putting physicians back in control of medicine
Alpharetta, GA (Vocus) October 15, 2009
In October 2008, Rick Jackson, Chairman and CEO of Atlanta-based Jackson Healthcare, proposed a radical plan to revamp the healthcare system. Since then, healthcare has taken center stage as the current administration spearheads an aggressive reform of the current U.S. healthcare system.
Despite the diatribes, political rhetoric and propaganda that have saturated the news, Jackson's core argument remains as relevant as ever: the relationship between physicians and their patients has been severed. Jackson believes this relationship is the foundation for a healthcare system that is affordable, accessible, efficient, safe and continually improving.
The following is an update on Jackson's beliefs regarding the current reform efforts.
Has the current debate on healthcare reform changed any part of your original proposal?
It has reinforced my belief that a wedge has been driven between physicians and their patients. This wedge, consisting of those entities which control the transactions between patients and physicians, is the root cause of our current inefficiencies and cost inflation.
The real motive behind healthcare reform is to reduce government spending on healthcare. It has nothing to do with incentivizing an integrated system that rewards quality and efficiency, while penalizing waste. The proposed solutions for reforming America's inefficient healthcare system treat symptoms, not the root problem.
What is the root problem with the U.S. healthcare system?
Physicians don't have an incentive to cut costs and reduce patient utilization. Patients don't have an incentive to manage their health and utilization. Actually, both are rewarded for overutilization, which drives up costs. This persistent cost inflation has brought us to a point where many patients and their employers simply can't afford the cost of their care and they can't afford to insure themselves against these costs.
The current belief is the government can spend healthcare dollars more wisely than physicians and patients in the marketplace. Instead, efforts should be made to help patients find and access the highest quality, lowest cost medical care in the country.
What are the components of your proposal?
First, we need to restore the relationship between physicians and their patients by removing the barriers that exist between them. Second, we should use existing technologies to expedite patient care, while reducing administrative redundancies and waste. Third, let's put physicians back in control of medicine so they can practice high quality, low cost medicine and self-police negligent practices. Fourth, we need a national fee schedule that eliminates provider networks and recognizes geographic cost of living differences. Fifth, we should use an independently managed trust fund that incentivizes healthy patient habits. And finally, we should reward physicians and private industry for controlling costs and driving new diagnostic and care innovations.
What current technologies do you believe would meet the objectives of healthcare reform?
I believe the key is tapping computer and banking technology and utilizing smart cards. A single smart card could handle payment for medical services and house medical history, while eliminating administrative overhead.
If every patient had a personal health smart card, similar to a debit card with a memory chip, imagine how much safer and efficient many of our medical transactions would be. The card would contain a patient's eligibility, coverage level, deductibles, protocols, medical history, care plan, etc. This card could be used anywhere. It could compute co-pays, and authorize pre-certifications and procedures for treatment. Medical providers would be paid immediately and administrative costs that currently exist in the system would be eliminated.
From a care standpoint, it could eliminate duplicate tests, labs and radiology procedures. And it would serve as a central repository for all medications a patient is taking, avoiding medication errors and mismanagement.
How would medical costs and payments be controlled?
A national fee schedule should be created and contain modifications based on the cost of living in each geographical region. This fee schedule would be approved by physicians, hospitals and relevant third parties, including actuaries. Medical professionals could still differentiate their income by service, efficiency and/or customer care. Other services that are self pay, such as certain surgeries, private rooms, birthing suites and the like, also could be added.
All physicians and other providers would be part of the same system, eliminating the administrative expenses of managing and supporting provider networks. This accounts for 1% to 2% of healthcare costs.
Also, a healthcare reimbursement trust would be established and managed by independent financial entities for beneficiaries. Just as insurance companies do, all funds held in the trust would be invested and all payors would pay premiums into the trust. Actuaries would determine ongoing premiums based on desired coverage and actuary tables would reflect higher out-of-pocket costs for those whose lifestyles make them poor health risks.
What do you mean by "putting physicians back in control of medicine"?
We need to trust physicians again. It's not fair to have a few opportunists handicap the majority of physicians who practice medicine for the right reasons. It's also not efficient to have legislation or insurance clerks second guessing every decision a physician makes regarding the care of their patients.
The first step is reducing malpractice and defensive medicine costs. The present cost of malpractice and defensive medicine is about 10% of healthcare costs. Physicians order unnecessary tests in an effort to protect themselves from negligence claims.
The second step is establishing national physician review panels. These are non-biased, independent peers who would control protocols for patient care, define what's medically necessary, approve exceptions and review malpractice claims.
How would your plan incentivize physicians and private industry while protecting patients against unethical practices?
Healthcare systems already exist where physicians successfully deliver low cost, high quality healthcare to their patients. Mayo Clinic and Cleveland Clinic are great examples.
Physicians who create a better financial model to cut the costs of medical and surgical care should be rewarded. The lowered costs would reduce premiums.
Private industry should be incentivized to develop innovative technology and pharmaceuticals in ways that make healthcare more efficient and cost-effective. Without these incentives, the future of medicine will depend on government and non-profit scientists and grants. In countries that have universal government healthcare, innovation has come to a screeching halt.
Technology now provides us the opportunity to return physicians to the practice of medicine. I believe this is the key to improve the quality of care patients receive and make it affordable and accessible to everyone.
ABOUT JACKSON HEALTHCARE--Founded by healthcare innovator Richard L. Jackson, Jackson Healthcare addresses the two largest challenges facing healthcare today: finding the right people and delivering the right information at the right time. The Jackson family of companies provides clinician staffing, anesthesia management, hospital management and healthcare information technology solutions proven to improve clinical and financial outcomes, as well as increase operational efficiency. Jackson serves more than three million patients in nearly one thousand hospitals each year. With a 43 percent compound annual growth rate in revenue between 2005 and 2008, Jackson was named among the "Fastest Growing Private Companies" by Inc. 5000. In addition, Jackson has been recognized as one of the "Largest and Fastest Growing Staffing Companies," in the country by Staffing Industry Analysts and "One of Atlanta's Best Places to Work" by the Atlanta Business Chronicle. For more information about Jackson and its companies, visit their website at http://www.JacksonHealthcare.com.