Whenever I hear people talk about how to take care of people with health care needs or about how to save money on health care, its seems like we hear the same old arguments.

We have comments from each side about the merits of lawyers, the insurance industry, doctors, hospitals, the federal and state governments, etc. While each one of these elements in some way contributes to the problem and I acknowledge these issues should be discussed, why not consider another way to mitigate health care costs AND improve the quality of life for the people who are being treated.

The big issue I am talking about is often referred to as disease management, but it can more easily be understood if I just describe it as making sure the patient is diagnosed in a timely manner and making sure the patient is compliant with the instructions of his or her health care provider.

Let me give you an example. Roughly 19 million people have diabetes in the USA today. Of these, roughly 12 million are diagnosed (7 million undiagnosed). Of the 12 million who are diagnosed, at least half are not compliant with their doctor's instructions. That means they do not test their blood sugar as often as directed and do not follow the dietary guidelines provided by their doctor. That means that roughly 2/3 of the 19 million diabetics in the USA are not treating their illness properly.

Before we go any further, lets take a minute to talk about diabetes. Its a degenerative disease, but if treated properly a person can usually live a long and full life. If not treated properly, however, it can lead to a variety of physical problems. If can increase the risk of heart attack or stroke by somewhere between 200% & 300%. It can lead to blindness, amputation or kidney failure. It can do a lot of other unpleasant things as well, but for the sake of brevity, I will stop with these unwanted results.

So think about it. We have approximately 12 million Americans with a degenerative disease they could treat for a relatively low cost who do not treat it either because they have not been diagnosed with the problem or because they do not follow their doctor's instructions. As a result, we have 12 million Americans who are more likely to have heart attacks, strokes, kidney failure or suffer from blindness and/or amputations and all the vaunted medical experts, insurance experts and governmental experts can do is talk about how we are going to pay for these events after they have occurred. Why doesn't someone start talking about how we can reduce these very preventable occurrences that are expensive for the health care industry and devastating to the lives of the patients?

Think about the cost to the insurance companies and the federal government for treating these millions of people for potentially avoidable strokes, heart attacks, amputations, kidney failures and blindness. We are talking about tens of billions of dollars here. Now imagine we had the foresight to take a small percentage of this money we will have to pay on the back-end and use it on the front end to prevent the problem. If we could come up with effective methods to diagnose more people with diabetes earlier and to do more to encourage and facilitate their compliance with their diabetic treatments, then we could avoid tens or even hundreds of billions in cost and untold loss and misery on the part of patients.

Now consider emphysema patients. This is another disease that is degenerative in nature. At some point, they usually require an oxygen concentrator in their homes as well as some combination of medication to help them breathe. They will go in and out of the hospital as problems arise and their condition worsens. If they follow the doctor's orders with respect to the use of the oxygen concentrator and the use of their medication, however, then they will spend a lot less time in the hospital. The "frequent fliers" who are not compliant with their doctor's instructions and go in and out of the hospital every few weeks cost the system a lot more money. If more of these patients could become compliant with their doctor's instructions, then billions more would be saved every year.

I could go on and on, but I hope these 2 examples bring the point home. Its not just about throwing more money at the problem, rationing the money we have differently or making people take thinner profits to provide health care. Its also about finding smarter and more cost effective ways to treat people. With the right incentives in place, we could improve the rate by which we properly treat people for their lesser illnesses and avoid or delay the larger ones.

How to implement this plan? Well the last thing you want to do is to create another government bureaucracy to implement it from Washington or put it in the hands of some call center paid by the private insurance industry. The government and the private insurance agency are the ones responsible for paying for our health care costs, but they are not the best suited to implement compliance plans. They should provide incentives for doctors, hospitals and home care providers to implement the program, because you need people on the ground with personal contact to evaluate the compliance of the patients and to recommend solutions. Sometimes its a matter of proper education about their disease and their treatments. Sometimes its a matter of monitoring the patient and making gentle reminders. Regardless of the resolution, its best done by someone they know at the local level working under some incentive plan given by the big guys.

