Anindo Saha, M. e. (2024, July). Artificial intelligence and radiologists in prostate cancer detection on MRI (PI-CAI): an international, paired, non-inferiority, confirmatory study. Retrieved from T…

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Government has driven up the cost of healthcare by favoring the insurance and pharmaceutical industries. Government policies have reduced supply and increased, even mandated, demand.

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Imagine walking into a clinic and seeing a kiosk, similar to going to McDonalds. You touch a screen and it begins asking you questions. You say you have hip pain. You fill out the questionnaire. It tells you what room to go to and at what time. You are seen by a doctor. Doctor sends you for x-rays. You get the X-rays and are told where to go for the results. You arrive and are told the results and are given a shot for your hip. The whole process takes a few hours.

My brother-in-law had an experience similar to that in Panama. That happened over a year ago.

Let’s go further than that. Imagine that you own a robot. It can clean your home, mow your grass, and wash your car. It can also be your doctor and prescribe medications. It can even perform surgery if necessary. Sounds like fantasy, but it might not be too far off, and the robot might be better than a human doctor.

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The Patient Protection and Affordable Care Act (PUBLIC LAW 111–148—MAR. 23, 2010 124 STAT. 119 , 2010), also known as PACA, ACA, or Obamacare, was passed in 2010. President Obama hoped to improve healthcare and make it more affordable.

This book is designed to give you short sections and help you think. The ACA is long. The table of contents is about 12 pages. There is no way to cover it in a few pages.

However, now I have given you a background to look at it. You learned about supply and demand. If you want the price of something to go down, you know that you must increase supply or decrease demand. You learned about risk and how insurance premiums are based on risk. You learned that to a politician, a provider is an insurance company, not a doctor. With that in mind, let’s look at just a few parts of Obamacare.

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The hospital was running ads in the local paper. I thought they were quite clever. The caption was “Focus on Health”. The words for the condition of the week were shown under a magnifying glass. The ad encouraged you to learn about the condition by attending a class at the hospital.

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Back in the 1980s, an elderly patient told me a story about the death of her grandmother. Her grandmother had become quite ill, and a doctor made a house call. After examination, the doctor said that she needed an operation. She would have to go to the hospital. The operation would cost about $100.

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I heard a so-called conservative say that healthcare competition in Washington State has been reduced to about 6 insurance companies from around 100 because of mandated benefits.

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I’ve heard some politicians say that everyone loves Medicare. We should just expand Medicare benefits for all. Ask the doctors if they love it.

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When I began practice in the mid-1980s, many chiropractors I knew had individual and family wellness plans. The patients would pay us a fixed amount every month and could come in for care as often as they wanted.

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As we saw in an earlier section, under the guise of protecting the public, government reduced the supply of physicians. We assume that a licensed healthcare provider is more competent than someone who is not licensed. To obtain a license a provider must first complete the required training and then pass an examination.

What about corporations? A corporation is a separate legal entity created by the government. A corporation cannot be trained or take an examination. In Washington State, healthcare providers can form a special form of corporation called a professional service corporation. All owners of the corporation must be licensed in one of the listed professions. The idea seems to be that everyone has a license to lose and will have an incentive to act ethically.

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That is often the first question a prospective patient asks. They liken the question to asking if we take major credit cards. The confusion is understandable. The patient presents a plastic card, just like a credit card, and expects the card to pay the fees.

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Remember the two contracts I wrote about earlier? One was the contract between the insurance company and the patient. The other contract was between the patient and the provider.

An in-network provider has a contract with the insurance company or PPO. The insurance company/PPO has a contract with the patient.

Providers who are members of the PPO are “preferred providers” or “in-network.” Providers who are not members are “out-of-network.”

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Sam Walton had a great idea. He contracted with suppliers and negotiated a reduced price in exchange for volume. Walmart would sell so much that suppliers were way ahead to give them a discount. Suppliers no longer had to worry about marketing. They could just focus on what they did best, making their products. Well, let’s just apply that approach to healthcare. We’ll let the insurance companies play Walmart.

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Business coaches have told us (doctors) that it is illegal to charge an insurance company more than we would charge a cash patient for the same service. I’m not an attorney and I don’t know if the law is federal, state, set up by court, or insurance commissioner. I suspect it has to do with The False Claims Act.

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When I began practice in the 1980s, some patients had insurance. They would pay me and give their receipts to the insurance company for reimbursement. The idea was simple. The patient had a contract with me to provide care. The patient had a contract with the insurance company to reimburse the patient for care. I had no contract with the insurance company.

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Insurance is compensation for loss. Two things affect the premium. One is the risk of loss. If the risk is high, the premium should be high. If the risk is low, the premium should be lower. The second thing that affects premium is the amount of the loss itself. If the amount is high, the premium is high. If the amount is low, the premium should be lower.

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One of the profs in my MBA program talked about the difference between insurance, investing and gambling. He was making a point about our expectations.

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Controlling the education system is a key aspect of government control of our lives. What we believe from an early age, we tend not to question.

Seeing what was coming, the Tennessee legislature passed a law making it illegal to teach evolution in public schools. In 1925, the leaders of the town of Dayton, Tennessee decided to challenge the law to increase business. (Linder, 2007)

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As the nineteenth century rolled to the twentieth, there were many different branches of so-called healthcare. Chiropractic, homeopathy, naturopathy, allopathy, osteopathy, ophthalmology, and podiatry are some of the more prevalent branches that have succeeded in some manner today.

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It didn’t take long for free people to decide that their health might require mandatory sacrifice from others. Massachusetts passed the first mandatory vaccination law in 1809. (Swendiman, 2008) The required vaccine was for smallpox.

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