A doctor's ideas for cutting health care costs

I have practiced medicine on the front-lines for more than 20 years. This is after my initial 12 years of training at major university medical centers. I have seen the best and worst of my profession in the hospital, doctors' offices and research labs. I have witnessed tragedies and miracles at 3 a.m., holding back my own tears to provide comfort to a grieving friend or family member.

There is nothing I would rather do than help my patients improve their health and comfort the ill. However, for the first time in my career, I am concerned about the future of our health care system.

Make no mistake, we do need reform. Quality care is expensive. We need to get better value and cut costs. However, we do not need to wreck the best health care system in the world. If you are sick you will do best in our present system.

We need to cut costs and make care available and affordable. Transferring the responsibility to the government is not the solution. Government does well at protecting us, and oversight. Government is not able to provide good service at the best price. This is where the private sector excels.

Costs in health care can be cut without robbing Dr. Peter to pay Dr. Paul. Primary care physicians do deserve better compensation, but not at the expense of the specialist.

We should not dismantle the best high technology medicine in the world. Advanced technology ultimately saves money and lives by avoiding the need for invasive tests and their associated complications.

So how do we cut the expense of medicine? Here are my solutions:

1. Incentivize the patient: We reduce the cost of car insurance for good drivers. Why don't we reduce the cost of health insurance for those with healthy lifestyles? If you maintain ideal body weight, normal blood pressure, sugar and cholesterol, don't smoke, eat a healthy diet and exercise, you should get more and more discounts on your health insurance. Prevention must be rewarded and it will then cut cost.

2. Put the patient in control, not the government. All able bodied Americans should be required to purchase at least catastrophic care. Routine expenses should be managed in Health Savings Accounts which can accumulate tax deferred. Imagine how the cost would decline if we had to spend our own money?

3. Tort Reform: It is absurd to think the current government effort is anything less than a power grab and not an effort to control costs, without a discussion of tort reform. Doctors order extra tests because every one of them feels like they have a bulls-eye on their back. Doctors fear the disruption in their ability to provide care to their patients getting into the web of the legal system. My solution is a system where loser pays. This would eliminate the frivolous law suits and dramatically cut costs.

4. The last year of life: Most of the health care dollar is spent in the last year of life. We need new laws that allow the physician, patient and family to focus more on quality and much less on quantity, during the last year of life. This is where enormous saving could be found.

5. More insurance competition, not less. We need to make sure there are many private insurance companies in each market and not allow a few to monopolize any single market.

The government's role should be oversight. That is what they do best. Providers of health care must be held accountable to ethical standards of practice. Increased taxes do not have to be the solution. The government will go bankrupt trying to take over the entire system. They should continue to improve what they already run (Medicare, Medicaid, etc.) and provide care for those American citizens who are unable to work and cannot afford care (about 15 million people).

Dr. Kronhaus hosts Good Day Health, a nationally syndicated weekend radio show heard on more than 150 stations across the country, and is featured Monday - Friday in the "Daily Dose" segment on Doug Stephan's Good Day, heard on more than 300 stations in morning drive. You can sign up for his free e-newsletter here.

Dr. Ken Kronhaus is a trained medical scientist and has been practicing cardiology for more than 20 years. He received his education at the University of Pennsylvania, obtaining an M.D. and Ph.D. in cardiovascular physiology, and was awarded the American Heart Association postdoctoral research fellowship. Dr. Kronhaus completed his medical internship and residency at Duke University, followed by a Clinical Cardiology Fellowship at the University of California in San Francisco. He is a spokesman for the American Heart Association.
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