8 Ideas on Healthcare Legislation from a Functional Medicine Perspective
A couple months ago, we published “Making Sense of Health Insurance in the Trump Era” to offer some insight into the Trump administration’s repeal-and-replace solution for The Patient Protection and Affordable Care Act of 2010 (i.e., Obamacare). Since then, we have come to realize that the problem with both the previous bill and the current legislation being discussed (the American Health Care Act) mirrors the underlying problem with conventional medicine.
Instead of diagnosing and addressing the cause of the problem, the American Health Care Act focuses merely on symptom relief. In the case of the medical industrial complex, the solution to healthcare is to spend gobs of taxpayer money on early detection and treatment of illness instead of focusing resources on keeping people healthy in the first place.
As a result, the medical industrial complex has become very skilled at treating illness but horrible at preventing some of the most costly chronic illnesses that afflict the population.
On a related note, the current administration is making the same mistake as the past administration by focusing efforts first on getting more coverage for more people and only secondarily, if at all, on reducing costs. The only attempt at cost-reduction we have heard much about is the notion of allowing people to purchase health insurance across state lines, which theoretically will increase competition and drive down the cost of health insurance premiums. But what about real cost reduction in healthcare?
What are the plans to reduce the actual costs of treating illnesses?
We have a few ideas:
- Make healthy food more affordable than junk food. Or at least stop subsidizing crops and other farm foods used in the production of junk foods — corn, soybeans, wheat, rice, sorghum, milk, and meat. These subsidies artificially reduce the cost of junk foods that contribute to obesity. A good start: the Agricultural Act of 2014, which includes funding for programs that support organic farming and provide incentives for those who receive food assistance to seek out healthier food alternatives.
- Lower premiums for those who lower their health risks through lifestyle enhancements. This is already being done by some companies to varying degrees, and it should continue. For example, insurance companies charge lower premiums to non-smokers, and some employers offer wellness programs to employees to encourage employees to stop smoking and lose weight.
- Pay doctors based on results and not on tests ordered and treatments provided. When you pay doctors for every appointment and test, they are going to be more inclined to schedule more appointments and order more tests; yes, even doctors will game the system. Instituting some system of performance pay, where doctors are compensated based on quality instead of volume may help to shift doctor and patient focus from merely treating illness to restoring health, which would be a huge step toward driving down healthcare costs. See “Getting Off the Patient Treadmill” for a good discussion that examines the pros and cons of performance pay in the medical industry.
- Reward patients for finding lower-cost alternatives. In some areas, the cost of an x-ray may range from $80 to $350. When insurance covers it, patients have no incentive to find the best price, but offering a reward to those who find a lower-cost alternative would provide that incentive.
- Offer tax credits/deductions for gym memberships, supplements, air and water filtration, mold remediation, and other costs that promote health. The current system provides tax relief for medical costs, the costs of illness, but no tax relief for the cost of health. Preventing chronic illness is much cheaper than treating it.
- Encourage patients to examine their bills. Health Savings Accounts (HSAs) are a great way to encourage patients to examine their bills, because they have to pay a portion. Perhaps insurance companies could also offer a reward or bounty for any error that a patient finds on a bill that results in a lower bill.
- Simplify the paperwork. Doctors should not have to hire an entire staff to deal with differences in insurance companies and compliance with government regulations. Systems need to be developed and implemented to take this burden off of doctors, so they can focus on their patients.
- Allocate all taxes on cigarettes, alcohol, and other unhealthy lifestyle choices to offset healthcare costs. These “sin” taxes often go into the state’s general fund, where they are used to help balance the budget. They should be used for smoking cessation or, at the very least, to help offset the costs of treating smoking-related illnesses.
These are just a few ideas, some of which are already being tested in various markets. If you have any ideas on how to reduce the cost of healthcare in the U.S. while making people healthier and covering more people, please share your thoughts by posting a comment below.