The U.S. healthcare system can be fixed

The U.S. healthcare system can be fixed

Benjamin Podgor

Senator David F. Durenberger’s article “Inside-Out, Bottom-Up Healthcare Reform” in the November issue of hfm offered some interesting observations that bear some comment. In particular, his discussion of “a more active role for the consumer” piqued my interest. There, Durenberger says:

We know that many consumers overuse the system, are uninformed about

the costs of health care. and make poor lifestyle choices that lead

to costly illnesses that are costly to treat. But we also know that

consumers will make good choices when they are motivated to do so.

We need to create incentives that will encourage us to care about

our health, to live healthier lives, and to use the healthcare

system more judiciously.

Well said. But Durenberger goes on to say, “Trust in providers has been eroded and must be reestablished.” With that statement, I think he misses the mark. Our healthcare system requires checks and balances–it’s not about trust. You have to take responsibility and action, and get involved in creating the solutions–not just go about casting blame.

When we apply the system of checks and balances to the healthcare system, the solution to today’s challenges becomes apparent. For example, we are told that about two thirds of the U.S. population is overweight, and that being overweight leads to many health problems. If upon visiting a physician, for example, a patient is told he has a weight problem and does nothing about it, then why shouldn’t we penalize that patient by making him pay his own medical bill? Perhaps the first time, the patient could receive a warning, and then be required to pay only after repeated treatments for health conditions associated with being overweight.

True, the solution is not a simple one. We would be asking people to modify their lifestyles. But anyone willing to make the changes would be rewarded with a healthier life. We try to give people incentives to make wise life choices when we offer them certain deductions as “carrots” in our tax laws. Why can we not similarly offer people incentives in our health laws that will not violate civil liberties. If we keep such incentives simple, and ensure they are well established, we should be able to reap substantial savings.

Durenberger has given us a good formula. It is up to each of us to make it work. All we need to do is keep our eye on the payoff–a healthy population.

Benjamin Podgor, CPA, Esq.


The editors reply: We appreciate these thoughtful comments. One of the reasons we started the “Commentary” feature was to offer readers an opportunity to consider different perspectives of the important issues confronting health care. In this issue, we are pleased to present the views of Newt Gingrich, who offers a timely consideration of the recently signed Medicare bill. We hope the perspectives voiced in “Commentary” will spark some lively debate. Readers’ input and opinions are always welcome.

COPYRIGHT 2004 Healthcare Financial Management Association

COPYRIGHT 2004 Gale Group