Solution to US health care: cost control

Totaling $3.2 trillion dollars annually, comprising 18 percent of the national GDP and costing 40 percent more per capita than any other national health system, why is health care so expensive in this country? A simple answer, really – there is no discernible method for cost control.

The CPT code-based system for hospital and physician reimbursement used by Medicaid, Medicare and private health insurers allows for open-ended reimbursement of hospital and physician services with very little push-back from the payers unless outright fraud is being committed.

Instead of allowing multiple CPT codes for each patient visit, there should be a single charge for the doctor’s time and a single charge for the medical supplies associated with the particular treatment. Note to the Center for Medicaid and Medicare: Please surrender your need for exhaustive medical information about every patient visit/treatment and immediately develop a new simplified CPT program for both general and specialty practice based on the above time and materials criteria.

Secondly, we need to reform ACA and private insurance so that patients with high deductibles (which is just about everybody) are equipped to “shop” for health care based on quality and price. We could emulate the “Medisave/Medishield” system operating successfully in Singapore, which features mandatory health savings accounts (comprising 6-8 percent of each paycheck) that allows citizens to buy catastrophic health insurance and pay for physician care, but back-stops the patient with a national website updated monthly that maintains a pricelist of services for all health care providers in the country.

Benefiting from a national program of price transparency, a U.S. health care “shopper” would have a better chance of finding an affordable medical provider to offset the lack of affordability under the current ACA/private insurance high deductible regime. Does the Singapore system work? Yes, it has been in place since 1984, costs 3.2 percent of GDP and has a life expectancy of 82 years with very low infant mortality.

I predict that, sooner than expected, the high deductible unaffordability of ACA/private insurance will force Congress into action on this issue with the cost/benefit analysis hugely in favor of making a change in the current high deductible/non-price transparent program.

This story was originally published November 30, 2017 at 4:38 PM with the headline "Solution to US health care: cost control."