American health care could use an overhaul

Published: Saturday, January 1, 2005 at 6:01 a.m.
Last Modified: Friday, December 31, 2004 at 10:46 p.m.
During 2004, I became elderly, was forced into Medicare, had a couple of occasions for routine medical services and assumed oversight of the health care of an elderly parent.
I essentially never saw a bill for the few medical services needed during 45 years of good, employer-provided medical insurance. I now receive from Medicare and secondary insurance full accounting of services, fees and payments. From those data, I readily confirm what I have long heard - the medical industry is shaking the money tree too vigorously.
Fees relative to services can be phenomenal, often with many hands in the pot! The privately well-insured not seeing costs of services likely shields the industry from censure and invites higher costs and unnecessary use of services. Hospital bills of wealthy and insured customers being padded to cover indigent care appears to occur and is exploitation of insurance and individuals.
Traditional medicine is reactive, remedial and fee-for-service. Services are delivered cafeteria-style - repeat visits by the elderly are a favorite strategy. Proactive medicine, directed toward keeping people healthy, should be better, potentially cutting incidences of illness and chronic disease and thereby cutting costs. Proactive medicine should include education of and more responsibility by individuals for their health and lifestyle.
Perceived urgent conditions at night or on the weekend often lead to misuses of emergency rooms, which are inherently expensive and typically lack patients' medical records. The latter may lead to many unnecessary, costly tests, and a four-hour visit may yield a bill for several thousand dollars!
These points lead one to conclude that America's health care system is broken and needs significant philosophical, structural and economic repair.
Glen Smerage, Gainesville

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