Your turn: Ideas could help reform health care

By Dr. Jhablall Balmakund. St. Cloud

A better health care system delivers appropriate care in a timely and fiscally responsible manner to individuals who need it.

Everyone agrees that the cost of medical care is exorbitant and will continue to be that way. A major problem is how to control and keep medical costs down. There have been many proposals and actions to contain medical expenses, most of them futile. We as a society have to be willing to make sacrifices. We have to be cost-conscious and responsible for our actions.

Here are some suggestions.

» Rein in physicians. Encourage and reward them to be clinicians. We need a logical approach to patient’s care garnered from the patient’s history.

» Physicians should order appropriate tests. If tests are deemed unnecessary, then none should be done. Many conditions not revealed by usual and preliminary tests are generally not treatable, so exotic, generally expensive tests should be done only after great thought.

Perpetuation of the testing cycle may make patients believe that something is wrong. If they must, physicians should refer patients to a specialist for further and appropriate testing. The patient’s security and confidence may increase, especially if the specialist concurs with the referring clinician.

Also, inform patients and their families that they may bear the costs of tests ordered inappropriately. That way they serve as gatekeepers of their health care costs.

» Physicians should rewrite and stress the patient’s responsibility in their bill of rights. Hold them accountable for their health and modifications of risk factors, following dietary and exercise recommendations.

Be compliant with medications and appointments. Guide patients to seek medical care at the right time and place. Help them educate themselves about their illness.

» Do not pay leaders of insurance providers and health care organizations outrageous compensations. Those organizations that are making profits in the millions of dollars are most likely overcharging customers. Decrease future health insurance costs with any windfall to the organization. Reward workers who are effective, efficient and innovative.

» Why dedicate an entire organization with a budget of billions of dollars — the Veterans Affairs medical system — to treat members of the armed forces? They are not lepers. Treat them like any other patient. Incorporate their system into ours, so that both systems can be used more effectively and efficiently. Have veterans insurance pay for their care.

» Clamp down on frivolous lawsuits. However, encourage patients’ rights. We need tort reform. Cap and control malpractice insurance. Charge physicians with good records a discounted premium.

» Government and private insurances could lower prices by negotiated contracts, especially for unique drugs.

Use cheaper drugs or generics of the same or comparable efficacy with adjustments made by the clinician for bioavailability.

» Encourage home care. Families with a sick member should all contribute to the care of the patient. If they are on welfare or unemployed, tie financial aid to the health of the sick member.

» Examine universal health care/socialized medicine. Many countries with this system provide better care at a lower cost, or meld the systems. Medical providers will have to decide which patient gets what services to improve cost benefit ratio.

Ultimately, we cannot expend resources for an exercise in futility. There will be opponents and proponents to changes. However, if we do not start looking for alternatives, then the cost of health care will continue to skyrocket.

In the next five to 10 years the cost of U.S. medical care will be about 20 percent to 25 percent of the federal budget. Unfortunately, in an effort to contain costs in a world of unlimited resources, physicians may lose sight of the primary goal — that is to preserve life.

This is the opinion of Dr. Jhablall Balmakund, a neurologist at the Neurology Clinic of St. Cloud.
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