the medical payment crisis to no longer take insurance, and only take cash for service. The last year as an OBGYN, I worked 90 hours a week operating one day a week and providing care in my office.  I made NO INCOME that year!  I made enough to pay my staff, pay my overhead, and malpractice insurance. It was not until now (the last 6 years) that I feel I am able to pay back my monetary investment in my medical education.  I am only able to do this because I do not take insurance!

Kathy C. Maupin MD

Gynecologist practicing Age Management Medicine

BioBalance Health Owner and Medical Director

10800 Olive Blvd, Creve Coeur, MO 63141

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author. www.BioBalanceHealth.com.