The time has come that we fire those in Congress, government agencies such as the Centers for Medicare & Medicaid Services and the insurance industry.
Healthcare in America consists of two major aspects. The first aspect is actual healthcare- the hospitals, doctors, nurses and exceptionally ingenious and advanced technology we have in America; the best in the world. This aspect of healthcare is continuing to advance and progress for the betterment of all patients.
The second aspect is the administration and cost. Because of third-party involvement and takeover of finances (insurance industry and government), we have miserably failed in controlling the cost of administering healthcare services across the country. We spent $10,000 per person in America in 2016, which is almost twice the average cost in most developed countries.
Currently, Congress is trying to reform the second aspect and they will fail again because they are the original architects and contractors who created the current mess. Basically, these are the architects and contractors of a giant ship (healthcare) they have built which is broken in every aspect. We cannot afford to hire the same builders for the new ship.
Therefore, we need an out-of-the-box answer to these problems and such an answer can come from only us: 300 million Americans.
The time has come that we fire those in Congress, government agencies such as the Centers for Medicare & Medicaid Services and the insurance industry. From now on, we will refer to this group as a “system.” The pharmaceutical industry is also a part of this “system,” which is a tough call because the dedicated scientists who work in the industry are of course the best in the world and may not be involved. However, the price gouging and astronomical cost of medications in America is a sad reality and, therefore, responsibility belongs to this industry to correct this problem.
So, if we fire the system, then who do we hire? The first group would be comprised of us: the people. The second group would be our doctors led by various societies. They will be charged to restore the nobility of what was once called a “noble profession.”
The third group would be all the nurses in America who are by far the best in the world. This group is the most compassionate and neutral party to help us achieve desired goals.
How do we accomplish this?
The answer starts with retaking control of these three elements from the grip of the “system” and transferring the power to patients and physicians.
If a patient presents to the doctor’s office with his own health record based on a simple Word-format program, data can be easily transferred from one chart to the other and there is no need for faxing and copying. The result is happy nurses and staff. Any information such as recent emergency department visits, hospital visits, different physician visits and all the tests done, will be instantly available wherever the patient is located.
This would prevent duplicate testing, redundancy of duplicate records everywhere and virtually create a paperless environment in a true sense.
Simplified billing systems can be used by documenting face-to-face time or a pre-defined visit fee. This eliminates the need for unnecessary documentation to justify billing codes. Clinicians can also choose not to use time function and directly negotiate the charge with insurance companies or patients for the services such as a
visit fee “or “procedure fee.”
Currently, physicians spend three minutes with the patient and 12 minutes completing the document and paperwork during a 15-minute visit. Instead, physicians can spend face-to-face time with the patient, resulting in much better patient satisfaction and higher level of medical care.
We doctors should demand payment at the end of the visit without any complicated billing system.
Let us bring 21st-century state-of-the-art medical information at the tips of the patients’ and physicians’ finger.
K Yogesh, MD, FCCP
and Niti Yogesh, PA-S