Scrolling through the Neoliberal - productivity -self-help, weird transformation of boomers and Gen-X new Facebook aka
LinkedIn
I came across a comment from
Mark Cuban
critiquing the current U.S. healthcare system and exploring why prices are so exorbitantly high. His thoughts immediately resonated with me, as they align with the ideas I discussed in my article, State-Led Universal Healthcare: A Pragmatic Path to National Reform.
I believe his critique adds a valuable layer to the conversation and could help make universal healthcare a financial reality. But first, let’s break down his comments, back them up with some literature, and sprinkle in my recommendations (and humour) on how to make this happen. LET’S GO!
Mark then shares "How do we enable those who can’t pay to afford care?", he eludes, and is the fact that we assume that is why we have insurance - but we all know that is no longer the care.
Key Takeaways:
It's SIMPLE STUPID!
- Healthcare is inherently simple but becomes complicated by opaque pricing and profit-driven margins. Like many things, we are gaslit into believing it’s far more complex, leaving us too exhausted to understand and dependent on those who profit from this lie. We’re being deceived by the very system we trust to take care of us… and, well, look where that’s gotten us. Just saying.
- In the United States, up to 550,000 people file for bankruptcy each year due to medical bills—that’s about 66.5% of all bankruptcies! (Cornell University, Scheinman Institute, 2024).
Insurance Meddling!
- Traditional unsubsidized insurance is relevant for only a small percentage of the population (Mark estimates around 8%). Mark even invited corrections and support on this figure, and honestly, I’m unclear too—so if anyone has solid data, feel free to help me out!
- Most healthcare payments are subsidized by self-insured employers, state governments, or federal programs (aka taxpayer-funded). And then there’s the whirlwind of FSAs, co-pays, deductibles, and HSAs—yet some people are coming for the alphabet mafia? My head is spinning!
- We have entire master’s degrees, undergraduate programs, and entire departments dedicated to untangling the convoluted mess of how we ended up with this healthcare system. Geesh!
The GOAL
- The focus is on reducing the cost of care so that employer contributions and taxpayer funding are sufficient to cover expenditures. Wouldn't this be deliciously amazing! NOM NOM NOM - Tastes like more!
Marks Proposed Solutions:
- Cost Transparency: Hospitals and providers should publish actual costs NOT prices, which would prevent manipulation and increase accountability.
- Negotiation for Fair Margins: Once costs are transparent, employers, providers, and government entities (like CMS) can negotiate fair margins.
- Reallocation of Resources: Fair margins would ensure doctors, nurses, and caregivers receive a greater share of healthcare spending.
Steps to Achieve This Vision:
1. Mandatory Cost Reporting:
- Hospitals and providers must be required to report the actual cost of delivering care—free from manipulated prices inflated by billing codes and other profit-padding factors.
- Honestly, every time I think about this, I’m reminded of a print I own: overweight men who look like wealthy aristocrats squeezing working-class people through what looks like a pasta or paper-flattening machine, with smokestacks belching in the background. Ew! The parallels to our healthcare system are disturbingly spot-on
2. Government Oversight:
- Legislate cost transparency at the federal or state level to ensure compliance. This will likely need to happen at the state level—Yooooo-hoooooo!?
Umair A. Shah, M.D., M.P.H.
,
Washington State Department of Health
,
Dan Newhouse
and Governor Bob Ferguson {Waves}. Please refer to my previous?article State-Led Universal Healthcare: A Pragmatic Path to National Reform.
- Create penalties for non-compliance and incentives for early adopters of transparency initiatives. Sadly, as I mentioned earlier, dishonesty in healthcare is rampant, so a little slap on the wrist or a little carrot might be necessary. It’s certainly better than someone dying from cancer or taking their own life due to chronic pain and depression, all because of an insurance denial or delay. Worse yet—vigilantism. GASP!
3. Standardized Cost Framework:
- Develop a national framework for healthcare cost reporting, enabling meaningful comparisons across systems and providers. This ties directly into the need for interoperability and information sharing, which are crucial for achieving cost—not price—transparency. Plus, better knowledge-sharing benefits everyone. Wink wink. ??
4. Data-Driven Negotiations:
- Employers and government payers can leverage transparent cost data to negotiate reimbursement rates with hospitals and providers based on fair margins. OMG, fair margins! Who would’ve thought—in healthcare, of all places? Shocking, I know.
5. Redistribution of Funds:
- Ensure that the majority of healthcare spending is directed toward those directly involved in patient care, such as doctors, nurses, and other caregivers.
- Lately, executives have been catching heat for their inflated salaries. As someone training for the sweet, sweet C-suites in an Executive MHA program, I get it. But I also come from the trenches as an occupational therapist, working alongside incredible nurses, SLPs, aides, techs, and doctors who do heroic work daily—for way less pay. Sure, being an executive is tough, but I’ve looked at patients in the eye when they were holding on by a thread, helping them see they had the strength to climb out of the darkest places. Not many executives can say the same. So, let’s share the wealth a bit more, shall we?
6. Public Awareness Campaign:
7. Pilot Programs:
- Start small with pilot programs to test cost transparency initiatives in select states or hospital networks, then scale nationally.
- I think Washington State would be a great place to pilot such a program. We are a midsized state, we have made bipartisan initiatives work in the past and are all about innovation! By implementing these measures, the healthcare system can move toward greater transparency, equity, and efficiency, ultimately benefiting patients and providers alike. LET'S GO!
Han, A., Lee, K.-H., & Park, J. (2022). The impact of price transparency and competition on hospital costs: a research on all-payer claims databases. BMC Health Services Research, 22, Article 1321.?
Cornell University, Scheinman Institute. (2024). Healthcare insights: How medical debt is crushing 100 million Americans.
Ubel, P. A., & Bach, P. B. (2022). Necessity for and Limitations of Price Transparency in American Health Care. JAMA, 328(17), 1683–1684. ?
#Healthcare #Leadership #Management #Healthcareinnovation #HealthcareImprovement #HealthcareData #Reform #Simple
