This website has a series of articles that describe what I have learned from my experiences with the healthcare industry in the U.S. My experiences include working in the medical industry for over 20 years as well as many personal encounters with the healthcare system in over 60 years of life. The articles are divided into two categories. One category is “The Healthcare Industry,” which discusses fundamental problems with the healthcare industry in the U.S. The other category is “Specific Health Experiences,” which describe my personal experiences with certain health conditions.  The key conclusions from the articles are summarized below. The articles describe various experiences that support these conclusions.

Key Conclusions

The Healthcare Industry

The healthcare industry maximizes costs and does have effective mechanisms to control costs. Free market forces have not been effective at controlling costs or providing optimal services in the healthcare industry. This results from several factors, including (a) the incomes of health professionals increase as more office visits, tests, procedures, and treatments are done, whether or not these actually benefit the patient, (b) patients have no good way to understand and compare costs, (c) there is no effective mechanism for dealing with fraud and abuse of patients in healthcare, (d) “best” medical care is provided without regard for costs, and (e) the strong financial incentives to increase costs are not controlled by competition or by regulation. In the absence of other mechanisms for assuring ethical behavior, the threat of lawsuits has an important role in dealing with incompetence and in limiting the effects of the financial incentives for practices that are detrimental to patients. (read full article)

Healthcare costs can be reduced by (a) patients becoming more active in questioning doctors and in participating in the decisions about their healthcare, (b) regulations that force medical providers to implement competitive practices, such as making information available about the costs and effectiveness of their medical services, (c) altering the healthcare system to make the financial incentives for doctors and other medical providers more aligned with the best interests of patients, (d) allowing Nurse Practitioners and Physician Assistants to have a greater role in routine healthcare, and (e) developing medical care with different degrees of risk and cost that are consistent with the wishes of different patients. (read full article)

Most types of insurance (e.g., home and car insurance) are intended to cover the costs for certain rare events that a person could not cover without insurance. However, health insurance has become a middleman for virtually all healthcare activities. This middleman role increases costs for healthcare due to the administrative costs, marketing costs, and profits for the insurance company. The costs and profits for the insurance companies can raise the costs for medical care by about 25%. In theory, health insurance could be beneficial for routine medical care because insurance companies have the knowledge and experience to negotiate better, more cost-effective medical services. Most patients do not have the specialized knowledge and experience to effectively negotiate for themselves. However, these theoretical benefits from health insurance companies have generally had limited effectiveness in practice. The Affordable Care Act (Obamacare) is an attempt to place requirements on insurance companies to make them produce the needed benefits for patients.

At present, healthcare is basically a work in progress with various experiments to try to find something that works reasonably well. Different strategies need to be tried and compared. The differing opinions about which strategy is best need to be resolved by actual experience, not by academic speculations or political ideology.

The politically conservative proposals to reduce government involvement in healthcare are based on the incorrect assumption that the healthcare providers will compete with each other, rather than continue the well-established non-competitive practices that maximize profits. The liberal proposals to require everyone to obtain health insurance without major interventions to reduce costs can also be expected to promote significantly higher costs. The lobbyists for the healthcare industry special interests dominate the political process to the point that the major choice is between different ways of enhancing the profits and control of the special interests. (read full article)

Specific Health Experiences

I experienced the intense pain of cluster headaches for a few years. In an informal article on the internet, a doctor speculated that cluster headaches were sometimes caused by a person becoming overheated by sleeping with heavy winter blanket when the weather warmed in the spring. That exactly fit my situation. When I changed the blankets, the cluster headaches stopped occurring. (read full article)

When I ate a low fat vegetarian diet I became increasingly susceptible to tension headaches. These stopped after I altered my diet to include more protein, including nuts, eggs, and eventually fish and seafood. (read full article)

I have received recommendations by medical professionals that were detrimental to my health many times over the years. In recent years I have rejected about 20% to 30% of the recommendations by doctors and often seek a second opinion when a doctor recommends an expensive or invasive procedure. (read full article)

I require a mattress with a specific degree of firmness to avoid back problems. A latex mattress that can be adjusted by shifting and replacing pieces of foam has worked very well for me. (read full article)

 

[Version of 7/27/2015]

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