Tuesday, June 16, 2009

Lower Health Care Cost by 50% by Getting Rid of the Lawyer, Number One Enemy and Threat to Clinical Care

1) There is 2% in medical malpractice insurance cost. Most of it ends up in the pockets of lawyers, filing weak cases to score in the lawsuit lottery.

2) There is 10% defensive medicine.

3) There is 20% spent on worthless end of life care that tortures dying old people, solely motivated by a need to protect oneself from litigious, scapegoating, greedy, family members.

4) There is at least 20% for unproven, gold plated worthless regulation and accreditation standards. As the authorities impose phony standards of care from evidence based medicine, shouldn't the authorities prove that every new standard imposed at the point of a gun has been proven to achieve better patient outcomes. This requires pilot studies and controlled experiments in every larger settings. All new standards are garbage science until proven otherwise. These accrediting and licensing authorities should be sued every time they impose their garbage standards.

5) There is 10% overhead for insurance disputes and billing. This includes about 2% ($31 billion) just to deal with insurance forms, reviewed here (requiring free registration). The lawyer has immunized these HMO companies from any accountability. Even valid claims of insurance bad faith will fail. They are now huge, mature industries. They no longer need unfair and unjustified immunities. Strong lobbying efforts should end their unconstitutional immunities. The first lawsuit should be for the free labor, and its resulting unjust enrichment, pre-authorizations being for their benefit, that they intentionally forced from doctors, something like $trillion.

6) There is the cost of medical errors, perhaps up to 5%. Every medical error is caused by the lawyer. Instead of thorough investigations and system changes to prevent them, errors are covered up because they will take down the entity when lawyers get a hold of the reports. Such reports are testimony against interest, an exception to the hearsay rule. Every word will be blown up in a poster or Power Point in front of the jury, and read aloud, over and over.

7) There is the retention of incompetent, unethical, and dangerous staff, costing another 5%, because employment lawyers would destroy the place if they were fired.

8) There is more self-care. People are fully capable of learning how to diagnose and treat a higher level of disorders than cuts and colds. Make many non-addictive medications available over the counter, most of which are safer than those available one, in use and in overdose. People should be able to read about the management of a minor, non-lethal ailment, its medication management, then to take a low dose of a medication over the counter. The package insert should be written at the sixth grade level.

9) The biggest untapped mine of medical advance, at no additional cost, is the off label use of many medications. End the draconian punishments for off label promotion by drug companies. And fund a lot of research into exploiting the medication we have now. One person's horrible side effect is another's life saver. Headache patients accidentally died from unknown internal bleeding caused by aspirin. The blood thinning side effect has saved countless heart attack patients.

Get rid of the oppression and plunder of the pestilential land pirate, and health cost would be 50% lower, have higher quality, with errors nearly gone. And, you would have enough money left to buy the uninsured top of the line executive grade health insurance.


Anonymous said...

Nonsense. 2/3 of all medical costs are incurred in the last six months of life. My suggestion is simply to let nature take its course: let people die. Treatment for cancer. Stop it. Treatment for AIDS. End it.

People may have a right to life but they don't have a right to an endless life. That's the gimmick. If lawyers are land pirates, the medical profession are vampires. There greed is even worse.

Supremacy Claus said...

I agree, the medical profession uses the lawyer as a pretext for worthless make work, that torment old people before their deaths.

When we say, drop cost by 50%, that means employment, because of cost goes to salary. Are people ready for that mass re-alignment.

GGFreeman said...

I can count the times -I- have seen a lawyer talking to a family in the ICU and someone in the family says, "Do everything you can save my dear, old 96 year old grandma."

That would be zero.

Blaming doctors for patient families and patient's themselves wanting to live a while longer is asinine.

Supremacy Claus said...

These families threaten litigation and elder abuse reports when doctors do not go all out.

Enclarity1 said...

Here's one: incorrect information about healthcare providers (i.e., doctors, doctor's offices, hospitals, outpatient facilities, labs, pharmacies, etc.) costs the health insurance industry $26 Billion each year. You see this in the form of returned mail and payments sent to providers that were sent to a wrong or outdated address, in the incorrect and out-of-date information about a provider in a health plan's provider directory, in fines paid for missing timely payments to providers, in duplicate or multiple duplicate payments to the same provider, payments to deceased, retired and sanction providers, and more. And all because a health plan or PPO has inaccurate demographic information (name, address, phone, license #, NPI, etc.) about a doctor, hospital, etc.

If you looked through a health plan's provider file, you'd be amazed at how many of the records are duplicated or have missing or outdated information. This wreaks havoc on efficient operations, timely claims payments and more. And if a health plan has different databases of the same information, the problem multiples.

Fortunately, there are ways to address this $26 Billion problem. I work for a company by the name of Enclarity (www.enclarity.com). And we're doing something about it to fix this problem and keep it fixed.

I mention this because I've learned there are many ways in which healthcare payers and providers have large inefficiencies in their operations that can be fixed, often with intelligent technology. While there's no one smart bullet that will solve the vast problems, costs and inefficiencies in healthcare, my example above is one way that we can reduce its cost. It can be easy to be pessimistic about fixing a problem this large. But if healthcare adopts techniques that are common in other industries, I am confident that we can make some significant advances.

Thanks for your insights in your blog. Depending on Congress to solve all the problems of healthcare won't do the trick. Legislation is a blunt instrument, and there will be winners and losers as a result. We all have stake in fixing this mess without reducing the quality of care we deserve. Your blog shows how the legal profession has a stake in making healthcare more affordable, just like technology does as well. If we all put our best ideas and imagination to fixing this often stagnant industry, I think we'd be amazed at what is possible.

Supremacy Claus said...

$26 billion will buy 2 million families top of the line insurance coverage.