Just imagine a way we can save billions upon billions in health care costs while also adding to the quality of life of the patients. Thats ought to be a goal we can all get behind. Now for those of you who want to go back to the same tired old discussions about nationalized health care and taking the profit motive out of the equation for health care providers so we can go a little farther on the same failed linear extrapolation, please be my guest.

who would like to comment on a healthcare proposal that could potentially improve quality of life for millions of people while saving the government hundreds of billions of dollars and not require a single new technological innovation?

Anyone?

Eliminate Insurance companies. Recent studies show that most of the rises in the cost of medical care are not b/c of the actually medicene but b/c of the administration people that act as the intermediary between the patient and the doctors, these are the insurance people. If there is a nationalized health care system, then their will be no need for medical insurance, hence the costs of medical care would plummet.

-Demosthenes

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"A people that values its privileges above its principles soon loses both."
- Dwight D. Eisenhower

Partly true but the rich will still have their insurances to make sure that they will not have to wait in line to get treatment. Our PM recently got an operation of his hip, a procedure that some people has to wait months or even years to get. I wounder how he managed to pull that of? Actually members of our Parliament has made sure that they don't have to wait in line. The same is true for "key personnel" in our industry, from specialist workers to board members.

Still many people do need constant medication and diets to live a somewhat normal life. I know, I got Psoriasis myself and it does not look pretty when I have forgot to visit the drugstore to get more medicine for a while. I currently need to renew my recipe for a special shampoo, and of course, yet again I forgot to call my doctor this morning. It is easy to become lazy about these things. Maybe we do need a reminder from time to time.

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Whoever fights monsters should see to it that in the process he doesn't become a monster.
Friedrich Nietzsche

Sorry, I'm not sure I understand how that relates to my point. Could you clarify.

-Demosthenes

__________________
"A people that values its privileges above its principles soon loses both."
- Dwight D. Eisenhower

Just that I agree that normal people should not rely on having a health insurance, still health insurances won't go away, there will always be a market for them. I am even against a system that expect people to get an insurances since some people are denied due of medical reasons. Consequently people may avoid going to the doctor to get a health checkup diagnosed since then they may be refused further insurance if it turns out that they MAY get sick.

Some people will however still get a separate health insurance to make sure that they get special treatment, it would be hard to outlaw that.

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Whoever fights monsters should see to it that in the process he doesn't become a monster.
Friedrich Nietzsche

Eliminate insurance companies is your pat solution to all healthcare woes. I know it by heart. Besides the fact that its impractical to remove the profit motive, I am most frustrated by the fact that you did not read the post at the top of the thread.

So you have no sympathy from me. lol

you would understand the issue is a lot bigger than what you are explaining here.

address private insurance. It was talking generally about healthcare and specifically about cost mitigation tools the government could take along the lines of medicare and medicaid.

So Dem, your always festive answer of eliminating private insurance really is not in the slighest way relevant to the original post. In fact, it would be largely counter-productive for a host of reasons we can talk about after you read the original post.

And NiceGuy, you are very nice, but you did not read my freakin post either. If you apply your comments about all the lines people go through to get treatment, then you are making an argument against the system you describe. In this very lazy country of ours where people do not read posts (joke), more than half the diabetics do not test their bloodsuger when the freaking stuff is mailed to their doorsteps. How many fewer people will go to the trouble of testing if they have to go somewhere and get in line? If you had read my post then you would understand that fewer compliant diabetics is the very last thing you want, because you will have more strokes, more heart attacks, more kidney failures, more amputations and more blindness as a result. The increased rates of occurance with these very costly physical ailments will suck so many more resources into healthcare that you will effectively be taking from us much more than the insurance companies ever took.

Its amazing, but when you make an informative post that goes beyond analysis of what someone felt after they read a headline, it gets ignored!!!