It is time to legalize marijuana for medical purposes. As one who is recovering from several surgeries, and the accompanying pain that goes with them, marijuana should be available for pain relief under doctor's supervision.
For years, doctors were stingy with the amount of pain medication given in the hospital and later at home. That seems to be changing, in recent years, painkillers are much more liberally administered to those who need them. Good pain management is proven to speed up the healing process.
Although I am not a marijuana user, I've read reports that people with certain types of cancers and other types of debilitating diseases find pain and anti-nausea relief when smoking marijuana. If we could devise a low cost way to deliver it to appropriate patients through prescription from a doctor, and purchased from a legal outlet, like a pharmacy, I am all in favor of it. Users would have to obey the existing traffic laws and would not be able to resell it to family and friends.
Many of the current drugs we take come from plants. In this case, you would get the relief directly from the plant itself, rather than in pill or liquid form.
If you agree with this point of view, contact your Wisconsin legislator.
They are currently discussing this issue.
Alan
Wednesday, November 18, 2009
Tuesday, September 8, 2009
A Private Sector Response to Health Care Reform
I have had several dozen responses to my recent blog: A 12-Point Program for Health Care Reform. It pleases me to say that almost all were positive and appealed to the readers's common sense. Since it was written, I've benefitted from many articles, broadcast reports, personal conversations. I also learned more about the thinking in Congress at a meeting of the Milwaukee Press Club, of which I am a member, featuring Rep. Gwen Moore (D), and Rep. Paul Ryan (R). Although miles apart on this issue, I was struck by how collegial these two members of Congress were to each other.
Since I began thinking about this issue several years ago, I never thought government control was the answer. I travel to Canada several times a year, and have never met a Canadian, liberal or conservative, who had anything good to say about their national health plan, or the outrageous taxes assessed to pay for it
I am still optimistic reforms must, can and will take place in the private sector. Have you ever seen the folks in "fly over country" so riled about any one issue before?
Congressman Ryan thinks there are many best practices in the private sector that need closer scrutiny and incorporation into our current reform efforts, and so do I. I agree with him that the Swiss model has merit and should be looked into more closely.
The first positive part of the Swiss plan is it is all private sector and covers 99% of the Swiss population, including the indigent. Second,
their system has good outcomes and is only 11% of the country's Gross National Product (GNP), as opposed to 17-18% or ours. Third, 87 private insurance comapnies compete for the Swiss to purchase their offerings. (Currentlywe have to purchase our insurance in the state where we reside, and often have a handful of offerings). They really keep a close eye on provider charges, and pressure them to reduce excesses in their systems. Quality of care is high, as well is patient satisfaction. Fourth, they top the profits of each health insurer at 5%. This eliminates many industry excesses.
Before we turn over our health care system to the same people who ran the "Cash for Clunkers" program so well, and who are on the verge of bankrupting Medicare and Medicaid, I think we need another push to have the private sector take the appropriate response, or we just may end up like Canada or England, hating our health care system.
Alan L. Gaudynski
Since I began thinking about this issue several years ago, I never thought government control was the answer. I travel to Canada several times a year, and have never met a Canadian, liberal or conservative, who had anything good to say about their national health plan, or the outrageous taxes assessed to pay for it
I am still optimistic reforms must, can and will take place in the private sector. Have you ever seen the folks in "fly over country" so riled about any one issue before?
Congressman Ryan thinks there are many best practices in the private sector that need closer scrutiny and incorporation into our current reform efforts, and so do I. I agree with him that the Swiss model has merit and should be looked into more closely.
The first positive part of the Swiss plan is it is all private sector and covers 99% of the Swiss population, including the indigent. Second,
their system has good outcomes and is only 11% of the country's Gross National Product (GNP), as opposed to 17-18% or ours. Third, 87 private insurance comapnies compete for the Swiss to purchase their offerings. (Currentlywe have to purchase our insurance in the state where we reside, and often have a handful of offerings). They really keep a close eye on provider charges, and pressure them to reduce excesses in their systems. Quality of care is high, as well is patient satisfaction. Fourth, they top the profits of each health insurer at 5%. This eliminates many industry excesses.
