Occupy Healthcare is a movement to influence and impact the future of healthcare, as well as an online community to discuss healthcare reform issues. They invited me to submit my perspectives, and below is what I sent.
Occupy Health Care – a proposal from Wayne Caswell, Modern Health Talk
Historically, the biggest impact in health outcomes has come from public health initiatives such as clean water, sewage systems, immunization programs, and smoking cessation. But that success is minimized by a “sick care” system that is profoundly broken. Perverse incentives cause practitioners to view patients as paying customers, diagnose and treat their symptoms, and keep them coming back, paying, for each test, drug, treatment and procedure.
The ACA was meant to fix that, with more emphasis on positive outcomes, wellness, and prevention, both to minimize the need for medical care in the first place and thus reduce costs, and to maintain a healthy and productive workforce that contributes to a vibrant economy. The ACA was a good start, but there’s still more work to be done, and it won’t come from private industry or the insurance model, because natural incentives prevent it, or work to sabotage it progress.
I often say the key to health reform is getting the incentives right, and that means getting private insurance companies out of BASIC health care entirely. Their profit motive gives them an incentive to increase costs, knowing that higher costs = more insurance customers paying higher premiums. What I proposed instead is a hybrid public/private model that would capitalize on contrasting incentives, eliminates the need for health insurance, and saves over $1 trillion per year.
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