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How would you improve US health care?

As usual, this is off the top of my head. Some areas may already be doing this. Others may not be possible at all. 

    1. Not every patient needs to see “The Doctor”.

    Physician Assistants and Nurse Practitioners are a great asset in family practice, Emergency Dept, Urgent Care, and many other settings. This needs to be expanded even more.

    2. Allow more M.D. to practice.

    4 yrs of undergrad, 4 yrs of med school, and 1 yr. internship should be enough for a general practitioner to hang out a shingle, if desired. A combination of insurers, certifying boards, and employers have prevented this from happening. What about our Doctors who don't "match" for a residency program? Can't we find a place for them in the healthcare arena?

    3. Not every ambulance patient needs an Emergency Dept.

    EMS crews need to have more and better options than ED or leaving them on their own.

    4. We need to re-educate the public.

    Diet. Exercise. Daily hygiene. Preventative care. 

    All these things drive up patient visits, length of disease, and complexity of disease processes.

    5. Everyone pays something.

    Good healthcare is not cheap. While no one should be turned away, no one gets a free ride either.

    6. Everyone sees an itemized Bill

    Ask someone how much a hotel room costs per night where they live. Most people will have a general idea even if they have never stayed there.

    Ask them what one night costs in the local hospital. Nobody knows. Just like everyone needs to be responsible for a co-pay or partial payment; they also need to see what is being charged and what the hospitals are receiving.

    7. More options and transparency at every step.

    Most patients are very passive consumers of their own healthcare. They rarely ask about alternatives, outcomes, or costs. 

    8. High quality / Fast /Affordable. Which do you want.

    A wise sawbones once told me any healthcare system can achieve two of the three above. The consumer needs to decide which two they want. Is the trifecta really beyond reach? Not sure.

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