Originally Posted by
Xville
I have several suggestions that would help lower the overall cost of care and improve outcomes:
1.) get rid of pbms. They are completely unnecessary and the big three are controlled by the biggest pharmacies in the world that work directly with the mfgs of the drugs.
2.) direct primary care for every primary care giver and get rid of things like copay, coinsurance. Basically get insurance out of those settings for the most part. Subscription models allow primary care givers to actually spend time with their clients and figure out what is going on rather than spending five minutes and subscribing a pill because hospital system a or b told them they need to write a certain number of scripts for medicine a or b a month. Yes this happens.
This subscription model should also help getting people to their primary care before a real problem exists or at least catch things early before they get cost prohibitive. The percentage of people with a primary care giver is extremely small
3.) price transparency for surgeries, imaging etc. this is starting to happen in some places and makes a substantial difference. UHC has a product thatÂ’s outstanding in this area.
4.) surgical centers for outpatient surgeries that arenÂ’t tied to hospital networks or systems. This also for the most part keeps insurance out. Again a substantial cost savings. There needs to be more of these.
I have a ton moreÂ… that are more drastic and would be a complete overhaul of our system but if these four things occurred, weÂ’d see a drastic reduction of costs across the board.
A big problem for a lot of my suggestions is that 1.) too much money, lobbying and profit for insurance companies. It’s not “evil profit” it’s the reality of the situation. Pharmacy is in general the only remaining industry with little to no regulation. 2.) the majority of the population has a very ingrained idea of how healthcare works in our country, and a lot of these changes may seem basic, but in practice they are scary for a lot of people. 3.) we are a very sick country due to our lifestyles and wants/needs/ food supplies/ quick fixes. brief example look at the explosion of semaglutide in this country. The impact of just those drugs on heath plans are astronomical, and in most cases, there is zero reason a person should be taking it.
Anyways I could write a novel on here and I have already wasted enough of my time.
