There’s been quite a bit of hoopla over the last … forever … about what to do with the rising cost of health care and what to do, if anything, for the people that cannot afford it themselves. Now, I am not a Libertarian. I think Ayn Rand was a hack and that Objectivism is teenage angst masquerading as legitimate philosophy. I tend to think that the answer to the second question I mentioned is basic tax and spend “nanny state” liberalism. However, I’m very much in favor of the notion of being responsibility-minded, particularly when it comes to our personal health care, and I wanted to put to paper some ideas I’ve been kicking around that might help lower costs.
Fire Your Physician
That might be a better title for the plan, but it doesn’t have to be that extreme. But the fact is that most of us are perfectly capable of doing most of the things a primary care physician does on our own. Fact is, I bet most of us have a story (from personal experience or from someone we know) catching the doctor reading WebMD (kudos, WebMD). Most of what a primary care physician does is help diagnose the issue and most of our issues are very easy to diagnose (or require some basic lab tests that can effectively tell you the diagnosis). Additionally, physicians write prescriptions.
In Mexico, however, some of those functions are filled by pharmacists and locals can come in and purchase the relatively mild end of the prescription drug spectrum without needing to see a doctor. If I know that I need to take an antibiotic, I can walk in and get one and the friendly pharmacist, who studied all of those drugs to get that job behind the counter, can help me select one. In the US, pharmaceutical education is practically wasted on retail where you can really only ask them about side effects and instructions. Interestingly, in the US, you do get a decent number of people that walk into drug store and ask questions like, “What should I take for this?” or “What does this rash on my butt look like to you?” or “Do you think this is herpes or genital warts?” The answer is always, “I can’t help you. Go see a doctor,” even though they’ll later comment about the poor guy with “the worst case of genital warts and such a small penis”. That they didn’t know the answer is not the reason that they can’t help you.
I’m not suggesting that we don’t need physicians and diagnosticians, but that we don’t need them for a lot of the doctoring we get. Wouldn’t it be interesting if you could doctor yourself for minor non-emergencies and check-ups? What would happen if labs and pharmaceuticals catered to you, specifically, and you could bypass the doctor’s office if you needed to? What if you could just visit a tech and an x-ray machine, for instance, to see if something is broken or sprained? Would the doctor’s office change, at all, in terms of its service to the people it needed to cater to? What if preventative medicine were pushed through better education and better physical access? And what if a base-level health plan catered towards those needs and emergency needs only? Would it be more or less affordable?