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Saving Health Care, today
(in 6 minutes)
THE HERITAGE FOUNDATION


We have a problem
(costs are too high)
Doctors are fed up
60% of general practice physicians surveyed said
they would not recommend medicine as a career.

Up to 50% of primary care docs intend to cut
back or quit.

Only 2% of medical students are considering
going into primary care as internists.

Since 1997, 50% fewer newly graduated U.S.
medical students chose primary care as a career
Many other problems
(which I’ll get to)
THE GOVERNMENT                            FLICKR: SILENCE99

CREATED THE PROBLEM (SURPRISE SURPRISE)
The Status Quo

     Employer-provided,
1)

     All-encompassing
2)

     Health Insurance
1) Employer-provided
Insurance

Leading To...

  Less Diversity of Choice

  Less Accountability to Action

  Less Competition
2) All-encompassing
Health Insurance
2) All-encompassing
Health Insurance


 ...is not insurance...
2) All-encompassing
Health Insurance

Car Insurance doesn’t pay for Gas

Flood Insurance doesn’t pay for Umbrellas

Life Insurance doesn’t pay for the flu
2) All-encompassing
Health Insurance

Car Insurance doesn’t pay for Gas

Flood Insurance doesn’t pay for Umbrellas

Life Insurance doesn’t pay for the flu

               THIS WOULD BE WASTEFUL
2) All-encompassing
Health Insurance

quot;Insuring primary care is like insuring lunch. You know
you're going to need it. You know you can afford it. Why
on earth would you pay a third party to pay the
restaurant on your behalf, adding overhead and taking a
big chunk out of the money you pay?quot;
                - Nick Hanauer of 2nd Ave. Partners
Tremendous Inefficiency

“The insurance companies are blind, they have no
idea what we’re doing, so what they want is paper.
Lots of it, buckets of it, tons of it. [We] put out
pounds of paper, to confound the people of the
insurance world.”
                                   - Dr. Garrison Bliss
Tremendous Inefficiency
Terrible Incentives

“We’re not paid to do our job well. [...] Since we
only get paid for visits, the effective and efficient
doctors simply get paid less, because we don’t
see you as often. For asthma, I get $200 to
prevent your asthma, but I get $10,000 to treat it.”
                                  - Dr. Jay Parkinson
No judge of value

“The higher spending is due to the provision of
unneeded and sometimes harmful care:
hospitalizations that could have been avoided with
better primary care; frivolous specialist consults;
overuse of diagnostic tests.”
             - Elliott S. Fisher, Dartmouth Medical School
The Solution:
HSA + HDHP + DPC
1) Health Savings Account-
  CASH FOR CARE
2) High-Deductible Health Plan -
  JUST IN CASE
3) Direct Primary Care -
  CARE FOR CASH
Tremendously Efficient
You’re the Customer

Email

Instant Message

Phone Calls

House Calls

24-hour access
FLICKR: GREYLOCH
YES, THATS RIGHT
HOUSE CALLS
Did I say Efficient?

You can save thousands per year, for a single
patient

Dr. Jay Parkinson ran the numbers, and got

TOTAL SAVINGS over 10 years = $54,395.60
THE HERITAGE FOUNDATION


We can turn this slope around
Lower costs dramatically, for better care
FLICKR: CISTAL
Live healthier
In better contact with our physicians
All by embracing the market
It’s about time, no?
?
All by embracing the market
It’s about time, no?
Saving Health Care

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Saving Health Care

Notes de l'éditeur

  1. Ben Woosley here. I’m an engineer by trade, a resident of New York, and I’m here to talk about 2 subjects I think a lot about. First: Health Care, specifically discussing what *you* can do *today* to fix the system. No politics, just choice. http://www.flickr.com/photos/quiplash/47545024/ (Attribution Noncommercial Share Alike)
  2. Dramatic increase in the cost of health care. Some of it necessary, good, much of it less so. http://www.heritage.org/research/features/BudgetChartBook/fed-rev-spend-2008-boc-S12-Medicare-and-Medicaid-Spending.html
  3. Many Doctors hate the system as well, and are opting out. For example, Primary care, the bread and butter of health care, the doctor you see the most, and should see at least once a year for your annual physical. Well, they’re simply not around. Very few medical students going into primary care http://blogs.usatoday.com/oped/2008/03/shortage-of-pri.html http://www.entrepreneurialmd.com/index/2008/11/18/angry-primary-care-physicians-are-just-saying-no.html
  4. How did we get here. Partly because guys like this aren’t focusing on the real problem. I’m here to tell you what I think that real problem is.
  5. Surprise! Washington did it again. Current medical policy is one of the great tradgedies of the modern age. http://www.flickr.com/photos/projectsilence/2072998389/
  6. Specifically, a policy which sprung up sometime around the post-depression years.
  7. Heard an insurer unfairly denied a claim? You can’t dollar-vote against them by switching providers. Only the employer can do that. Nor can you easily switch to an insurer who serves your specific needs (e.g. acupuncture enthusiasts). Also, you can’t pick the lowest-priced providers. Higher prices, less accountability. Bad stuff.
  8. the insurer takes on routine costs as well as extreme ones, whereas all other insurers cover occasional, unlikely costs
  9. the insurer takes on routine costs as well as extreme ones, whereas all other insurers cover occasional, unlikely costs
  10. the insurer takes on routine costs as well as extreme ones, whereas all other insurers cover occasional, unlikely costs
  11. http://tvw.org/media/mediaplayer.cfm?evid=2008030136C&TYPE=V&CFID=2679569&CFTOKEN=45205340&bhcp=1
  12. 4-5 employees per doctor, to deal with insurers. Estimated 40%+ of primary care health care dollars
  13. http://www.poptech.org/popcasts/?viewcastid=228
  14. An account for paying medical bills directly. You have control over the value of the health exchange, and the power to cut through the inefficiencies of the existing system, without sacrificing the tax benefits
  15. Health Insurance is still important and necessary, when it’s *Insurance*. HDHP pays out for those serious, but unlikely health events that we hope never happen, the same way we hope our house never burns down, or our we’re ever in a car accident. They’re there to cover the bills in the catastrophic case, but not before. Just where they belong.
  16. This is the main person in your health care life. They take care of your flu, your broken bones, your stitches. They help you get a smoking cessation program or encourage you to lose weight. You pay them cash for their time, just as you do other folks.
  17. 4-5 employees per doctor, to deal with insurers. Estimated 40%+ of primary care health care dollars
  18. http://www.flickr.com/photos/greyloch/2666407838/
  19. http://blog.jayparkinsonmd.com/post/70104332/high-deductible-health-insurance-saves-you-54-395-60
  20. http://www.heritage.org/research/features/BudgetChartBook/fed-rev-spend-2008-boc-S12-Medicare-and-Medicaid-Spending.html
  21. http://www.flickr.com/photos/clstal/2441925592/