Doctor’s Blog

Healthcare: What is it?

Healthcare is simply taking care of a person’s health. The complexity of healthcare comes from the individual as a whole. Healthcare differs from one person to another. Some may require more attention and some, not as much. Everyone who is concerned about their body from the physical, to the mental and emotional aspects of well-being, tend to stay on top of what it means to them, to take care of themselves. Healthcare differs in regions as well. Depending on where a person is located, good healthcare may not be accessible. Getting good healthcare is trivial sometimes when it comes to preexisting conditions as well as onset of health issues that are unexpected. Sometimes it may be difficult to choose the best route of insurance if you do not do your research. It is necessary to check the resources that are available so that you can receive the best healthcare possible.

Regular Doctor Visits

Being healthy begins with getting regular check-ups, and following the advice from your healthcare professional. Doctors, specialists, and others in the medical field, usually do their best to give the most beneficial support to their patients. If you are in need of a good physician, there are many reviews online and sometimes, through word-of-mouth, you can find what you are looking for in a doctor. Sometimes people are not so keen on going to the doctors out of fear of what may be brought to their attention. It is understandable to take the approach of “I’d rather not know.” If you want to have a better chance at living a life of clarity in terms of your health and possibly, an even longer life, it is best to know if there are any health issues present that need addressed.

Take Control Now

In most states, you can locate healthcare for your physical, mental, and biological wellness. For the physical aspect of your healthcare, it is necessary to have a personal care physician and you are entitled to choose one that best fits your needs. For the mental health care for an individual, for problems such as depression, anxiety, etc., a mental health clinician can be located in your county or city’s directory. You can also search on Google for a list of reviews for the clinicians that you find. Getting physical exams, tending to your mental health and getting blood work conducted are great ways to stay on top of your health care and engage in a life of good health and well-being. When you take responsibility for your own health, you take less chances of having negative health outcomes in your future.

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Many models are being put forth to reduce the cost of healthcare in the United States right now. Two of these models include the reference-based pricing healthcare system and the value-based pricing healthcare system. Let’s briefly discuss each of these models.

Reference-Based Pricing Healthcare

In a reference-based pricing healthcare system, insurers define a reference price for medical procedures and allow their members to choose a healthcare provider that offers that service under that reference price. The price of a procedure is often determined by some percentage, usually around 120 percent to 300 percent, of what Medicare would pay. An increase of 20% – 200% may seem like a lot, but it’s important to consider the fact that Medicare typically reimburses hospitals at a much lower rate than other insurers do. This can sometimes be as low as ¼ the amount other insurers must pay.

When this model is implemented, prices tend to fall as hospitals in the area compete to maintain or gain market share. However, it is important to note that this system will have little to no effect on the cost when the patient doesn’t have the luxury of shopping for the best price. This includes emergency medical attention, locations that have little or no competition between hospitals, and areas where hospitals are not transparent about their pricing.

Value-Based Pricing Healthcare

Under the value-based pricing healthcare system, healthcare providers are paid for the quality of the care they provide rather than the number of services they provide. This system would emphasize the organization of a medical facility and its ability to maximize the value it provides its patients. Value-based pricing would also make the innovation of new technologies at lower costs a must as healthcare providers would ensure that patients received the most efficient therapies available.

For this system to work, a significant amount of work on the infrastructure of the healthcare system needs to be done to monitor both the outcomes of treatment and what factors caused those outcomes. A physician or drug manufacturer should not be held responsible for the outcome of treatment if the patient decides not to take their treatment as prescribed. Unfortunately, without the requisite infrastructure to ensure that treatment is being administered properly, determining their pay based solely on the outcome of treatment can do just that.

There are many more models that could potentially reduce the cost of healthcare being proposed and tested today. Keep yourself updated on the future of healthcare by continuing to read our content, and feel free to contact us if you have any questions.

