Healthcare Costs Must Be Controlled by Patients

The debate on healthcare reform today revolves on how they could fix the waste in hospitals, doctor delivery, etc. But there is evidence to suggest that nothing is going to get fixed till the people who are requesting healthcare, the patients, have a direct stake in how much costs. The very best evidence of this I heard was from Steve Forbes (wouldn’t you know). Now I do not agree with Steve Forbes all the time but this is simply an observation he made. There are at least 2 healthcare areas where people have to pay as they go and shop by price and value.  One of the areas is plastic surgery and one is Lasik. I did the research on Plastic Surgery and low and behold the average procedure had an inflation rate between 2001 and 2007 is around 2%. That’s right 2% during a period where standard healthcare costs are rising annually over 10%.  I’ll bet you will find the same low inflation rate in Lasik.  Why are these two areas cost controlled so well? The main difference from your family physician is that the patient has to pay directly for these two procedures out of their own pocket.  Because of this people vote every day with their dollars for better outcomes with less cost. And MOST of the outcomes of the 1000′s of procedures done every day are just what the patient wanted.

There is a second significant difference between those to areas of medicine and the mainstream illness areas, those two items are fully discretionary.  You don’t have to have them to survive.  It is for that reason that we have the desire to fund healthcare for everyone.  It is also for that reason that I am not advocating we should go to a fully personal pay healthcare system.  What I am advocating, from the evidence, is somehow creating an individual stake in the cost.  Patients need to CARE how much it costs when they select a Doctor, Hospital or procedure and make good value decisions on that basis.  Patients can be trusted to make good decisions most of the time. And the collective intelligence of our entire country will then be turned to fixing the problems because everyone needs healthcare and every time they need it they will be focused on getting the most efficient and effective care.

Here is the evidence:

From http://www.ineed2know.org/plastic-surgery-costs.htm I got the average 2002 costs.

From www.boardcertifiedplasticsurgeon.com/cosmetic_surgery_costs.html for the 2007 costs.

I selected just a few of the very frequently used procedures, reported are the Doctors cost.  There are far more of all of the procedures done in 2007 than in 2002. One of the issues reported as a cause of the tremendous healthcare cost rise is much more demand stressing hospitals and doctors. Well, there’s lot’s more demand here and the average inflation of these procedures appears to be just about what the average national inflation rate has been.

2002 Eyelid Surgery was $2,455 average cost and in 2007 it was $3,134, an annual inflation of 4.6%.

2002 Breast Augmentation was $3,436 and in 2007 it was $3,816, a mere 1.8% inflation rate.

Botox in 2002, $422 in 2007, $501 an annual increase of 3.1%.

Breast Implant Removal, $2,084 vs. $2,380 for 2.4%.

Finally a Face Lift actually showed a negative 1% inflation, 2007 cost was more than 6% less than 2002.

Again I’m not saying that we should completely go to a no insurance pay as you go but I am saying that if we all had a stake in the cost of our healthcare we would vote EVERY DAY for better outcomes and less money and low and behold we would get it.

Improving Structure of Home Healthcare Organization

The structure of your home healthcare facility has to be well developed in order to offer high-tech facilities to your patients. For achieving organization goals, you need to ensure that all the treatments are properly done. For making your home healthcare business successful, better facilities along with improved structure are essential.

For improving the reputation of your healthcare organization, you need to hire professional doctors and qualified staff. Your staff needs to be friendly, so that they can treat different types of patients according to the situation. Appointing experience nurses can reduce half of your work pressure.

For creating good image in the society, your organization needs to be perfect from interior as well as from exterior. You have to clarify your goals with your staff members and management, if you want your organization to be on top. Besides this, you can take advice from your staff regarding how to achieve these goals.

With different opinions and advices, you can create good image in your community and can understand your staff members. You can also make departments for getting your work done in a better way. You can ask your employees about what position they desire to work, as it can lift your organization reputation.

This will allow your employees to work freely and perfectly, as they can perform their interested work. Also, make sure that you offer regular promotions in order to keep your staff members in touch with your organization. You can promote employee according to performance and qualification.

With this way, you can understand better about your management and employees. Your staff can play a major role in promoting your organization on top. Thus, make sure that you pay attention on both staff as well as patients, if you want to make your home healthcare facility successful.

