Essays on Rebuilding America: Medical Care: Availability, Not Cost Could Be The Real Crisis

Columnist : Jonathan Williams

by Col. Frank Ryan, USMC Ret.

The health care crisis seems to be on everyone’s mind today. Politicians have unique solutions to sell you with the objective being your vote. Getting your vote is, unfortunately, not what good health care is really about.

The medical care crisis is real and it is multi-faceted. While we mainly focus on cost and the uninsured, the real concern should be about availability. The number of doctors over age 55 is significant. When those doctors retire, the question will not be about cost of medical care but instead it will be about the rationing of medical care. The shortage of practicing nurses is already well known but the shortage of doctors is only now becoming a focus of discussion.

In order to revitalize our health care system and provide the solid foundation necessary for access to health care for all, we must drastically overhaul how health care is thought of today.

The individual is the starting point for good health care. We cannot continue to rely on drugs or surgery to reverse years of poor health habits and poor diets. The true solution to our health care crisis is personal responsibility. This will take years to be effective but it is the only true long term solution.

In the shorter run, our health care system must emphasize wellness and not illness. At present, the emergency room is the physician of choice for many Americans at great cost to all. It is important to allow nurse practitioners, physician assistants and nurses greater autonomy in providing medical care. Not all medical issues require a doctor. Additionally, the AMA and research facilities should be encouraged to develop standard medical examinations and treatment for each risk group or age, especially the aged. This improves early diagnosis and allows for treatment at a much lower cost than remediation later.

Medical systems must be streamlined by providing funds that will be used to renovate health facilities and find creative means of providing health care. Let the private enterprise system encourage solutions. Government imposed pricing with Medicare and Medicaid, regulatory approval processes, and litigation risks all work together to deny you the very thing that our political leaders tell you they are working for. Additionally, insurance companies frequently base their reimbursements on Medicare and Medicaid, while at the same time requiring additional paperwork to justify payments. More realistic rate structures and simplified billing administration are needed to encourage the free market system to work as they are intended to work.

Tort Reform is needed as well. We must limit non-economic damages for awards, and give the state licensing board greater latitude to punish negligence. Concurrently, physicians and health care providers have to be willing to police their own ranks.

To alleviate the shortage of health care professionals, we need to encourage careers in health care through a nationwide tuition assistance program, loans, and tax incentives. It is absurd that our tax code fails to reward education. If you want to fight medical care shortages, encourage the career (and all careers for that matter) by providing for the deductibility from income of tuition payments. To provide for care to the poor, non-profit health care facilities will partially fill the gap but I would also recommend that the tax code be modified to allow health care practitioners to deduct the market value of their charity care to the poor as a tax deduction on their tax returns.

Prescription drug approval processes and research are needed to significantly reduce the costs of developing new drugs. Making villains out of drug companies to get votes is counterproductive.

Finally, revision of HIPPA and the Stark Act to reduce unnecessary and cumbersome regulations which increase costs but do not improve health care should be undertaken immediately. Once again, the Congress passed well intentioned bills with no understanding of the impact on the industry.

Great health care emphasizes wellness, personal responsibility, and a society that is willing to lead the effort of encouraging health care careers. Bandages will not fix our health care problems today but redefining how health care is provided will. We need to break health care in order to fix it.

Col. Frank Ryan, USMC (ret.), serves on the board of directors of the Lincoln Institute of Public Opinion Research, Inc. and he is a commentator for American Radio Journal.)

Col. Frank Ryan, USMC (ret.), serves on the board of directors of the
Lincoln Institute of Public Opinion Research, Inc.
and he is a commentator for the American Radio Journal.)