BLOG: Should doctors have a say in health care reform?

There has been some historic news on the health care reform front this month. The U.S. Senate passed legislation that would repeal much of the Affordable Care Act.

Although there is little chance that this type of legislation would survive the presidential veto, it is a sign that change is in the wind for a substantive new direction. Whether the changes are accomplished by repair, revision or replacement of the Affordable Care Act, no criticism of the law is really legitimate without a constructive alternative.

We continue to hear what politicians have to say about health care. We have to live with what insurance and health plans think we should do. Everyone talks about programs that are consumer driven or patient centered, but what do doctors and health care providers think about health care reform?

We are the ones that have invested in extensive health care education and spend our lives building health care careers. Why is it that no one seems to care about what we think about on this important topic?

Most of us know what we would like to do to provide better care for our patients. However, we end up spending our time doing pointless things that are required for compliance or to prevent the risk of a lawsuit or finding creative ways to do things that are reimbursable because the payments of our basic services are reimbursed below our cost.

So, this is your chance to express your thoughts on what you would like to see in a new health care program. There has been active dialogue in the comment section of several of my blog posts. I get feedback for some of my ideas from the payer community and my friends in optometric education, and many of the thoughts and concepts of this feature are considered and discussed by health care decision makers.

These are some of the features and concepts that I would like to see in a new health care plan:

1. Every citizen should be covered for basic health services that focus on health education, wellness and prevention with insurance type coverage for catastrophic health events.

2. The cost of this basic coverage should be based on the individual risk factors that would predict the expected need for care.

3. Individual risk factors should be determined by comprehensive health history including family history, social habits and vital signs.

4. Health risk should be determined annually through a network of health care providers including, but not limited to, optometry, dentistry, podiatry, chiropractic, mental health and pharmacy care as discussed in my blog on the problems with the health care exchange.

5. Coverage should include those services desired by the young and healthy such as routine vision, dental, mental health and other services, but said services must include a review of primary health care issues at each encounter

6. Health care must be charted and documented in an electronic format and delivered to all health care providers involved with the care of each patient.

7. The “tax” or other penalty for not enrolling in the system must be higher than the annual cost of health coverage, and said fee or penalty would be delivered to the health care payment system.

8. The cost of coverage would default to the maximum for citizens that failed to present for the annual check-up to re-set their individual rate.

Although individual freedoms and rights are critical to life in America, there are a number of issues where the freedoms of the individual affect the freedoms and rights of the community. I would suggest that basic health care services are one of critical social issues of the day that require a group effort to assure the health and safety of each individual.

The above points are my opinions; those that know me will tell you that I have been known to change my opinions when presented with a compelling argument. You are free to disagree in the comment section below and perhaps change my mind in my quest to develop a better health plan.