Healthcare Reform: A Way Forward

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Healthcare Reform: A Way Forward

The healthcare reform impasse is a distraction. Whether you are for free market or single payer the status quo is designed to keep you locked in the maze where promises of winning at all costs or fixing the broken system is the cheese that everyone is chasing after. Over the past 8 years there has been one constant no matter who is in power – our healthcare system continues to get worse.

Since the passage of the ACA healthcare costs have gone up, choice of doctors has gone down, access has narrowed and our healthcare system is now last among the developed countries for delivering efficient, cost effective quality medical care.

Maybe it is time we step back and ask a few simple questions:

Will throwing more money into this system really make it better?

Will centralizing it make it better?

Will giving the parties that have nothing to do with the doctor patient relationship more power to control treatment options help?

Will doubling down on exchanges, subsidies, expansion of Medicaid transferring the wealth from middle and working class taxpayers to the government and medical insurance administrators really make our health care system better?

Will universal insurance coverage divvied up by corporate players who make money by controlling access to care really improve the quality of health care?

Will shifting the power to control every cent of the healthcare dollar to the insurance company, Big pharma and the hospitals really decrease healthcare costs?

We have tried this for 8 years and what has it achieved?

Hospitals have gotten richer while decreasing charity care

Physicians in private practice now account for 30% of practicing physicians down from over 60%

Many physicians have left the practice of medicine and a growing number of RNs have left clinical practice to join the ranks of administrators as case managers.

In short, the problem with the reform effort to date has made the mistake of empowering the drivers of high healthcare costs. The framing which has centralized and corporatized the healthcare system which accounts for one-sixth of the economy was used to vilify physicians as the mechanism to monetize the doctor and the patient. It was masterful, but when you learn that 7 cents of the healthcare dollar is actually spent on the independent physician, it becomes obvious that the framing was designed to drive emotion at the expense of reality.


The answer to healthcare reform is to change business as usual. Doctors and patients need to remove themselves from the mill designed to grind them both into the ground to extract money at all costs at the expense of health, talent and the delivery of care based on individuality and the Hippocratic Oath.

The choice is clear. Consumer driven choices such as direct primary care practices, cash based practices which are based on price transparency and competition with freedom to choose how a patient is treated vs one-size-fits-all conveyor belt medicine driven by algorithms where an administrator and bureaucrat will decide the patient and the physician’s value.

This is why whichever political party that is in power in Congress will not repair our healthcare system. Doctors and patients have become cash cows feeding the broken system. Giving subsidies to the insurance companies and hospitals by taking money from taxpayers to do it is a complete farce. Single payer will only hasten the the transfer of power from the doctors and the patients.

It is time to go down a different path. The process needs to start over so that the healthcare system can be made better for everyone. How about asking practicing doctors and patients what is broken and get their ideas about how to repair it. Clearly doing the same thing so that nothing changes is not working…..but maybe that’s the point

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