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We spend 2 or 3 three times as much as most other countries on health care.

The Cost of Medicines

Obviously, we should let our government negotiate the cost of medicines.

  • Every other government negotiates this cost.
  • Also, the US buys more medicines than any other entity in the world.

As detailed in our articles on Free Medicines and Pharmaceutical Companies, if we take over pharmaceutical companies or buy out patents or keep patents after government funding of research for medicines, we could

  • eliminate their fraud, waste, and profits
  • streamline their research in a cooperative way
  • fight all diseases needed instead of just the profitable ones
  • provide all medicines at cost, usually for just pennies

Emphasize Prevention with More Family Doctors

A wealth of evidence shows that emphasizing prevention with care by family doctors protects people’s health better at lower cost.

Clearly, emphasizing nutrition education and intensive, early treatment for chronic diseases, obesity, and addictions saves massive amounts of money for hospitalization and surgeries later on in life.

  • The Japanese people see their doctors an average of 4 times a year, 4 times as often as Americans do.
  • Danish people are in touch with their family doctors an average of nearly seven times a year.
  • Japan, Denmark, and Cuba emphasize prevention, saving a great deal of money on chronic diseases and contributing to their longer life expectancy.

Yet we pay specialists far better than we do family doctors, leading to a shortage of family doctors.

Specialists like nerve or bone doctors often emphasize risky spinal surgery without trying enough physical therapy first, just to make as much as $750,000 a year.  This is very dangerous.

We should encourage family practice by paying family doctors more.  They can save us money with early care and prevention and reduce inappropriate, risky specialty care.

Expand the Use of Nurse Practitioners

We have a shortage of family doctors.

  • By 2025, we will need over 50,000 more family doctors.
  • But most residents in family medicine don’t plan careers in family practice because the pay is so much better in other specialties.

We should expand the use of nurse practitioners.  They get advanced clinical training and have a rigorous national certification process.

  • Many studies show nearly nurse practitioners deliver high-quality family care at significant cost savings.
  • They can assess, diagnose, prescribe medicine, order tests and medical equipment, and admit patients to hospitals.
  • Often, these studies show nurse practitioners provide superior care than family doctors, spending more time with patients on prevention and counseling.
  • Yet only 22 states and Washington D.C. let nurse practitioners deliver patient care without physician oversight.
  • The Veterans Administration lets nurse practitioners deliver care independently, regardless of the rules in their states.
  • The National Academy of Medicine, the Federal Trade Commission, and other major oganizations endorse eliminating restrictions on the independent practice of nurse practitioners.

Waste, Unnecessary Care, & Fraud

Expert studies show at least 1/3 and perhaps even up to ½ of US health care is wasted on unnecessary care, inefficient care, excessive paperwork, inflated prices, prevention failure, and fraud.

  • Americans get more MRIs and CT exams per person than people in other countries.
  • Doctors who own these machines tend to use them far more aggressively, much more than other doctors.
  • One study found 26% of family doctors inappropriately order too many CT or MRI scans.
  • We needlessly repeat 20% of lab tests just because the doctor doesn’t have access to the results of the same test performed earlier.

Reduce Fee for Service

Doctors admit our fee-for-every-service health care system causes unnecessary procedures and surgeries like cardiac stents, heart bypass surgery, colonoscopies, and back surgeries for money.

  • The rate of coronary angioplasty is 3 times the rate in Canada, with no increase in life expectancy.
  • In people with stable heart disease and no or limited chest pain, medicines and lifestyle counseling prevents heart attacks just as well as inserting stents to unclog blocked arteries or even performing bypass heart surgery.
  • Exercise therapy can be just as effective as arthroscopic knee surgery to relieve arthritis pain.
  • Our rate of Caesarian births is twice that of the next highest country.

Many doctors’ organizations agree we should phase out fee-for-service and replace it with more emphasis on fixed salaries and paying for preventive care and healthy outcomes.

End Unnecessary Pain & Suffering in the Elderly

Over 80% of Americans prefer to die at home, yet less than 20% actually do.

Elderly people often get far too much high-tech treatment, even when there is no hope of improvement, they are terribly deteriorated mentally and physically, and it just prolongs their pain and suffering.

Because of this, ¼ of all Medicare spending goes to patients in their last year of life.

The vast majority of Americans don’t have a living will.  Unfortunately, this leaves family members in charge, often with appalling results.

Very often, families tell doctors to treat their loved ones if at all possible.  This goes far beyond just comfort care, even in hopeless cases.

Unfortunately, this often forces invasive urinary catheters, breathing tubes, and even surgeries for stomach feeding tubes onto scared, confused patients with dementia who have no idea what is going on.

These procedures are often painful without improving the quality of life.

  • Sometimes this can be horrific.
  • For example, using CPR on a frail, elderly patient can sometimes break ribs.

Our doctors often show little regard for quality of life, because of the lucrative business of ordering more procedures and also because of a lack of training for and discomfort discussing end-of-life decision making.

Yet doctors know better.  When doctors themselves face terminal illnesses, they’re far more likely than their patients to choose less aggressive treatments.

Often, comfort care actually prolongs lives because the ordeal of invasive treatment procedures can contribute to further deterioration.

One study found 69% of people with incurable lung cancer and 81% of patients with colon cancer didn’t even know their chemotherapy couldn’t cure them.

People with advanced dementia don’t even get a say in what happens to them.

We should encourage the sacred option of dying comfortably at home with loved ones.

We must train doctors to provide complete information about prognosis and treatment options.  When doctors give this realistic information, patients generally choose to have less interventions.

We can help far more people to plan early by asking simple yes or no questions about end-of-life health care wishes in honest, supportive, sensitive discussions:

  • at the time of diagnosis with terminal illnesses
  • anytime a person goes in the hospital
  • anytime a person enters a nursing home

Gun Control & Access to Healthy Food

Better gun control laws would also help us save massive amounts of wasted money in health care.

We could also improve access to healthy food in poor neighborhoods, where often the only cheap, easily available food is fried or fast foods.

All of these things would greatly reduce our health care spending while giving every American free health care.

 

In these ways, we could all see family doctors far more often, with no significant wait times, and probably live longer.

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