Turn the Tables
‘We the People…’ appear to have the chance to turn the tide on Health Care Reform. Keep our fingers crossed!
But doing nothing is probably not the right course either. Some changes need to be made, hopefully for the better. So here’s my modest proposal for health care reform were I writing a Bill:
- Insurance portability. I know many a person who is locked in jobs for fear that in changing jobs they or one of their family members would lose coverage in the switch. That is not good for the economy as the person instead of advancing economically stagnates in place. The govt loses their slice as well.Decouple the insurance from the employer and tie it to the individual/family. The individual should be able to take their policy where ever they desire.
- Employer assistance. The employer is no longer required to offer insurance. For those employers that wish to defray a portion of the cost, however to acquire quality employees, the funds are tax free both from the provider and the recipient.
- State Control is minimized. No State can require coverage provisions as many do today, driving up costs. If you don’t drink, why should you pay for mandated alcholism coverage in your policy? That’s subsidizing substance abuse, but a topic for another post.States may retain oversight for the purposes of process and consumer protections.
- National minimum and Ala Carte pricing. States shall convene once a decade to determine a minimum national insurance standard applicable to all citizens in all states. By minimum, those routine procedures that the majority of the population would expect to face plus a risk factor of catastrophe events.Other service options would be offered ala-carte. Maternity, Elder Care, Military service, etc would be provided as riders available for purchase. The national baseline would have a cost cap adjusted for inflation to encourge insurance providers to be extremely competitive thus inducing everyone to have coverage. Those in high risk categories can purchase additional coverage that lifts the cap to higher levels.
- HSA become unlimited. Individuals can contribute to HSA’s with not limits. Monies can be used to defray future years when they know their adoption of ala-carte costs will be higher.
- Nationwide Competition. Any company wiling to commit to the national policy minimum as outlined may compete for clients in any State of their choice. Subject to the their good standing in business practices while in State.
So you say to yourself. Ok but it does not sound like it would save money? Well there is a radical component to this that would be phased in –
* Medicare/Medicaid is phased out. Elders would be able to stay with MM or go to the new scheme. Feds would still issue checks but now they do it to cover baseline and elder care options.
* VA is abolished. Instead the government would be treated like an employer and would subsidize the coverage of vets care under the plan.
* In-service military personnel would also be subsidized 100% in the plan. DoD would still be responsible for combat medical service due to the nature of the beast.
* The Federal insurance plan is abolished. The govt types can get HC just like everyone else.
* Hospitals no longer are required to treat the uninsured.
Put the patient or the patient’s family back in control and they will by increments drive the costs down. No labyrinth of federal review, just a once a decade review of what procedures constitute baseline. Insurance companies would have to compete for clients. Over the long haul it ends up cheaper. I can guarantee one thing. The Bill as I propose could be drafted in about 20 pages. The difference in print costs would probably save $2-3m. That’s a start.
Everyone’s life has different needs. So what would you like to see in a open competitive national health standard?
[1]
The bottom line is that health care reform has to be just that, rather than a power grab.
Bobby Jindal wrote a column for the WSJ in July in which he also mentioned medical lawsuits. That’s of major importance and unfortunately, one of the last things politicians will address. (It would be nice to have less lawyers in Congress!)
These were Jindal’s bullet points:
[2]
Definitely agree that medical tort reform has to be considered. Fact probably ought to be done before you do what I am proposing.
Something I have always wanted to see in doctors offices is a plaque on the wall that says –
Patients killed
Patients injured
Patients served
and the national averages for that practioner’s specialty. Patients will drive the bad ones out of the profession.
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Without tort reform, there is no way we can reduce medical costs.
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Agreed, tort reform is the number one requirement, by itself it lowers costs appreciably. Dr Dog has all the other key elements.
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“Without tort reform, there is no way we can reduce medical costs”–bc
Even with medical reform (ObamaCare), there will still be a tort problem. The Democrats aren’t going to kill the goose. . . The gooses grandma maybe, but not the goose.
