My Healthcare Wish List for Christmas

December 20, 2012

Santa, fire up those elves! People like me, as well as doctors and nurses, could really use your help.

Dear Santa,

I’m not a doctor, but I did play one on TV. Well, it was only a commercial, but I got to wear a lab coat and everything. And I’ve worked with doctors for a really long time and know a bunch of medical words and stuff, so, I hope you will take that into consideration because I’m asking for some things that are really important. Nothing for me personally, mind you, except for that iPad and maybe a new Audi R8 twin turbo, but, that’s for another time. We’ll talk later.

This is more of the “Miracle on 34th Street” kind of thing, you know, faith and understanding that helps people to believe in others and in important ideas to make them real. And this one is going to make my other list look pretty doable.

You see, Santa, a whole lot of people like me on the business side, and doctors and nurses and, well, all of us in healthcare, could really use your help.

Things are getting very tough. We have to figure out how to care for more and more people with less and less resources and under a whole new bunch of truly expensive regulations made by government people that mean well, but don’t really understand how things work in real life. What’s worse, all of these new regulations don’t really fix anything like enabling hundreds of billions in unnecessary costs to be eliminated, but add lots of new ones without paying for them.

So now we have one set of people calling employers greedy and mean for planning ways to avoid rules that would make them pay for insurance or tax penalties for people who don’t get paid very much because most, particularly those in food and hospitality industries, can’t afford to do it and compete. In other cases, employers are opting to pay a few thousand in taxes rather than ten thousand in benefits. Their problem is that if they provide benefits and their competitors don’t, they will price themselves out of business. All the while almost everyone’s employees forego care because it goes to deductibles, making things even more expensive in the long run.

Then we have another set of people who think insurers are bad and insurers who don’t invest in long-term solutions, so there are even more regulations that increase costs. Then, the insurers fail to invest in prevention, which ensures the cycle of increased costs continues, meaning people get less and less coverage, perpetuating and exacerbating the cycle.

Then, we have insurers, particularly government ones, who think doctors and hospitals are all fat cats who game the system and are paid too much, so they reduce payments or fight paying them while adding regulations and procedures that add costs despite overwhelming evidence that they are wrong in their assumptions, reducing access to care for the people, making things even more expensive.

Then there are the people themselves who are overweight and sedentary and one in four who smoke, all of whom are inviting serious chronic diseases that are becoming epidemic, adding cost on cost.

Then there the states that have programs to provide insurance to the poor and are resisting adding new programs that are federally mandated, but not paid for, because they are financially strapped.

And politics is everywhere while common sense and understanding are not.

Santa, we have a real mess on our hands as hospitals and doctors and employers and insurers and state governments and the federal government all do what they think they have to do to protect their interests and the public is square in the middle, being squeezed from all sides.

So, all I want for Christmas, dear Santa, all we all want for Christmas, is for the blaming to stop and the cooperating to begin. And, maybe the stuff on our regular lists if it isn’t too much trouble.

Yours truly,

Jimmy D.