Commentary on a healthcare proposal

I’ve long been critical of the Affordable Care Act as well as proposals from the GOP.  They simply do very little to address the fundamental reasons for high cost.  However, Karl Denninger has made a nice stab of something close to what I could agree with.  I’ve long held that part of any solution is basically a Uniform Commercial Code writ large, and Mr. Denninger’s plan misses a few important ideas.  A few suggestions:

  • Rather than merely post pricing on website, require that they be structured in some machine-readable format.  A microformat would probably do nicely.
  • Records should absolutely be the property of, and always accessible to, patients.  However, a series of flash sticks is not the right way.  Introduce the concept of a data broker, specify some data structures, and let Google, Microsoft, Amazon, and the insurance companies all figure out who can build the best experience for patients.  Patients can choose their portal.
  • For the love of Pete, standardize insurance cards, coding, and programs.  A simple scan of a barcode should be able to help patients and providers alike determine exactly what they have, whether it’s valid, and what it will help with.
  • Similarly, standardize insurance dispute, payment, and claims processings means and timing.
  • I’m not completely sold on the idea of lifestyle changes as a panacea.  It’s certainly one thing that should be looked over, but then, really that’s an issue of mental health– something that our current system basically refuses to deal with.