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You are right Tony, the Dems wont allow it, but if the R’s could propose a sensible, non-government, easy to understand solution and run on it in 2010 it might sell just like the Contract With America did.
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Thing is Bruce, the best and brighted aren’t in Congress, so the solution will have to come from regular folks like us.
So give me a few minutes while I think. . . . .
[8]
1. Loser pays, including the loser’s attorney.
2. If executive salaries can be capped, so can punitive damages.
[9]
drdog– that would drive doctors to only see simple, easy-to-treat patients with a given disease.
can’t capture quality that easily.
[10]
Doc, something that I would add to your list of items would be that all consumers would pay at least 10% of their medical expenses out of pocket — perhaps capped at $10,000 or so a year. The decoupling of the medical consumer from the cost of medical care has done enormous damage to the management of health care costs. It must be put where it rightly belongs — between the consumer and the service provider. Market forces are a wonderful thing when allowed to work.
[11]
aureliusx
drdog– that would drive doctors to only see simple, easy-to-treat patients with a given disease.
I’ll grant that could be a problem. Its is a symptom of the problem facing Medicare right now. Docs will treat those where the billing matches the services and pass on the rest.
Ya got an answer for that problem?
[12]
MPT,
Good catch, some sort of copay mechanism is needed. They could cover out of the HSA if they so desire too?
[13]
2. If executive salaries can be capped, so can punitive damages.
CT -
Goit something against guys like John Edwards?
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They could cover out of the HSA if they so desire too?
Absolutely. Long as they are in the loop.
Another thing I would like to see is forcing some transparency within the health care system with regards to billing. All services and products should be priced out no different than a restaurant menu or hotel so that a consumer can make intelligent decisions with regards to cost/benefit/quality/quantity before the services are rendered. Because of the insurance mess it is very difficult to tell what the actual charges are for services as billing is a shell game between the health provider and the insurer. This obsfuscation makes it very difficult for a consumer to understand what the actual charges. Transparency is key so that consumers can participate in the decision process and for market forces to work.
[15]
Obama is currently speaking at a “town hall.” He reminds me of a carny pitch man.
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MPT,
Another good suggestion. Having experienced this first hand I can tell you that pricing is relative which is BS. I tell anyone who heads for the hospital that 90% of all bills tendered are wrong. Challenge on sight what they hand you.
[17]
A left’s remorse. Compliments of HotAir.
I figure he will be the first and last black president for a generation. Probably also the last person to ever get a shot at the WH from the State of Illinois. Till Chicago flushes its machine the country can’t afford another mistake like this.
[18]
The Liar in Chief just promised the people of Colorado that his Health insurance reform won’t cost us very much…….Everything the government does costs us money…..The deficit will increase, taxes will go up and the quality of care will plummet….aside from all of that it is all good……
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O/T…but this REALLY pissed me off. Top “story” up on Yahoo now:
Overrated tourist attractions
These popular U.S. tourist traps may leave you feeling underwhelmed or exhausted. Forget the Alamo
Never been…but will indeed go someday. NOT because I expect a thrill a minute, or the ultimate “spa experience”. But because it is part of the collective history of our great nation.
But DENIGRATING any and everything about our history is EXACTLY what the media is about these days.
Don’t know where RWY is today…but his prediction of secession is looking more likely, and sounding better all the time!
[20]
JR,
As is typical of jaded tour types. San Antonio can be a bit of fun if you plan it right. You do the Alamo, Riverwalk, and nearby SeaWorld. Makes for a leisurely 4 days. If you want to burn a week. Then take the other days and book a B&B down around the San Padre Island area. Just veg out, enjoy the beach and maybe do some fishing. Makes for a great week and cures the Tex-Mex fix.
[21]
If I had to think of the toughest sell for a historical visit, it would have to be the Black Hills where the remains of the 7th calvary at the Little Big Horn are located. If I am ever in the general area I will go, but never just for that.
[22]
drdog…but not too far from the Black Hils is Mt. Rushmore.