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Whatever Happened to Affordable Healthcare?

Healthcare costs are increasing faster than any segment of our economy.

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If the goal is affordable, accessible, quality healthcare we need to address the cost of healthcare before we figure out who will pay. Historically payers and providers have been at odds. Providers want to do as much as possible. The motivations on both sides are varied. One way to reduce cost is to partner payers and providers through Population Health models. This works similarly to the old HMOs except it does a better job of taking into account the level of disease in the population. These models take the big data from payers regarding what is cheapest and overlap it with the big data from providers regarding what works best to determine the most cost efficient, effective treatments. Community health centers use this and reduce overall cost by 28% while providing better outcomes. My employer is currently using this model with a portion of their Medicare population and again, that group of patients has 25+% savings and better outcomes.

Government interference has led to some of the problems in healthcare. With the growth in government interventions and more complicated billing practices has come an explosion of administrative costs. Add to this that physicians now spend 50% of their time on administrative paperwork and the problem becomes overwhelming.

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One way to reduce the administrative costs is to overhaul billing practices. Bundling of payments has shown promise in this area. In that system a knee replacement, for example, has a set cost no matter the complications. This has the added benefit of rewarding the hospital system for efficient care.

The third-party payment system in healthcare removes consumer driven price reduction. Expanding HSA’s and allowing insurance plans that provide basic preventive health along with catastrophic coverage but leave all the rest to the consumer could bring back some price competition between healthcare systems. The lower cost of these plans would allow consumers to build a healthcare fund giving them more control over their own spending.

There are advances in healthcare that are being made in research. But what good will those advancements be if no one can afford them.

It seems very few members of Congress have an interest in reducing healthcare cost. We only seem to hear arguments about who will be paying these costs. Democrats want it all on the taxpayer, Republicans want as much as possible on the consumer. What few seems to realize is that the taxpayer and the consumer are the same people. They are the employed Americans. If we have plans that expand government health coverage our taxes go up. If we have plans that result in large numbers of uninsured our hospital cost/insurance premiums go up. The only way to make a true difference is to reduce costs.

So that is why I am running. Not because I dislike Jim Sensenbrenner, I don’t, but because we need people in Congress who understand and are willing to attack this problem at its heart.

What do you think about this? Call (262) 419-0019 to leave a voicemail, and I might share your thoughts on this website!

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