Monday, July 2, 2018

US Health care is too darned expensive

American spends 19% of GNP on healthcare.  That is twice as much as any other country in the world.  That means that American products are 19% more expensive than they might be, just to pay the workers health care. No wonder we face such a massive trade deficit with China, and nearly ever other place in the world.  Our products are too darned expensive.  And American health care costs drive up the price of our products.
Here is my list of things we ought to do about the health care cost crisis.
1.  Drug companies are ripping us off with ridiculous drug prices.  We could fix this overnight.  Simply allow duty free import of drugs from any reasonable first world country, like Canada, the EU, Japan.  Many US rip off priced drugs can be bought overseas from half the US prices.  This is a federal issue.  Nothing a NH state senator can do about it. 
2.  Clamp down on the malpractice racket.  The lawyers turn every adverse outcome into a river of cash for themselves.  NH has done some good work here with the malpractice court.  We could do more.  We could pass a law stating that prescription, manufacture, and administration of any FDA approved drug or device is never malpractice, even if the FDA later withdraws their approval.  We could crack down on lawyer approved malarkey testimony in malpractice cases.  We could require that "expert" witnesses must be practicing MD's who have treated more than ten similar cases within the past year.   A lot of "expert" witness no longer practice medicine, they just travel from trial to trial testifying to whatever the lawyer wants in malpractice cases.  This is a state issue.
3.  Clamp down in ridiculous regulations.  For instance, Dartmouth Hitchcock, down in Lebanon, has the roof lined up from side to side with humongous air conditioner units.  That's because some regulator demands that the air conditioners hold hospital temperature to plus or minus 1 degree F.  That's ridiculous.  I used to run an Air Force Precision Measurement Equipment Lab  (PMEL we called it).  We got all over Base Civil Engineers because the PMEL air conditioner could not keep PMEL temperature below 95F on a hot summer day.  In actual fact, this hospital regulation is totally unnecessary.  As long as air conditioning holds the temperature down enough to prevent patient suffering, they will get well. Some of the mickey mouse regs are federal, some are state.
4.  Stop prescribing so many opioids.  The Wall St Journal says that 80% of Medicaid patients in West Virginia and Kentucky are getting prescriptions for pricey opioids.  Which gets the patients onto heroin when the opioid prescription runs out. This is a mixed issue, part federal, part state, part medical profession.
5.  Stop doing so much heroic treatment on elderly patients who are at end of life.  No matter what the diagnosis, there is always some expensive procedure (a CAT scan for instance) or operation that might extend the patient's life by a few weeks.  In many cases, the elderly patient would be happier to just go home and die quietly in bed. This is a tough issue, but we could help by enlisting the elderly patient's family in decisions to do expensive things on very elderly patients.  My mother felt strongly about this, and was glad to have her two grown sons take her to the hospital and then back home.  She managed to die quietly at home at age 91.  

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