What You Should Know About Our Medical Care System and Its Effects on the Rising Cost of Health Care

May 23, 2016

Medical Care Costs will exceed the average household income by 2030, according to a recent study published in the Annals of Family Medicine. We dedicate over 16 percent of our economy; $2 trillion a year to medical care.

Both public and private medical expenditures are growing at rates which outpace comparable countries. Despite this higher level of spending, the United States does not achieve better outcomes on many important health measures. Kaiser Family Foundation April 2011.

Background – How did we get to where we are today with a medical care system out of control with no end in sight? Let’s look at how we got here and what might be some of the components of the system that need changing.

Physicians started out in the early years as general practitioners which meant they prescribed medicine and did surgery. Over time some physicians sought more schooling and became specialists. In addition to the prestige of being a specialist they are paid more money.

Although physicians are mostly in solo practice there is movement to small specialty groups. The incentive for this is the opportunities to decrease practice expenses and, especially for specialists, to enhance revenues from profitable services.

The use of Nurse Practitioners and Physicians Assistants has helped physicians meet the growing demand for services. Since most care is delivered at the primary care level, to meet the need for primary care a new specialty called Family Practice was developed. However there are a growing number of people seeking care from alternative medicine practitioners, e.g. acupuncturist, chiropractors, massage therapists, and naturopaths. I feel this latter trend will broaden the base of services and help to reduce costs by providing less expensive alternatives to the more expensive services of traditional medicine.

Prescription Drugs are important to preventing and treating illness and can help avoid more costly treatment. However, prescription medication abuse is probably the most common form of drug abuse in our country at this time.

Although prescription drug costs are relatively small compared to hospital and physician cost they are rising at a higher rate. Insurance is paying a greater portion of drug costs and patients are paying less out of pocket for their prescriptions, which makes them less concerned about prescription costs.

Medical Insurance – It started out with payments made directly to physician from patient. Then medical insurance in mid-1930’s and then 1965 the government became a major payer through Medicare for elderly and Medicaid for the indigent. The coverage by a third party has taken the patient out of the control of payment. This has led to a lack of concern for the cost of care by the patient, a factor in the rising expenditure for care.

Compensation tends to drive the business model. Since the bulk of services are paid for on a fee-for-service basis there are built in incentives to produce more services thereby increasing costs.

Preventative Services – Services that can save lives are not given the attention they need. A January, 2012 study published by the American Journal of preventive Medicine finds that Doctors are not performing the preventive services the patients need. There are a number of reasons these tests are not performed: it doesn’t pay as much as treatment services and usually these services are not covered by insurance

Patient Centered Care – Today with the change in disease from acute infectious to chronic requires patient participation. Most of the major diseases have a behavioral component which means the patient treatment involves behavior changes that only the patient can do.

The Solution – to rising costs is to decrease the number of sick people and increase the number of healthy people. To do this requires we look at a New Health System Model which means includes adding environmental, heredity, behavioral, and nutritional health components, in addition to our medical care system.

My name is Frank Nastars and Five Factors of Health is my website. I developed this site because I am concerned that we are on the wrong path when it come to Health Care. It is my belief that Optimal health requires more than just health care, it should include the environment, heredity, behavior and nutrition. I have spent over 50 years in Health Care.Included on my website are products and Information that will help people reach their optimal health

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