Before we turn over our health care system to the same people who ran the "Cash for Clunkers" program so well, and who are on the verge of bankrupting Medicare and Medicaid, I think we need another push to have the private sector take the appropriate response, or we just may end up like Canada or England, hating our health care system.
Alan L. Gaudynski
Thursday, August 20, 2009
A 12 Point Plan for Health Care Reform
As a former executive with a major health insurer in Wisconsin, I have thought for many years what I would do if I was asked to reform health care in the United States. In my role as a communicator and lobbyist for this organization, I've explored the points-of-view of providers,
insurers, legislators, regulators and patients. I've concluded that any reform legislation need not be 3,200 pages. There are plenty of "best practices" to explore and incorporate in any reform plan. Also, much of this need not be legislated. Just rely on the best resources of the private and public sectors in using common sense in attacking reform.
I don't think we need to "blowup" the current system. It does need work, and is not perfect by any means. My 12-point plan is based on years of observation of how the system works and how it could be improved. I've worked in upper management of a major health insurer and two of Wisconsin's larger hospitals. During the past 20 years, I've also consulted with many fine funders and providers of health care, and have been a patient myself. Some of my points may be considered unconventional, and not in the mainstream of thinking of current health insurers. For what it is worth, here are my thoughts.
First, revise medical liability laws to make them more realistic so more medical students are attracted to the primary care specialties of family practice, pediatrics and internal medicine.
Currently, malpractice insurance for these specialties is excessive, and may deter students from pursuing these specialties.
Second, to improve competition and lower prices, remove the current provision that we may only purchase health insurance licensed by the state in which we live. Set national standards for health insurance and let us purchase plans anywhere in the United States.
Third, self-insured (ERISA) plans do not have to include state mandated benefits, although many do. Let the individual or employer purchasers have the same freedom to select a plan free of some or all of the state's mandated benefits such as chiropractic, AODA, birthing services, acupunture, etc. Premium costs could be reduced substantially.
Fourth, go back to a community/age-rated system popular with some plans 30 or 40 years ago. Premiums would be based on the community's providers actual charges. Comparisons could be made to other communities' charges by employer and individual purchasers. These purchasers could put pressure on local providers to accept best practices and qualitiy initiatives from the lower-cost communities to reduce costs.
Fifth, insurers must remove the pre-existing condition provision and include that risk in the community/age rating system of determining premium. This could provide incentives for communities to initiate and support well city/community health programs aimed at reducing utilization.
Sixth, hospitals need to develop a better triage system for people, especially the uninsured, who present themselves for care at emergency rooms. Only true emergencies should be treated there. Work with all levels of government to set-up 24-hour clinics down the hall or next door to treat the non-emergent patients at a much reduced cost. Today the cost of care for these patients is often passed on to the people who have insurance, thus raising their premiums.
Seventh, many of our non-insured are illegal immigrants. Have the State Department explore ways to work with the offending countries who allow their citizens who enter our country illegally to take more fiscal responsibility for their lack of emigration enforcement. Perhaps a substanial reduction in foreign aid to those countries could be rerouted to help pay for illegal immigrant health care. This is a very controvertial area, so much thought needs to be considered in how to do this. The current system is not working.
Eighth, develop a better tax incentive program which encourages all individuals to purchase health insurance. Have the tax benefit based on the annual income of the health insurance purchasers, with better tax benefits for lower income individuals.
Ninth, develop premium lowering incentives for people who show marked improvement in their health like weight loss, lower blood pressure, blood sugar, smoking cessation. Do not continue to punish people for past health care sins with higher premiums if they make positive changes.
Tenth, another "must do" for reform is the development of an easily transportable and easily updated electronic medical record system. This alone, could save hundreds of millions of dollars in duplicative or unnecessary tests each year. (A friend of mine is in the process of trying to patent and market these flash drive-type devices for your keychain or in a credit card format).