In regard to your recent article in the Wall Street Journal, “Why the Amazon, JPMorgan, Berkshire Venture Collapsed: Healthcare Was Too Big a Problem” and the reasons for failure.  Haven failed because it did not use first principles thinking. The people that ran Haven thought that by using technology, innovative ideas and big data they could lower the cost of healthcare.

Haven failed because it did not use first principles thinking. The people that ran Haven thought that by using technology, innovative ideas and big data they could lower the cost of healthcare.

But they neglected to ask and answer the question why do we need healthcare in the first place? Many would answer we need it to preserve health. If you think about it, health is preserved by clean air and water and a proper sewer system. Health is also preserved by an appropriate diet, adequate exercise, proper sleep and avoidance of toxins such as cigarettes, drugs and alcohol. Early detection of disease is also important as well as compliance with treatment of chronic disease. Thus any healthcare reform should focus on improving public health.

Nevertheless most of us would still like care when we get sick. Ok then, what should healthcare look like? If we treat healthcare as the commodity that it is, we know that the best way to insure an adequate supply at the lowest possible price is to permit the laws of supply and demand to work. Our current system is a highly government regulated system largely influenced by lobbyists who represent doctors, insurance companies, hospitals and drug companies. The consumers I.e. the public has little to say about it. But they could have a great deal to say.

For example, large groups of consumers or large companies, by organizing their workers and their families, can overcome this system. Companies that self insure can use the healthcare cooperative model with the “co-op” owned by the employees. Financial incentives based on lifestyle would result in lower healthcare costs by decreasing utilization. Ownership of the cooperative would pass the savings from the cooperative to the employees. It allows employees to remain members even if they leave the company. By transferring ownership of the cooperative to the employees, companies are no longer responsible for healthcare and can concentrate on their core business.

An innovative cooperative can educate its members to utilize independent providers of healthcare and avoid hospital systems as much as possible. They can publicize providers that offer transparent cash prices for services. Other savings can be achieved by the cooperative owning the electronic medical record (EMR) and granting access to providers as well as to patients. By owning the EMR, the cooperative would own the data.

The cooperative model encourages the use of technology, innovative ideas and big data to improve access, decrease bureaucratic inefficiency, improve diagnostic accuracy, improve treatment outcomes. The failure of Haven illustrates how the current insurance system is resistant to change in spite of the rhetoric to the contrary.

Steve Goldstein

The news that broke last November that both Pfizer and Moderna had developed an effective vaccine against Covid-19 brought hope to a planet that had been suffering for months from the ravages of the once-in-a-century pandemic. An article that came out at the time in the Wall Street Journal offered explanations for how the vaccines were developed and tested in months rather than years. The vaccines also were developed using technologies that point the way to treatments for a variety of diseases, including cancers.

Typically, a vaccine is developed using a weakened or inactive version of the virus that it is designed to ward off. Without getting into too many details, the process is long and laborious. Before the Covid-19 vaccines, the quickest a vaccine had been created was about four years.

Both Pfizer and Moderna used a new technology using messenger RNA to deliver the genetic code of the virus, taken from the outer spike proteins to human cells. The cells then created the same spike proteins that were derived from the virus. Then the body’s immune system took care of the rest.

The beauty of this approach is that drug labs can create mRNA vaccines quickly once the genetic code of a virus has been sequenced. The development of vaccines would take weeks instead of years.

The fast prototyping of the new vaccine promises other applications, including cancer treatment. Often, even when the disease is beaten back, it can return in a mutated form, sometimes years later. The mRNA method can tailor-make vaccines that can attack cancer tumors based on their genetic makeup. So, even if a cancer returns after going into remission, healthcare professionals can tailor a new treatment to attack the mutated form of the cancer, keeping it in check and thus increasing human lifespans.

Drug companies had been working on mRNA vaccines for years. But it took the Covid-19 pandemic and President Trump’s Operation Warp Speed, which poured money into the effort and cut red tape, to bring the first vaccines to a clinical setting. The number of lives saved will be beyond evaluation.

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