And this is what we need. Not just in medicine, but in many areas.
We need to field the public for very good ideas and implement them.
My husband is a soldier and he sees MANY areas where we could cut military spending without cutting pay, military resources or readiness.
But the way that the system works, it rewards failure.
Let me give you one very small thing that’s been bugging me for years about TriCare.
My daughter’s doctor said that she needed to see a cardiologist. The cardiologist ran a bunch of tests, said that this was wrong and that she needed a neurologist.
The cardiologist can’t send her to a neurologist. He sends his report to my dr’s PM (suggesting the referral to the neuro), then my daughter has to make another appointment to see her PM who then gives her a new and separate referral to a neurologist.
The inability of one specialist to refer to another is stupid as hell.
So TriCare now has to pay for a NEW appt with her PM to get a new referral to the new specialist.
Now we not only add the cost of the appointment to the PM that wasn’t necessary, we add the paperwork with TriCare.
I know it seems small - $75 for an appt, half an hour of a TriCare employee to process this appt - but do this a thousand times... ten thousand times... twenty thousand times a year...
How much is this extra step costing taxpayers?
When you factor in that this stupid rule applies to every soldier, sailor, airman, marine, retiree and military dependent, it adds up.
Where can I go to suggest this small change that would probably save the military healthcare system a billion dollars each year? I’ve written a letter to TriCare. I’ve written op-eds. I’ve blogged about it.
Nobody listens. Nobody cares.
THAT is the problem with gov’t programs. Once the system is in place, nobody is motivated to change it.
Trust me, if a private insurance company found a way to cut a ton of money from their budget AND make their customers happier, they’d do it.
In 2005 the Texas High Risk Insurance Pool commissioned a study to figure out why nobody was using the program. The study found many issues with the program and multiple suggestions to fix it. The Texas legislature ignored the study.
I love the idea of an ‘x-prize’. There are many, MANY people out there smarter than me. But it’s worthless if there’s nobody to implement these ideas.
This is why we keep putting our hopes in politicians. In our minds, that’s what they’re hired to do. But *their* motivation is to get elected.
Trust me, if a private insurance company found a way to cut a ton of money from their budget AND make their customers happier, they’d do it.
Therein the wisdom of Paul Ryan's initiative to turn Medicare into a voucher program. Private insurance companies would never stand for the waste and corruption that exists within any government program.
Costs can only go down. Service can only improve.
In the interest of full disclosure: I am a dialysis patient, on Medicare. It's my understanding that dialysis patients are responsible for around 2/3 of all Medicare outlays.
The treatments are expensive...and they keep us alive almost indefinitely.
My wife is an accountant...and she views every statement and invoice we get -- from providers, Medicare and the supplemental insurance. Medicare normally pays around 1/3 the cost of the invoice..and the supplemental provider automatically pays 25% of that. And, shazam, everybody is happy.
But it's obvious what is happening. Every time Medicare ratchets down the percentage of the bill they will pay, the suppliers ratchet up their invoice -- so that their eventual compensation is equivalent to their real cost of service (plus profit).
Thus, a totally artificial price structure is in place that has no relationship to reality...and is ripe for corruption.