The Book!

Monday, August 29, 2016

Fixing the Health Care System


The aging population is putting an increasing strain on OHIP and other provincial health plans. On the other hand, our current health care system is absurdly inefficient. We ought to be able to cut costs.

The monopoly given to doctors to prescribe causes vast extra costs to nobody's benefit but the doctors'. In the real world, a patient who has been taking a medicine for years is likely to know more about it than the doctor they have to go to to renew a prescription. Proposal: as in some other countries, give pharmacists the right to prescribe. That alone would cut out a huge number of unnecessary doctor visits.

Add a small deductible to public health insurance. This would discourage frivolous doctor and hospital visits, without really keeping anyone who needs it from health care. The true value of health insurance is in covering catastrophic expenses, not a quick clinic visit to see about a nosebleed.

For purely political reasons, we currently publicly fund some voluntary procedures. For financial reasons, even aside from human rights concerns, we should not fund abortion and sex change operations.

We are already at the point that AI software can diagnose more reliably than a human doctor. The rigorous educational qualifications we require of MDs are a waste. We ought to allow someone with the training of a nurse to diagnose and prescribe treatment in most cases, with the aid of diagnostic software, referring on to specialists only for more complicated treatments.

We ought to allow those who want to to pay extra for prompt treatment outside the government system. Yes, this gives the rich an advantage, but it is a matter of human rights--the right to life, and the right to property. Moreover, it helps everyone by taking some strain off the public system--making it easier to give essential care to the poor, with shorter waiting times. The one danger is that doctors might abandon the public system en masse. To prevent this, doctors' fees might be capped; or, better, a certain number of years spent in the public system might be required before a doctor could legally practice outside it.

Makes more sense than rationing treatment, which is where we are now.


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