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askjohnfung uploaded a new video
(1 day ago)
Doctor-Patient Relationship (#56)
Seeing a doctor is not like going out t...
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Doctor-Patient Relationship (#56)
Seeing a doctor is not like going out to buy something. It involves a whole range of issues that hinge heavily on trust, personal responsibility, and ongoing maintenance. The nature of this relationship has not changed much until about 50 years ago with the rise of drug manufacturers, hospitals, and insurance companies, which are for-profit corporations. This is brought about by the development of medical technology. We also saw governments in many countries taking over the health care business.
The traditional relationship between doctor and patient still remains strong in many non-Western countries, especially in the Chinese countryside where ancient Chinese medicine is practiced. However, health care cannot escape the inevitable changes brought about by modern technology. The problem is not how much we dislike the change, but how best we can make it serve the community.
The traditional relationship between doctor and patient has been largely destroyed in modern days. The following is a description of what has happened:
Payment and Price
Up to the 1950s, people paid out of pocket when they visited a doctor, except for a big operation where they might get help from the government or somewhere else. When you pay with your money, you tend to negotiate the price down and you dont overuse the service. The doctor cannot charge too high a price for fear of driving the patient out the door.
Medical insurance changes all that. Just like an all-you-can-eat buffet with a fixed price, the patient tends to overuse the medical service for the fixed amounts he pays the insurer as premiums. The doctor wants to charge the highest price that the insurer can accept. This results in higher costs. Moreover, both the patient and doctor relinquish their rights to negotiate for the best price. The insurer becomes the final arbiter besides being middleman. It will set a price that maximizes profit without regard to the interests of either doctor or patient.
Thus, the doctor does not practice ethics because he wants to charge the highest price. He also wants to make the patient come often for more insurance payments. The patient must settle for less service than he wants. He has to pay for what the insurer refuses to cover. As a consequence, medical insurance destroys personal responsibilities inherent in doctors and patients. It results in higher medical costs, more profits for insurers and doctors, and higher premiums and out-of-pocket costs for patients.
Quality vs. Quantity
Do you think you are getting better quality now than prior to the 1950s? In those days, doctors still made house calls. Furthermore, when you consulted a doctor, he would not ask you to fill out an insurance form at the door. He would invite you in and asked about your problems.
Nowadays, we have all kinds of new medical technology and wonder drugs that have the potential to better our lives. How far are we from this lofty goal? Modern medicine comes with a high price attached that only the rich can afford. It benefits only a small segment of the general public because the government, charity, or insurance agrees to pay for the high cost.
Modern health care has sophisticated technology. The missing dimensions are: care and ethics on the part of the doctor, self-responsibility on the part of the patient, and mutual cooperation for prevention and good health maintenance. Good health care does not have to be expensive. It must achieve physical and mental wellness for the majority of the population.
Over-Testing & Over-Prescription
The payment system for doctor carries a misguided incentive: fee for service instead of a fixed salary. Doctors are paid extra for the tests they order and the drugs they prescribe. This results are over-testing and over-prescription. There is a better model to follow that attracts national attention: Mayo Clinic in Rochester, Minnesota. This clinic operates at a much lower cost than the national average because they have a different pay system for staff members.
Technical Details & Scare Tactics
Maintaining good health is not complicated if you use your common sense. However, health care providers tend to add complexity to boost their image. The worst part is to use scare tactics. Have you seen all the technical stuff and scare tactics out there? When people talk about health these days, the conversations are full of technical jargons. Does it have to be that way?
www.herbsandtea.com
July 2009
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askjohnfung uploaded a new video
(2 weeks ago)
Fixing US Health Care System (#55)
The whole complicated problem can be s...
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Fixing US Health Care System (#55)
The whole complicated problem can be summarized in just two words, runaway costs. At present, legislation is being drafted in the US Congress for health care reform, accompanied by a few months of debates, and possible passage by yearend.
Without bringing the costs down, health care reform cannot succeed. The following examines the various ideas to be incorporated into the legislation:
1. Single payer system. It is clear that the present private system driven by profit does not work. What if the government takes over? This has worked in most developed countries, albeit not perfectly. The big hurdle is public opposition because most Americans believe, rightly or wrongly, that only private enterprise can provide good quality and choice. However, they dont see that there is no competition in health care, resulting in runaway costs. The idea of a government takeover will unfortunately energize the opposition, thereby jeopardizing the chances for passing the reform bill.
2. Government insurance. Instead of a single payer, the government establishes a public health care insurance company to compete with private ones, thereby lowering costs and offering more choices. The private insurance companies do not want this to happen for it will cut into their profit margin.
3. Universal coverage. The government insures or subsidizes all the uninsured to create the biggest market under universal coverage. In the insurance business, a bigger market tends to reduce costs.
