With millions of Americans rapidly approaching an age where they will be covered by Medicare and additional millions soon to be insured by the Affordable Care Act, there is no question that government's total expenditures on health care will increase. • The trick will be to see if we can slow the rate of unit cost increases. If so, then it is entirely possible that we can have an even more robust health care system that is within our national budget. Here are a few changes that might help accomplish just that.
A national health card for medical records
Medical record-keeping is currently a mess. A single national standard for maintaining patient charts is necessary and doable. There are many facets of our lives where industry has adopted standards for providing a particular product or service. This idea is not entirely novel in health delivery systems. France has a national health card used by every citizen that stores all their medical information. It works well. Security has not been a problem. And, it is embraced by French citizens.
With a single card containing the treatments provided by all physicians and hospitals that treat a particular person, we can replace the costly and often confusing redundant systems currently in use. Also, by having your entire medical record in one place, there should be fewer doctor and patient errors. You won't have to worry about forgetting to list a particular drug you are taking; your doctor will be aware of all previous treatments and diagnoses.
Because the French already have effective technology in place, it might just be possible to acquire a turnkey system. There may be no need to take years to develop a new information system.
Funding for more medical residents
Most are well aware that graduating doctors do a residency in a medical specialty. Many are probably unaware that most residencies are funded by the federal government. In recent years, funds committed to the residency program have basically stagnated even as medical school enrollments increased, and that's a problem because there are new medical school graduates who cannot find a residency easily. This poses a problem because the demand for medical services is increasing.
Congress should earmark funds for additional residencies. An immediate benefit of a larger program is that residents are low-paid relative to other physicians, and cash-strapped hospitals with resident programs use them to help balance budgets and/or control rising costs.
Longer term, an increase in the number of residency positions will permit medical schools to grow their programs and produce more doctors. There is nothing like an increase in supply to hold down the price of a product.
A greater supply of doctors can go a long way in helping control salaries.
Bargain with drug companies
Government-sponsored health insurance programs must be permitted to bargain with drug companies for lower prices.
Other countries do, but the United States is barred from doing so under current law. That's just not right.
One procedure, one price
The final point may be the most controversial, but it shouldn't be. If a medical provider is willing to offer a certain service at a particular price to one insurance provider, then it should provide that service at the same price to all other patients treated whether the patient is uninsured or covered by another insurer. There is something wrong with charging the person least likely to have the ability to pay, the uninsured, what is likely the highest price paid by any patient.
Further, if each doctor specifies a price for every procedure, then she can publish that list for all to see. For nonemergency services, a patient could shop by price and that could be an important determinant in who gets the business. A posted price lets everyone know how much a procedure costs — before the fact. We generally don't know that now. An increase in transparency can only make for a more informed consumer and a more informed electorate.
These are just some of the ways we can put the brakes on increasing health costs even while increasing the quality of care provided.
Richard Meyer is a professor emeritus in the College of Business at the University of South Florida. He wrote this exclusively for the Tampa Bay Times.