Everyone seems to be talking about how we can fix our “broken” healthcare system. Yet, nobody seems to talk about why healthcare is so expensive in the United States. You can blame it on insurance or the government. But what it really all comes down to is abuse and law suites.

Abuse and law suites are like siblings when it comes to health care. Massive amounts of people abuse our emergency rooms, ambulance services and even clinics. This is allowed to happen because these people can’t be denied medical care as the medical providers will find themselves in legal trouble.

Of course the people abusing our medical system typically have government aid, or don’t pay at all. Medicaid and Medicare programs are only reimbursing 20-30 cents on the dollar right now. That’s pretty bad considering what it costs to do business in healthcare. So what do the providers do to make up this lost revenue? They raise their prices! Which ultimately means that the private insurance companies get shafted with the high rates. When people abuse the system and don’t pay their bills, the healthcare providers lose money on supplies, wages, procedures, etc. It’s no wonder that the majority of private doctors offices and clinics don’t accept government insurance programs. Why would they?

Law suites closely follow abuse on the “rising healthcare costs” scale. Excessive medical malpractice suites have driven malpractice insurance through the roof. Once again, the doctors have to make up this loss somewhere. It is actually rare to find a doctor who has yet to have a malpractice suite filled against them. Whether the suit is legit or not, it is typically easier and cheaper for the insurance companies to just settle and pay up rather than fight it out in court. Excessive malpractice suites then lead to “defensive medicine”. Ordering expensive unnecessary tests to “cover their asses”. Once again, only contributing to rising medical bills. Doctors wont follow their training and instincts in fear of legal repercussions.

Does this mean that a doctor who shows gross negligence shouldn’t be held liable for their actions? Absolutely not. But suing your OB/GYN because your baby came out with 6 fingers isn’t what I would call reasonable.

Throwing more money at the problem doesn’t fix anything. We need to attack this problem from the ground up. Hospitals need to be able to deny treatment to non-urgent patients. They crowd our emergency rooms and eat up useful resources. Perhaps some public education and readily available low-cost clinics and urgent cares would tackle a good portion of this problem. The other thing that needs to be addressed is the idea that being transported by ambulance will get you seen faster. One of the big ideas behind EMS 2.0 is that EMS professionals could offer other solutions, rather than just transport to an emergency room. These are just a couple things that could significantly reduce the cost of healthcare.

Let’s quit covering up these problems and attack the real issues. Think of it like treating an illness. You can treat the symptoms and give some temporary relief. Or you can correct the core of the problem and fix it all together.