Thank you for the many emails. I did try to respond to all, but if I inadvertently missed you, my apologies. The general consensus was frustration with our broken system. Many offered personal experiences while others offered sage advice. All of this got me to thinking. I wanted to share some ideas that I believe our organizations would be wise to explore and advocate.

The first is an adaptation of a brilliant idea shared by my good friend and colleague Ray Brill. Ray suggested a clever way to apply existing technology to better control costs and access to care. Essentially, he described a universal health care card that would contain vital fixed patient insurance data. The card could also be coded to immediately access patient demographic and health history from a secure portal that would be universal for all insurers. Used like a credit card, just running it would permit instant checking of benefits and copays, and allow immediate approval for examinations, procedures and medications. This would completely and instantaneously automate insurance claims and would reduce administrative costs exponentially. It would also streamline office flow and dramatically decrease the cost of providing care.

Second on my list would be to immediately implement federal licensure for all professions, including optometry. In an age of rapid technological advances, increasing personal mobility and expansion in telemedicine, failure to nationalize licensure is just poor health care policy. Federal licensure should be set at the most advanced level currently held by each profession. While medicine has long railed against expansion by “secondary providers,” escalating shortages of MDs and disruptive technology will force these changes anyway. It’s time organized medicine put the needs of patients ahead of its own economic agenda. Failing that, it will be done for them at even greater disadvantage. Mark my words.

Finally, the federal government should require all insurers to engage practicing health care providers in an oversight position to ensure balance and quality of care. Insurers should be subject to the same QOC audits providers are forced to endure.

While these are just a few ideas, imagination, determination and mutual cooperation can, indeed, put Humpty Dumpty back together again.

Arthur B. Epstein, OD, FAAO Chief Medical Editor artepstein@optometricphysician.com