A Partial Answer to National Health Care
(November 11, 2006)
Correspondent Jim Twamley (last seen here in my "wheel estate" entry) sent in a
"Partial Answer to National Health Care" from the road. What I like about his
partial answer is 1) that it is partial--no one idea will solve all our healthcare
problems; 2) it employs market forces, and 3) it eliminates insurance claims and all
the paperwork which chews up 30% of all the money spent on healthcare. By offering
basic medical services on a cash basis, it encourages people to only spend money on the
care they actually need, as opposed to the "free" care paid by insurance--which is anything
but free to the employers and government.
As you know my wife and I travel in our RV full time. As a result we see and experience many
things that others do not. Not only do we see the normal tourist sites but we also observe
people, communities and trends. One of the trends that I intend to invest in at its future
IPO is what I call "drive through health care."
Thank you, Jim, for the thought-provoking observations and commentary. Low-cost
treatments which are paid in cash certainly seem like part of the total solution.
We recently visited Jeff and Wanda our long
time friends who reside in North Carolina. Jeff was a Nurse in the U.S. Navy and went back
to school to become a Nurse Practitioner (a PhD. no less). He is now the manager of a whole
group of Nurse Practitioners who have offices in pharmacies and even some Wal-Marts. For
$60.00 you can see a Nurse Practitioner without an appointment and get your medical needs
taken care of with the convenience of a co-located pharmacy. How cool is that!
Practitioners are very good diagnosticians and (under the supervision of an M.D.) can
prescribe medicine just like a regular Medical Doctor. NP's can refer you to medical
"Specialists" just like any Family Practice M.D. would. In fact, we have a crisis in the
M.D. field in that most of our current medical students don't want to be Family Practice
docs. Instead, they want to be "Specialists" (more $$$).
Bottom line, if we don't do
something like encourage and promote "drive through health care," and soon, we will all
be looking for a Family Practice doc and waiting in long lines at crowded germ-infested
These NP walk-in clinics were designed by the same person who designed the Starbucks
interiors, so they are very pleasant and inviting spaces. Wal-Mart and the other large
pharmacy chains must be thinking that this is a reasonably inexpensive way to provide
on-site health care for all their employees. This is a new concept that seems to fit the
American lifestyle well. If we can keep this type of care inexpensive from the start it
will be a boon to those who currently have little or no access to health care.
need the government to do is to limit NP malpractice litigation, promote the profession
by officially recognizing them as a professional body by cutting their statutory reliance
on supervising M.D.s. and allow them more freedom to do what they do best - family medicine.
Do these things and the marketplace will keep access to medical care at optimum levels and
the price of health care to a minimum.
I even like this concept better than socialized
medicine because it resides in the heart of the American retail marketplace and fits our
"drive through" lifestyle. Socialized medicine costs too much and is ineffective
precisely because it is not driven by market forces. Customers suffer because they
have little or no say in how socialized health care is managed. Just look to Canada
to get a snapshot of the slow, overcrowded ineffective deployment of socialized
medicine. Socialized medicine is "camp out in the lobby bring your sleeping bag
and extra food" medicine while this new model is "drive through" or "just in time"
medicine. This is a huge part of the answer to our health care crisis, but we need
to help the NP community get this off the ground and the sooner the better!
P.S. In honor of Veteran's Day, I want to mention that Jim is a retired Navy Chaplain.
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