[Trample the Elderly]

Originally Posted by Schneed10

There are lots of places costs can come from, though.

When you pay your health insurance premiums, some of the money gets paid out to doctors to cover office costs. Some gets paid out to hospitals to cover costs of getting an operation and staying in the hospital. Some gets kept by your insurance company so they can pay their people and make a profit. Some gets paid to the pharmacy where you pick up the drugs your doc prescribed you. Etc.

So hospitals can play a role by: Being more efficient. Hospitals are big huge places and administration needs to be on top of doctors and staff to treat patients fast, get them healthy, and get them out sooner. The longer a patient stays in the hospital, the more it costs. Many times a doctor will order a MRI or a lab test to confirm a problem before he makes his next move, well if the hospital dawdles in getting that test done it delays the doctor, which screws up his schedule, and before you know it the weekend rolls around and he says well just keep the patient until Monday, I'll do a procedure then.

Doctors can play a role by: using more efficient staffing. Nurse Practitioners can address 90% of physical ailments, and they make right around $100K as opposed to $150K on up to god knows what.

Insurance companies can play a role by working to simplify their reimbursement agreements with providers. Make the payment system simpler so there are fewer denied payments and thus fewer appeals. The less you have of this kind of stuff, the fewer administrative support employees your insurance company has to pay.

The government can play a role by:

- Mandating and helping hospitals, insurance companies, and doctors get up to speed with Information Systems allowing seamless integration of medical records and information. This prevents deaths due to drug interactions and would cut workers out of the system. Each hospital and doc office needs filing clerks just to handle the massive files of charts. Imagine how much you could save doing away with those salaries.

- Forcing insurance companies to reimburse according to Medicare rules. It's a simple way of doing it. I'd suggest they add a pay for performance mandate too.

- Cap malpractice awards. Huge multimillion dollar payments to plaintiffs only drive up malpractice insurance premiums to doctors and hospitals, who just end up raising their charges and passing the hit along to all of us.

- Providing incentives for the poor and underinsured to use a primary care doctor. Preventative medicine saves us the most money in the long run. Poor people need to stop using the ER for the sniffles.

And the people can play a role by learning when you really need to see the doctor, and when you can let that sinus infection clear up on its own.

What about just paying your doctor cash when you really need to see him?