June 27, 2009 - Healthcare Reform

Why don't they get it?

The problems with healthcare are obviously a very complex; however, there are a few things that are at the heart of many of the issues.

It is time that the payers are removed from the beds of the hospitals and providers. Competition is stymied because providers are not forced to compete with one another, but instead they complete for the best contract with the insurers.

In addition to the issues created when competition is stymied, costs soar when the complexity of the payment system requires entire departments to manage. In the new healthcare model (the efficient model), the cost of care should be the cheapest for the person that has cash up front at the door and most expensive for the person with insurance that has very complex payment requirements.

Note that my push to change the model of payment does not mean that I do not support improvements in quality. Pay for performance and other concepts to force providers to have excellent outcomes and practice evidence based care. These are good things.

What I am really suggesting is that we must overhaul the system such that receiving payment for services provider as suggested by your physician should not be a complex issue. Submit the claim, get the payment, close the case.

So, how do we manage utilization in a system like this? That should be the responsibility of the individual insured party. When they contract with the insurer to provide coverage, information should be provided showing clearly what is covered and what the max payments for these services are. While I do not believe that insurers should contract with providers, it would be fine for insurers to note that a specific provider has a charge structure that is approved. This, however, should never be a negotiation. In the event the insured chooses to seek services which exceed the cost of their insurance coverage, the provider can agree to accept the insurance coverage as payment in full or the insured will be responsible for the balance of the bill.

I sincerely hope that we focus on FIXING healthcare rather than simply adjusting a few statements and increasing the complexity of the system. We aren't going to have a cheaper healthcare system by simply leveraging more technology.

June 24, 2009 - Jackson Paramedic Students

Today I went with Kaye and Sherrie to teach PALS to Jackson State Paramedic students. I was very impressed with their knowledge and skill level. These students asked a lot of great questions and were all eager to learn. The area around Jackson is very lucky to have such a great group of students coming out of the program. I wish all of these students the best of luck to pass their paramedic national registry exam and I hope to be working with these professionals soon. Every now and then it is fun to get back into the clinical mindset :)

June 23, 2009 - A Day Without a Cell Phone

It was the best of times. It was the worst of times!

Today I left my cell phone at home. Never did I believe that not having my cell phone would be considered a catastrophe; however, I found out today just how attached to technology that I have become. I depend on my phone to wake me up in the morning, guide me through my schedule throughout the day, inform me of new important (and sometimes uninportant) information that becomes available during the day, and to provide a communications link to me wherever I am and whatever I am doing.

That really is starting to sound more like a ball and chain than a cell phone, but that is what I depend on it to do for me. A day without it was quite a challenge.

On a different note, I wanted to also say a special thank you to Julie, Wesley and Cameron today for the wonderful Father's Day gift of shoes that I received. My feet appreciated a nice pair of shoes all day... and I am sure I will get many more days of good wear. Thank you!

June 21, 2009 - Father's Day

Today I am the proud father of two great boys, but I am especially proud of Wesley. After working for the past few weeks to teach him to swim and be comfortable in the water, Wesley took off in the pool today.

With his swimmies on and his life-jacket donned, Wesley proved that he had learned what his daddy taught him. I tossed the ball into the water and he jumped in, began kicking his feet and working his hands taking him straight to the ball where he grabbed it and brought it back. The game of fetch was on!

Wesley played the game of fetch until I was tired and we went inside together to share in a bottle of gatorade and a bag of cheetoes. I don't know who had the bigger grin-- me or Wesley, but we both had great fun.

I got the best father's day ever-- a whole day with the boys!!! I am so proud to be daddy to Wesley and Cameron. They are great boys and I look forward to seeing what they learn each day. They are growing so fast.