In Part I “Unconnected Healthcare,” we discussed the many disconnections in healthcare today. In this article, we will flip the tables and discuss what the healthcare system would be like if it connected care to the patient at every step.
Imagine if you will, a world where healthcare was completely connected to the patient. In this world, the goal would be to provide the best healthcare at the lowest price possible. This would apply to doctors, hospitals, pharmaceuticals, regulators, and insurance companies.
This would greatly change our current system. It would still be a free-enterprise system, but with common goals and a complete twist to the existing priorities. In this world, everyone would all be on the same page trying to address the health of people.
In this system, costs would be transparent. I recommend a fix-cost system where the cost of the treatment or drug is the same to all people. For those insured, the insurance plans could be simple. Perhaps the plans could be based on paying a certain percentage or nothing if the item was completely covered. the Those without insurance would simply pay the stated price. However, a reduce price would apply for certain people with an inability to pay.
With information about costs, the doctor and patient could work together to decide on the direction of treatment. The patient would no longer suddenly being surprised by overwhelming medical bills. Different facilities could charge different amounts, but all the information would be available to everyone. Thus, if a person’s heart surgeon is associated with two hospitals, they could choose the one with the lower cost.
The insurance company would save money by not attempting to overturn every decision that a doctor made (okay, a bit of an exaggeration). Instead, they would trust the expert who is familiar with the patient’s case to make the best decisions for the patient. The insurance companies would run periodic audits on doctors and healthcare facilities to ensure that they are treating appropriately. This would be a win-win for the doctors and the insurance companies, not to mention the patient.
Likewise, hospitals would drive decisions based on doctor’s recommendations for the patient rather than some government goals or regulations. Thus, if the doctor thinks a woman who has recently given birth needs to stay a couple of extra days, they would make that decision. No one would need to jump through hoops and hope for approvals to make it happen.
Additionally, the ability to get medication would be made easier. The total amount available would remain the same, but if you needed medicine two weeks before you ran out, you could get it. The date of the next refill would remain a month or the specified interval after it would have been if you filled it on time. Thus, if the refill is due on the first of the month, it would remain the first of the month for the next refill no matter when you last refilled it. In this case, trust is shown that the patient will use it appropriately. If they do not, they may run out or have other issues, but that is a separate issue that should not be managed by limitations on all patients.
Lastly, pharmaceuticals would have incentives to find medicines that cure rather than manage symptoms. They would also be encouraged to look to natural methods and ingredients rather than just focusing on chemical combinations. There would be a focus on limiting side effects.
And, companies would not advertise directly to the consumer except in a limited manner for over the counter drugs. This would drastically cut the cost of drugs in two ways. First, the pharmaceuticals would have far smaller advertising budgets. Second, fewer drugs would likely be prescribed since people wouldn’t constantly be told “Ask your doctor if . . . is right for you?”
If all goals were in support of the best quality of care for the patients at the lowest possible cost, many things in the medical world would change. Board of directors would even have a different view on executive salaries. There would no longer be multi-million dollar bonuses to hospital executives that cut cost at the expense of the patients. Instead, patient and staff feedback would drive the business, including bonuses to executives.
In a world where all healthcare is connected to the patient, everyone wins!