Tuesday, September 10, 2013


How is it that we have advanced computers, with wireless networking, cameras, GPS, and high res monitor, at our hips that cost less than 1 week's basic wages, and yet, our medical community is abysmally expensive, slow and technologically stuck in the 1960's?

Here are some pricing forces that I see -- 1) Increased demand with a growing aged population, 2) Limited supply with a strong bottleneck on who can be a _licensed_ doctor and practice, 3)  a legal environment with unbounded jury awards to victims of malpractice, incentivizing doctors to practice defensive medicine which focuses on high potential cost lawsuits, rather than solving the patient's need.

These factors I observe cause 1) expensive, limited access (through the bottlenecks to basic access), 2) misdiagnosis (by encouraging the doctors to focus solely on high potential liability tests rather than zeroing into the most probable complaint of the patient).

One possible solution I came up with is the following, which could be implemented at the state level initially:
--Allow medical clinics to specify a limit on the pain and suffering award (cap) at the entrance and all forms that patients fill out. This limit would be allowed to be no less than 1 years salary of poverty wages for an American single adult. The clinic/office would need to be able to demonstrate that they have financial resources to cover that possible scenario on demand to a state officer.  If the amount were not clearly indicated at the entrance to the clinic and not clearly presented to the patient on patient signed documents, then that clinic would not enjoy that pain and suffering cap. The state would have the discretion of penalizing offending clinics by suspending the protection for periods of time, for example, if the clinic mislabeled or hid their sign.
-- I see this working in practice as follows: 1) a small clinic, run by a nurse, chooses a $30,000 pain and suffering cap, and purchases such insurance. Places the sign "$30,000 P&S cap" at the entry, adds it to the paperwork patients fill out. A patient sues the nurse after visiting the office and the judgment awards all costs of rehabilitation (example, rehabilitation is $100,000), plus $30,000 pain and suffering. The pain and suffering fund must then after payment demonstrate solvency or the state suspends the protection.
Scenario 2) Large clinic, expensive ads: Pain and suffering broadcast is $1,000,000 (P&S). The patient who has a suit against a doctor has suite capped at rehabilitation plus $1,000,000.
Clearly in this scenario the individual patient may 1) make a rational decision about which office they visit for certain maladies versus others (A simple cut, visit the $30,000 clinic, a more unusual circumstance, the pricey office). 2) The office may control their costs, and as such may have less of an incentive to practice purely defensive medicine.


Please let me know of any more ideas you may have to improve the medical experience for Americans.

The Search Begins...

I am reaching out to people who can question beyond political or religious ideology and discuss without fear...  Why look across the galaxy when helpful people may be on the same planet?