Saving Health Care

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Here I explain why Health Savings Accounts and Direct Primary Care (ala Qliance of Seattle and Hello Health of New York) are the cure for what ails the American health care industry. Which is, again …

Here I explain why Health Savings Accounts and Direct Primary Care (ala Qliance of Seattle and Hello Health of New York) are the cure for what ails the American health care industry. Which is, again in short: insurance run amok.

I prepared these slide for "Sound Off" at the New Hampshire Liberty Forum, and the talk was delivered in just 6 minutes.

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  • Ben Woosley here. I’m an engineer by trade, a resident of New York, and I’m here to talk about 2 subjects I think a lot about. First: Health Care, specifically discussing what *you* can do *today* to fix the system. No politics, just choice.


    http://www.flickr.com/photos/quiplash/47545024/ (Attribution Noncommercial Share Alike)
  • Dramatic increase in the cost of health care. Some of it necessary, good, much of it less so.

    http://www.heritage.org/research/features/BudgetChartBook/fed-rev-spend-2008-boc-S12-Medicare-and-Medicaid-Spending.html
  • Many Doctors hate the system as well, and are opting out. For example, Primary care, the bread and butter of health care, the doctor you see the most, and should see at least once a year for your annual physical. Well, they’re simply not around. Very few medical students going into primary care

    http://blogs.usatoday.com/oped/2008/03/shortage-of-pri.html

    http://www.entrepreneurialmd.com/index/2008/11/18/angry-primary-care-physicians-are-just-saying-no.html
  • How did we get here. Partly because guys like this aren’t focusing on the real problem. I’m here to tell you what I think that real problem is.
  • Surprise! Washington did it again. Current medical policy is one of the great tradgedies of the modern age.

    http://www.flickr.com/photos/projectsilence/2072998389/
  • Specifically, a policy which sprung up sometime around the post-depression years.


  • Heard an insurer unfairly denied a claim? You can’t dollar-vote against them by switching providers. Only the employer can do that. Nor can you easily switch to an insurer who serves your specific needs (e.g. acupuncture enthusiasts). Also, you can’t pick the lowest-priced providers. Higher prices, less accountability. Bad stuff.


  • the insurer takes on routine costs as well as extreme ones, whereas all other insurers cover occasional, unlikely costs
  • the insurer takes on routine costs as well as extreme ones, whereas all other insurers cover occasional, unlikely costs
  • the insurer takes on routine costs as well as extreme ones, whereas all other insurers cover occasional, unlikely costs
  • http://tvw.org/media/mediaplayer.cfm?evid=2008030136C&TYPE=V&CFID=2679569&CFTOKEN=45205340&bhcp=1
  • 4-5 employees per doctor, to deal with insurers. Estimated 40%+ of primary care health care dollars
  • http://www.poptech.org/popcasts/?viewcastid=228


  • An account for paying medical bills directly. You have control over the value of the health exchange, and the power to cut through the inefficiencies of the existing system, without sacrificing the tax benefits
  • Health Insurance is still important and necessary, when it’s *Insurance*. HDHP pays out for those serious, but unlikely health events that we hope never happen, the same way we hope our house never burns down, or our we’re ever in a car accident. They’re there to cover the bills in the catastrophic case, but not before. Just where they belong.
  • This is the main person in your health care life. They take care of your flu, your broken bones, your stitches. They help you get a smoking cessation program or encourage you to lose weight. You pay them cash for their time, just as you do other folks.
  • 4-5 employees per doctor, to deal with insurers. Estimated 40%+ of primary care health care dollars

  • http://www.flickr.com/photos/greyloch/2666407838/
  • http://blog.jayparkinsonmd.com/post/70104332/high-deductible-health-insurance-saves-you-54-395-60
  • http://www.heritage.org/research/features/BudgetChartBook/fed-rev-spend-2008-boc-S12-Medicare-and-Medicaid-Spending.html
  • http://www.flickr.com/photos/clstal/2441925592/



Transcript

  • 1. FLICKR: QUIPASHI Saving Health Care, today (in 6 minutes)
  • 2. THE HERITAGE FOUNDATION We have a problem (costs are too high)
  • 3. Doctors are fed up 60% of general practice physicians surveyed said they would not recommend medicine as a career. Up to 50% of primary care docs intend to cut back or quit. Only 2% of medical students are considering going into primary care as internists. Since 1997, 50% fewer newly graduated U.S. medical students chose primary care as a career
  • 4. Many other problems (which I’ll get to)
  • 5. THE GOVERNMENT FLICKR: SILENCE99 CREATED THE PROBLEM (SURPRISE SURPRISE)
  • 6. The Status Quo Employer-provided, 1) All-encompassing 2) Health Insurance
  • 7. 1) Employer-provided Insurance Leading To... Less Diversity of Choice Less Accountability to Action Less Competition
  • 8. 2) All-encompassing Health Insurance
  • 9. 2) All-encompassing Health Insurance ...is not insurance...
  • 10. 2) All-encompassing Health Insurance Car Insurance doesn’t pay for Gas Flood Insurance doesn’t pay for Umbrellas Life Insurance doesn’t pay for the flu
  • 11. 2) All-encompassing Health Insurance Car Insurance doesn’t pay for Gas Flood Insurance doesn’t pay for Umbrellas Life Insurance doesn’t pay for the flu THIS WOULD BE WASTEFUL
  • 12. 2) All-encompassing Health Insurance quot;Insuring primary care is like insuring lunch. You know you're going to need it. You know you can afford it. Why on earth would you pay a third party to pay the restaurant on your behalf, adding overhead and taking a big chunk out of the money you pay?quot; - Nick Hanauer of 2nd Ave. Partners
  • 13. Tremendous Inefficiency “The insurance companies are blind, they have no idea what we’re doing, so what they want is paper. Lots of it, buckets of it, tons of it. [We] put out pounds of paper, to confound the people of the insurance world.” - Dr. Garrison Bliss
  • 14. Tremendous Inefficiency
  • 15. Terrible Incentives “We’re not paid to do our job well. [...] Since we only get paid for visits, the effective and efficient doctors simply get paid less, because we don’t see you as often. For asthma, I get $200 to prevent your asthma, but I get $10,000 to treat it.” - Dr. Jay Parkinson
  • 16. No judge of value “The higher spending is due to the provision of unneeded and sometimes harmful care: hospitalizations that could have been avoided with better primary care; frivolous specialist consults; overuse of diagnostic tests.” - Elliott S. Fisher, Dartmouth Medical School
  • 17. The Solution: HSA + HDHP + DPC
  • 18. 1) Health Savings Account- CASH FOR CARE
  • 19. 2) High-Deductible Health Plan - JUST IN CASE
  • 20. 3) Direct Primary Care - CARE FOR CASH
  • 21. Tremendously Efficient
  • 22. You’re the Customer Email Instant Message Phone Calls House Calls 24-hour access
  • 23. FLICKR: GREYLOCH YES, THATS RIGHT HOUSE CALLS
  • 24. Did I say Efficient? You can save thousands per year, for a single patient Dr. Jay Parkinson ran the numbers, and got TOTAL SAVINGS over 10 years = $54,395.60
  • 25. THE HERITAGE FOUNDATION We can turn this slope around Lower costs dramatically, for better care
  • 26. FLICKR: CISTAL Live healthier In better contact with our physicians
  • 27. All by embracing the market It’s about time, no?
  • 28. ? All by embracing the market It’s about time, no?