4. Basic safety net. The government provides a basic safety net for all citizens. In order to keep the costs down, only catastrophic insurance against cancer or incapacity is provided to all citizens. Those who can afford more may buy any kind of additional insurance they wish from the private sector.
5. Free flow of information. All health care providers are required to publish their prices and services on the Internet so that consumers can compare and choose the best low price.
6. Reduce wastes. Health care in the US costs trillions of dollars a year. Making the system more efficient will reduce billions dollars of wastes. A major effort to digitalize all medical records and store them in a secure database is already taking place.
7. Limits on insurers. Insurance companies are not allowed to pick and choose the healthiest customers to maximize their profits.
8. Limits on lawsuits. A reasonable limit is set on compensation for health damages unintentionally caused by doctors, hospitals or drug companies. The goal is to inject some certainties into the operations of the health care business with a goal to reduce costs.
9. Limits on drug companies. Current preferences granted to drug companies are reviewed with a view to bring down drug costs to the public.
10. Appeal to providers conscience. Doctors and hospitals are encouraged to support the reform. They are reminded of the call of their noble profession to serve the public, rather than profit maximization.
11. Public education. The public is reminded of their personal responsibilities to live a healthy life, and not to abuse or overuse the medical system.
12. Grand Compromise. Health care reform in America is the most difficult because of the status quo. Anybody can find a good reason to reject reform. The general public is concerned about too much government intervention. The drug companies, doctors, hospitals, and other providers worry about reduced profit margins. The insurance companies fear that the government may drive them out of business. The trial lawyers do not want a limit on how much they can sue for medical mistakes. It is up to the Obama Administration to forge a grand compromise with various interest groups. Despite all the hurdles, the chance for success is much better now because most people know that the current system is not sustainable.
www.herbsandtea.com
June 2009
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askjohnfung uploaded a new video
(2 weeks ago)
US Health Care Crisis (#54)
If you live in the US, you must be aware of t...
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US Health Care Crisis (#54)
If you live in the US, you must be aware of the health care inflation during the last ten years. Legislations are now being drafted in the US Congress for health care reform, followed by a few months of debates, with the hope of eventual passage by the end of 2009.
Previous presidents have attempted health care reform with little success. This time we may have a good shot at it. The reasons are two fold. First, the costs of health care have ballooned out of control, causing a lot of pain to the average citizen. Second, big companies also feel the pain of paying for the high cost of health care benefits provided to their employees. When big business complains, legislators listen.
President Obama has underlined the urgency of reform. Above all, what is more important than good health for our workers at reasonable costs? If we fail to contain this runaway inflation, it will have an adverse impact on American competitiveness around the world. American products will not be able to compete due to the high costs in health care.
What causes the health care inflation in the US? This complex situation is summarized as follows:
1. Health care is not like cell phones, PCs or autos where perfect competition reduces the price. In America, a hospital can charge exorbitant prices and gets away with it. So can a drug company for a new drug, or a doctor performing a surgery.
2. There is lack of information about prices and quality of health care. As a consequence, consumers cannot make comparisons and choose the best low price.
3. Health care is subject to scare tactics by the providers, such as If you dont do this test or procedure or this drug, something real bad will happen.
4. Insurance companies have become an annoying middleman between doctors and patients. They have destroyed the traditional relationship between supplier and consumer. Instead of direct negotiating with the patient, the doctor wants to charge the highest price the insurer is willing to pay. On the other hand, the patient wants to get the most medical service out of the fixed monthly premiums paid to the insurer. What does the insurer do? The insurer will simply enforce a price where he can make the most profit without regard to either the patient or the doctor. In the end, both the patient and the doctor lose.
5. Trial lawyers have also intruded into health care. They look for mistakes made by doctors or drug companies, and the damages done to the patients. They will help the patients sue the providers for an exorbitant amount of money. While saying they are helping the victims, the lawyers in fact take the biggest slice of compensation upon winning the case. This has caused doctors to be overly defensive. To protect themselves against lawsuits, doctors tend to order more laboratory tests for patients than necessary.
6. Most Americans believe that the free market can solve all problems. This is true provided that there exist perfect competition, free flow of information, and other conditions. In health care, none of the ingredients of a free market exists except profit maximization by drug companies, insurers, lawyers, hospitals, doctors and other specialists at the expense of the public.
7. Many legislators kowtow to the health care providers because they are rich and powerful, especially the Republican Party. As a result, there is insufficient government supervision of the health care industry. The Republican legislation a few years ago to provide drug benefits to seniors is a prime example of government kowtow to the drug companies. The legislation forbids the government to negotiate with drug companies to buy drugs at lower prices. Can you imagine a government writing laws to forbid itself from doing something good to the public?
www.herbsandtea.com
June 2009
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They Are Interesting and funny,
Thanks for taking the time sharing the knowledge.
Greetings and Blessings, .:.
Jonathan.