Do-It-Yourself Health Care: 10 Steps You Probably Don’t Know About

No one would be shocked that simple actions positively affect health outcomes and costs — things like regular hand washing, printed medication lists, and correct identification of patients before surgery. But most of us are unaware of the simple things WE can do as individuals to make our own health care safer, more affordable and more satisfying. Yes, of course, doing healthy things reduces your health care costs and makes you safer and happier. You expect a doctor to say that. However, today, and in subsequent posts, I want to focus on the actions you may know little or nothing about. We have more power than we think to improve costs and quality of healthcare for ourselves, our families, and our businesses. This matters, since in the decades I’ve been in practice, it appears the cavalry will never arrive to save us.

 

Colluding on a Colossally Bad Idea.

According to the World Health Organization, the US healthcare system is the most inefficient system in the world based on healthcare spending and outcomes. One reason is that, unlike most other consumer markets, healthcare lacks serious competition on price. When was the last time you were able to compare prices on drugs, lab tests, or x-rays? It’s coming, but you need to know where to look to make it work for you.

 

Secondly, there are many opposing incentives built into the current system. For example, a primary care doctor with a 10 minute appointment slot is more likely to send a diabetic patient to a specialist than manage that illness themselves, something any reasonably trained primary physician could do given enough time. But if the system that employs the doctor profits more when people see specialists, what is the system’s incentive to give the primary doctor more time with their patients? Even private physicians face this “churn and burn” pressure. In an insurance based model, docs are rewarded for how many patients they see, not how much they do for that patient while they are together. How do we change that?  Likewise, why wouldn’t insurance companies vigorously roadblock your ability to spend “their” money if the goal is to maximize dividends to their shareholders?

 

Third, the US government (and citizens) lack agreement on whether health care is a right or a privilege, an argument that most healthier, more efficient nations decided decades ago. No wonder the US population is less confident in its healthcare system than people living in other equally industrialized nations. If we really want improvement, we may have to stop focusing on identifying the “bad guy” and recognize that the entire system employs mostly good people colluding with a colossally bad idea constructed out of healthcare’s past.  

 

Consider the long standing business model of healthcare — when and how healers anywhere in the world and across time have been rewarded. We have always paid our practitioners to stop our illness or pain, not promote our health. Therefore, together we’ve built  a healthcare “industry” that thrive on our infirmity … or our fear of infirmity. In free markets, businesses can’t be built on the idea that consumers will no longer need them.

 

If we turn to the government, however, hoping they will take over or somehow temper this insanity, we find politicians on both sides pointing fingers at their favorite agents of doom. Pleasing donors trumps common sense and even common courtesy. Let’s accept (for now) that substantive health-care reform won’t stick until we have substantive campaign finance reform.

 

To emphasize the enormous power you didn’t think you had, this series will cover…

  • Insurance and its alternatives: The quick and not so dirty,
  • When NOT to use insurance: These are not the prices you’re looking for.
  • Direct primary care: Reward your doctor for the right things.
  • Prescription costs: Say the magic words!
  • Labs/tests/studies: Where is Kayak.com for healthcare?
  • Your medical information: If you want something done right…!
  • Cash; You’ve got the power!
  • Surgery: Yes…you can!
  • Urgent /Emergency care: Less is more.
  • Time really is money … and safety… and health.

Stay tuned, leave comments and share liberally with your friends and family. You won’t believe how powerful we can be together!

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