The first interesting healthcare idea I've heard in a long while
While it's a dubious public service that I perform by directing people to Slashdot (the external URL for this article), the original poster writes about an idea for "fixing" healthcare that I've never heard of.
Premise: The cost of malpractice insurance is both a burden on patients and medical practitioners who are additionally discouraged both from practicing and offering certain (possibly medically necessary) procedures.
Supposition: Transfer the burden of risk to the patient by making medical practitioners immune to malpractice lawsuits, and allowing patients to purchase insurance against a possible negative outcome from a specific medical procedure. The amount of insurance would hopefully realistically reflect the "actual" risk of loss and premiums would be affected by the history of the patient, the medical practitioner (and maybe their facilities) and the procedure itself. The poor would be subsidized in some way.
As I see it, the interesting parts to this are:
- The medical practitioner (and their facilities, perhaps) doesn't escape liability since, if they screw up too much, people will pay much more to insure procedures with them. If there's a true transparent marketplace in effect, people will avoid these screw-ups.
- Since the bearer of insurance (the patient) also has the responsibility to prove actual, ongoing and probable future loss, buying a huge insurance package does not mean an automatic huge payout -- possibly (in the aggregate) limiting the amount of malpractice claims
- This will utterly fail unless there's a transparent and open marketplace for medical procedures or the required insurance, i.e., patients can easily find out what the negative outcomes of procedures/treatments are and can likewise easily find out what their insurance premiums would be for each alternative treatment/doctor/hospital/outcome/payout combination.
The big strikes against this are:
- A per procedure premium is a disincentive to receiving treatment. Will this promote better preventative medicine or healthier lifestyles? I don't know if that's a realistic and widespread effect.
- Insurance companies have an incentive to underpay the outcome and patients (as a class) are much less able to fight injust/wrong decisions than medical practitioners.
- The worse your health history, the more expensive further treatment becomes. If there is no income related upper limit to premiums (i.e., subsidized) then what happens when someone is bankrupt trying to mitigate/cure an expensive condition?
- Partly due to legal liability concerns (e.g., HIPAA or PIPEDA) and partly due to the value inherent in personal information, medical practitioners jealously guard patient data whenever possible. A fully transparent marketplace that this approach requires seems difficult to achieve.