How to Reduce Medical Care Costs

By Robert (Bob) Koshnick, MD, FAAFP 


The cost of medical care at 19.7 percent of the economy in the U.S. is unsustainable. Medicare is expected to be insolvent by 2026, and those calculations do not fully reflect the cost of COVID. Minnesota’s per capita health care spending since the early 1990s has consistently been 10 percent above the national average, so Minnesotans spend about 22 percent of their income on medical care*.  
 
I recently published a book on reducing medical care costs and regulatory burdens and empowering patients to manage their own care: Empower-Patient Accounts Empower Patients.   
 
It is my belief that everyone should have a primary care physician/provider with a direct patient-to-provider relationship. Patients should be in control of their primary care payment, with the option for Direct Primary Care without financial barriers or copays for preventive care, acute and chronic care management and hospice care. Physicians/providers sole professional commitment should be to the patient, not employing corporations. 

How can medicine be more cost effective?   

  • Empower patients with expense accounts to give patients control of their primary medical care.  
  • Pass Direct Primary Care legislation on a state level 
  • Pass the Primary Care Enhancement Act on a national level. 
  • Legislate referenced-based pricing to provide price transparency for consumers. 
  • Legislate communication and medical error dispute resolution (Iowa’s Candor law).  
  • Remove state and federal regulatory mandated overhead. 
  • Make medical care a matter between patients and their physicians.  
  • Have people directly pay for primary care, generic drugs and incidentals. 
  • Support high deductible health plans to cover major medical expenses. 
  • Reserve the use of insurance for major medical expenses.  

Access my recent presentation on Empower-Patient Accounts

*Reference not provided. 


Koshnick is an MAFP member and on our Legislative Committee. He is passionate about increasing patient access to quality, affordable health care.  
 
Views and opinions expressed in our guest posts are those of the author and do not necessarily reflect that of the Minnesota Academy of Family Physicians. 

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