What Can't We Learn From Our Neighbors?

Like all countries, the US has characteristics that make it unique from other countries and characteristics that we share with some or all of our neighbors. We pride ourselves on our idea of individual freedom and capitalism. Yet we are the only developed country that relies on the market to regulate our health care. We, as a society, need to escape from the idea that the market regulates itself. That may be true, of a transparent, free market. Which is not what we have. We have tremendous influence by specialist and industrial lobbies, and the government interferes in the market which makes it unable to regulate itself. Furthermore, the market can't regulate itself when the demand is so intimately tied into human emotion and health. I can go without a fancy car if its too expensive, but am I going to deny my daughter the expensive CT scan the doctor says she needs?

The most important thing we need to take from other countries is to treat access to health care as a fundamental human right, regardless of race, or creed, or gender, or income level, then we may take the next step. We need to look into options for non-profit insurance options, which will work within our free market system to bring down prices such as they have in Sweden and Australia. We need to look to other, successful systems to try to keep the medical community regulated, help them to regulate themselves, such as the NICE committee in the U.K., which centrally reviews new technologies, drugs and treatments and reviews the evidence supporting them and makes recommendations.

We need to encourage (NOT MANDATE) those recommendations and encourage our health care providers to follow them, by including internal reviews within hospitals and local umbrella organizations, and including state of the art care recommendations at medical meetings and practice bulletins in medical journals. Universal medical records will decrease the cost of repeating tests and improve communication between professionals. We need to focus on the primary care and preventative medicine, and reserve specialty care for those who truly need it. The primary care provider needs to take responsibility for coordinating specialist care and maintaining basic health care while allowing specialists to focus on their specialty, with financial incentives for physicians providing primary care based on combination indices of numbers of patients and health parameters of those patients.

We need to learn from ourselves too! We need to look at what has worked within our states at a local level, where caps on lawsuit pay-outs for malpractice have decreased the cost of malpractice insurance and encouraged physicians to continue to practice in states such as California and Texas. Medical systems that are relatively self contained and able to share information, with physicians paid by salary (based on a composite of number of patients seen and procedures performed) are more cost effective and provide more standardized care without sacrificing quality, such as the Kaiser system in northern California and the Mayo Clinic.