Health reform that offers relief from fear and greed

What if we had considered the following items within health care reform?

What if physicians were able to practice medicine with reduced fear of malpractice litigation? Some estimates believe the cost of defensive medicine approaches 30%.

What if patients were to be offered a different process for conflict resolution before litigation, one that is partially driven by greed? What if this process provided a remedy which met all our future financial and medical needs at the same economic level we were accustomed to when the event occurred? Some say greedy self-deception, a potential windfall, a sense of being personally offended, or lottery mentality drives many current litigation decisions.

What if a lawyer sought the truth, the whole truth and nothing but the truth? Some would say there are several truths and our current ways are working well to expose the truth. Most understand the whole truth ultimately exposes any partial deception.

What if insurance companies were competing to empanel the highest quality providers instead of the most providers at the lowest cost? We find our current methods to limit access and delay care dissatisfying and actually add to greater cost and confusion.

What if the government involvement was primarily to provide information and a safety net supporting citizens who at no fault of their own become medically unable to meet their individual needs? Many find current government oversight to be overextended, overcomplicated, overbearing, overgrown and overstated.

Consider the following options.

Let’s do tort reform that removes needless management, complexity, control, size, and excesses for the system. Creating a government “no fault” assurance, not insurance, where those adversely affected and who exhaust their resources will receive support and care. This will allow physicians to order tests needed to confirm rather than defend a diagnosis. It will remove patients from needless exposure to risky and duplicative testing and provide appropriate support when the unexpected or unexplained occurs. This does not even address the wasted time, energy and resources used to manage our current disputes.

Let’s create lawyer advocates which are trained to mediate for the best interest of everyone: physicians, patients, and government. Physicians that distinguish themselves as high risk will be exposed and referred to the proper medical board for discipline. Patients who limit their recoveries in order to favor themselves financially will be exposed and result in their benefit being reevaluated accordingly. When government systems fail to meet the patient’s needs, legal oversight will expose that too. Wherever a truth exposures a benefit for patients, these lawyers will advocate for it.

Let’s create insurance companies who are the purveyors and advocates of quality rather than just limit consumption or cost. Goals will include clinical review of duplicative claims or irresponsible treatment plans in managing the care. It will create a transparent public report. Instead of denying care they will encourage, monitor and enable the best accepted clinical standards of care that leads to favorable clinical outcomes.

This major paradigm shift will not take place without realigning and removing disincentives currently driving the “medical bus.” Almost all of the rhetoric and actions thus far regarding reform in healthcare have referred to cost savings. Reform like this offers relief from fear and greed which seems to drive many of our costs. The bus will be rerouted toward the best intended destination by focusing on quality care. Achieving this will be a positive change we can all believe in. We must stop chasing escalating costs while avoiding savings that truth, trust, and transparency offer. To allow these to escape our grasp will serve to enhance our fear and greed. We must decide now to discard our differences that divide and rally around principles that align. Now is not the time to fight well, now is the time to win, and everyone wins when we all do right.

Ernie Vesta is CEO of Vesta Healthcare Solutions, LLC.

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