Healthcare and Cultural Diversity

More than ever before healthcare professionals are subjected to dealing with a number of vast and various cultural diversities. As cultures within the U.S. continue to grow the understanding of how to deal with them must also grow. If cultural differences are not communicated appropriately it can cause uncomfortable and confusing situations for both the healthcare provider and patient. This can cause the patient to suffer due to loss of trust and respect causing the patient to be less likely to follow a treatment plan. Culturally competent healthcare is considered a human right, and increasing numbers of culturally inappropriate lawsuits filed in court are being won. Some cultures, such as Ethiopian, Islam and Chinese have very different laws, views and beliefs about healthcare. Because there are so many differences there are many legal implications that could possibly arise from cultural ignorance in healthcare.

Ethiopian traditional belief is that health results from equilibrium between the body and the outside world and that illness arises from disequilibrium. Ethiopian culture also believes in the use of herbs and spices for medicinal purposes which can sometimes have adverse interactions with western medicine. For example, large amounts of garlic and ginger are used for the common cold which can act as an anti-coagulant in high doses. Cinnamon is also used for the common cold which increases stomach acid and may inhibit tetracycline (an antibiotic used for many bacterial infections). Basil is used for headaches and insect repellent which acts as an anti-coagulant and has hypoglycemic agents due to the oil extract increasing blood clotting time and synergistic interactions with insulin. Most studies show people of different cultures do not tell their physician about their traditional medicine use out of fear of being judged. One legal implication that can arise while treating an Ethiopian may be a physician treating for a bacterial infection with tetracycline unknowing that he or she is taking large amounts of cinnamon for a suspected oncoming cold. If the cinnamon interacts with the tetracycline the bacterial infection can spread causing further harm even potentially fatal harm resulting in a legal dispute.

The Islamic culture considers an illness as a punishment for their sins. Abortion and assisted suicide is not permitted. Pork and alcohol is forbidden and Muslim women can’t be touched by men who are not immediate family members. Muslims also fast from dusk to dawn for one month a year. Some legal issues that can arise may be a result of a physician prescribing insulin or heparin which contains pork ingredients to a practicing Muslim, or a cough syrup containing alcohol. A Muslim may not be aware that our western medicine contains these products. In addition, if a Muslim is fasting at a time of illness causing weakness and dehydration this can be seen as the physician not providing proper care, all possibly resulting in a legal dispute.

Some Chinese theories about health are based on the observed effects of Qi. They believe Qi defends the body from pathological factors, provides movement and supports growth and development. They believe things like poor diet, poor lifestyle or strenuous work can deplete one’s Qi. Yin and Yang is probably the most significant theory followed, it is the balance between opposites like cold vs. hot or excess vs. deficiency. The Chinese believe some bodily organs contain more Yin and others posses more Yang and will relate this to hot and cold with health complaints. For example one may complain of a “weak kidney” and insist their kidneys be tested when in reality they may be having back or knee pain or diarrhea. A “hot liver” is a common complaint which can refer to itchiness, skin eruptions or emotional stress. Medicine is also considered to have hot and cold effects. This makes it common for Chinese people to take less medication then prescribed to “balance” out the effects, and many would not tell their physician because they believe they are in the best position to judge their own health needs. So there could be a possibility of legal disputes if a liver complaint is made and the physician orders diagnostic tests and possible medication for the liver if in fact the complaint was made only due to emotional stress or itchiness. There can also be a possible legal dispute if the physician did not explain the importance of taking all of a prescription and the patient started taking less to balance their Yin and Yang and the medical issue persists or gets worse.

In conclusion, as one can see there are many different healthcare beliefs in different cultures. Some of these differences can cause confusion and misunderstandings for both the physician and patient. And although most western physicians will try to address an ailment of someone from a different culture in their best interest, it may conflict with their beliefs. Healthcare and cultural ignorance amongst all physicians is a subject that needs to be addressed. Proper training in cross-cultural healthcare will ultimately lead to a better understanding of the patient’s needs and complaints, more respect for the physician and better adherence to treatment causing less legal disputes and a pleasurable, successful experience for the patient.

Here is a short video pertaining to health care and cultural diversity http://www.youtube.com/watch?v=XF8yZRgcSkg