In an earlier post, I discussed why the conversation about health care reform needs to change. We need to talk less about health insurance and more about making people healthier. We need to prioritize proactive disease prevention rather than reactive disease treatment if we’re ever going to reverse the chronic illness epidemic in our country and get costs under control.
1) Create a New Layer of Health Care
I discussed this in my last post about health care reform. In addition to the emergency and traumatic care layer and the fragmented layer of specialists, we need a layer that focuses on preventing and reversing chronic illness.
Board certified functional medicine practitioners would help people get to the root cause of their problems, provide the education required to make better health decisions, and develop individualized plans to restore and maintain health and wellness.
2) Reward Good Behavior
Health insurance costs aren’t structured like any other form of insurance. If I cause a car accident three times in six months, my premiums will increase because I’ve established a history of risk. However, if I go a couple years without any tickets or accidents, points will disappear and my premiums will go down.
That’s not how it works with health insurance. Everyone is in the same pool, and we all share each other’s risk. I go to the doctor once a year for a health screening but pay the same as someone who goes once a month.
Wouldn’t it be great if the system rewarded good behavior that produced healthy outcomes? This is what we’ve been doing through the Long Branch CityWell Program. Through education and the implementation of personalized functional medicine programs, we move people from the high-risk category to the low-risk category. People make real lifestyle changes that enable them to meet standardized biometric criteria like normal body fat composition, body mass index, waist circumference, triglycerides, blood pressure, glucose, etc.
A standardized national protocol can be easily established and should be part of annual physical exams for everyone over age 30. If you have people competing to be healthier, you save the entire pool a lot of money. You drive down rates. You create competition among insurance carriers.
Our elected officials need to figure out how to reward people who take good care of themselves. There is no better incentive than living a wellness lifestyle!
3) Automatic Coverage for People Born with Genetic Conditions
I think it’s fair for every U.S. citizen who is born with a genetic condition like cystic fibrosis, childhood cancers, and behavioral issues such as autism, all of which require medical intervention, to receive coverage paid for by all taxpayers through government health care. Add these people to Medicare and no one can be denied coverage.
I don’t mind if my insurance dollars go to providing superior treatment to people who were born with genetic conditions. It’s not like they got sick because of poor lifestyle choices. They deserve to have the best quality of life possible.
4) More Billing Transparency for Insurance Carriers
Another problem is the lack of transparency in the way insurance carriers bill doctors. Under the current system, a doctor in North Jersey will pay a very different amount than a doctor in South Jersey for performing the same tests or surgeries. This creates administrative complexity and an unfair playing field which contributes to high insurance costs.
5) Put an End to Advertising for Garbage that Makes Us Sick
It’s time to shut down advertising for foods and products that cause chronic illness. We did this with beer, liquor and tobacco. Why can’t we do the same for soda and breakfast cereals when the scientific evidence that establishes a connection between those products and chronic illness is black and white?
To be clear, I have no intention of running for office. I don’t know how to write laws. But I do know how to care for people. I know how to be an investigator and uncover the root cause of disease and dysfunction. I know how to develop individualized wellness plans that reverse chronic illness.
The things that are part of everyday conversations between functional medicine doctors and patients need to be part of the health care reform conversation in Washington.
If you agree that we need to talk less about health insurance and more about making people healthier, please share this article with your local representatives and demand a change in the conversation.