Eleventh, as a condition of getting health care coverage, each individual should have to register his or her advanced directives for end stage of life health care. The family anxiety and waste in the area are staggering. This would go a long way to provide ethical health care in the final stages of a person's life.
Twelfth, take personal responsibility for your own health and the health of your loved ones.
The resources are all around you. Take advantage of them and you will lead a longer, healthier and happier life.
Alan L. Gaudynski
insurers, legislators, regulators and patients. I've concluded that any reform legislation need not be 3,200 pages. There are plenty of "best practices" to explore and incorporate in any reform plan. Also, much of this need not be legislated. Just rely on the best resources of the private and public sectors in using common sense in attacking reform.
I don't think we need to "blowup" the current system. It does need work, and is not perfect by any means. My 12-point plan is based on years of observation of how the system works and how it could be improved. I've worked in upper management of a major health insurer and two of Wisconsin's larger hospitals. During the past 20 years, I've also consulted with many fine funders and providers of health care, and have been a patient myself. Some of my points may be considered unconventional, and not in the mainstream of thinking of current health insurers. For what it is worth, here are my thoughts.
First, revise medical liability laws to make them more realistic so more medical students are attracted to the primary care specialties of family practice, pediatrics and internal medicine.
Currently, malpractice insurance for these specialties is excessive, and may deter students from pursuing these specialties.
Second, to improve competition and lower prices, remove the current provision that we may only purchase health insurance licensed by the state in which we live. Set national standards for health insurance and let us purchase plans anywhere in the United States.
Third, self-insured (ERISA) plans do not have to include state mandated benefits, although many do. Let the individual or employer purchasers have the same freedom to select a plan free of some or all of the state's mandated benefits such as chiropractic, AODA, birthing services, acupunture, etc. Premium costs could be reduced substantially.
Fourth, go back to a community/age-rated system popular with some plans 30 or 40 years ago. Premiums would be based on the community's providers actual charges. Comparisons could be made to other communities' charges by employer and individual purchasers. These purchasers could put pressure on local providers to accept best practices and qualitiy initiatives from the lower-cost communities to reduce costs.
Fifth, insurers must remove the pre-existing condition provision and include that risk in the community/age rating system of determining premium. This could provide incentives for communities to initiate and support well city/community health programs aimed at reducing utilization.
Sixth, hospitals need to develop a better triage system for people, especially the uninsured, who present themselves for care at emergency rooms. Only true emergencies should be treated there. Work with all levels of government to set-up 24-hour clinics down the hall or next door to treat the non-emergent patients at a much reduced cost. Today the cost of care for these patients is often passed on to the people who have insurance, thus raising their premiums.
Seventh, many of our non-insured are illegal immigrants. Have the State Department explore ways to work with the offending countries who allow their citizens who enter our country illegally to take more fiscal responsibility for their lack of emigration enforcement. Perhaps a substanial reduction in foreign aid to those countries could be rerouted to help pay for illegal immigrant health care. This is a very controvertial area, so much thought needs to be considered in how to do this. The current system is not working.
Eighth, develop a better tax incentive program which encourages all individuals to purchase health insurance. Have the tax benefit based on the annual income of the health insurance purchasers, with better tax benefits for lower income individuals.
Ninth, develop premium lowering incentives for people who show marked improvement in their health like weight loss, lower blood pressure, blood sugar, smoking cessation. Do not continue to punish people for past health care sins with higher premiums if they make positive changes.
Tenth, another "must do" for reform is the development of an easily transportable and easily updated electronic medical record system. This alone, could save hundreds of millions of dollars in duplicative or unnecessary tests each year. (A friend of mine is in the process of trying to patent and market these flash drive-type devices for your keychain or in a credit card format).
Eleventh, as a condition of getting health care coverage, each individual should have to register his or her advanced directives for end stage of life health care. The family anxiety and waste in the area are staggering. This would go a long way to provide ethical health care in the final stages of a person's life.
Twelfth, take personal responsibility for your own health and the health of your loved ones.
The resources are all around you. Take advantage of them and you will lead a longer, healthier and happier life.
Alan L. Gaudynski
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