100th post!


Hantavirus has killed two travelers in Yosemite National Park and sickened several others. Hantavirus is a relatively rare but nasty viral illness spread by rodents. It occurs largely in Western states. The World Health Organization is all over this and has advised travelers to “avoid exposure to rodents and their excreta.” Thanks for the tip, WHO.

U.S. healthcare system wastes $750 billion per year. That’s a staggering number. There’s no easy answer to this problem, but from a physician perspective I’d recommend a couple of things. Unnecessary services- $210 billion/year First, a universal health care database. Some folks will bristle at having the government store health information on them, but until this happens it will be very hard to reduce duplication. Second, give physicians “safe harbor” practice guidelines for areas of practice that are particularly litigious where defensive medicine drives up cost. If you are within these guidelines, then you cannot be sued for malpractice. As it stands now, a doctor doesn’t have to do anything wrong to get sued. This would eliminate many frivolous lawsuits and significantly lower cost without the need for Tort reform. Inefficient delivery of care ($130 billion); Excess administrative costs ($190 billion) Third, simplify medical billing and reimbursement. One of the reasons doctors have less time for patient interaction, is that we’re so consumed will filling out the chart properly, checking the appropriate number of boxes, and signing 6 pieces of paper for every patient. All this stuff is mandated for us to do by the insurance carriers who will deny payment if documentation is not perfect. If I could cut out “billing and coding specialists” and the insurance companies didn’t have armies of employees and even entire outsourced companies dedicated to trying to deny claims on the basis of documentation, then insurance costs would fall dramatically. It would also allow doctors to spend more time on patient care and less time being box-checking bean counters. Inflated prices ($105 billion) Fourth, limit “me too” drugs. Do we really need 12 different ACE inhibitors or 7 different nasal steroid sprays? Limiting the number of redundant medications would drive drug companies to truly innovate and lower prices on existing drugs.

It’s a start.

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