Anybody with a little common sense knows that healthcare definitely needs to be reformed and that it can be done in a much more simple manner – a manner that doesn’t require Americans to submit to an eventual single payer government mess like what our seniors have been given with Medicare.
Since most of us can agree that the promises of social security and Medicare are broken, why would we want to trust our healthcare to the same government that has systematically run these programs into the ground?
Please check out the topics below regarding where our current system stands and where it could easily go with just a little reform - not the monstrous 1000+ page bureaucracy that has been proposed (that even a Democrat representative say he hasn't read because he would need to have several lawyers on staff to understand it).
First, I would say that, for the most part, the American healthcare system is pretty darn good. Certain representatives have made assertions that the World Health Organization has rated our healthcare 37th in the world. Here are some things they haven’t told you about the WHO’s rating:
THESE RANKINGS WERE BASED ON 3 FACTORS
1. OVERALL HEALTH OF THE POPULATION:
This figure relies on many other factors in addition to insurance coverage - diet, exercise, genetics, etc. For example, we can probably all agree that Americans aren’t the slimmest, healthiest eaters in the world. We like our vices and our food. Well, the 1st factor in the WHO rating takes obesity, diabetes, liver failure, and heart disease into consideration and weight it at 30% in deciding how we rate in the world. This largely has to do with personal choices and NOT health insurance, yet our leaders cite the WHO rating as a reason to enact government run healthcare.
2. RESPONSIVENESS:
This has more to do with overall hospital/medical office performance, management, attitudes, etc. So, if you have a rude staff, you will score lower as a country. Again, this has very little to do with how our current insurance plans contribute to our WHO rating.
3. FAIRNESS OF FINANCING:
Yes, this has more to do with insurance, however, the concept of FAIRNESS is subjective and based upon the individual's perception of what is fair. For example, is it fair to deny chemotherapy drugs to a woman with late stage breast cancer because it is not cost effective? (As they do in England). Is it fair for you to be required to pay for my health insurance when you have to pay for your own, as well? Who at the WHO actually determines what is fair and how countries are rated on this factor?
These rankings are not exactly a treatise on how to insure a population of hundreds of millions and the WHO agrees that these figures may not be the best way to rate healthcare systems in their own document located at http://www.who.int/health-systems-p
THE TRUTH ABOUT AMERICAN HEALTHCARE
1. STATISTICS:
If you want to talk actual objective statistics, anyone who really believes that we are 37th in the world is saying that, given the choice, they would rather have ANY of the cancers listed below in Europe than here. Ted Kennedy, who received life extending, cutting-edge brain surgery at the world-class Duke Medical Center should thank his lucky stars that he wasn’t a European citizen when he needed this surgery. Do we really want to go down the same road as Europe with these survival rates?
2007 cancer survival rates (taken from "The Lancet Oncology):
a. Colon/rectum cancer: 56.2% survival in Europe, 40% in the UK, and 65.5% in the US.
b. Breast cancer: 79.0% survival in Europe, 69.7 in the UK, and 90.1% in the US
c. Prostate cancer: 77.5% survival in Europe, 51.1 in the UK, and 99.3% in the US.
2. FREE MARKET:
Much of America’s HUGE success in cutting edge medical techniques, surgeries, medicines, etc. is related to our free market system. Why do you think we have so many foreign medical students who want to learn here? Yes, doctors should and do want to help people, but who is going to spend hundreds of thousands of dollars and years in medical school, internships, and residencies when they cannot recoup that time/cost? If we turn to a government controlled single payer plan, the best and the brightest will no longer turn to medicine as a profession.
3. WHAT OUR CIVIL SERVANTS ARE SAYING:
a. If you think that the ultimate goal of this bill is not a government run single payer system, you are naïve. Our own president and many of the people in charge of this bill have said that this is where they want to end up – this bill is but the first step to their ultimate goal.
b. Although our president recently said that Medicare benefits will not be affected, the bill contains cuts to current Medicare advantage subsidies as well as cuts in what Medicare will pay for services. So, Medicare will not tell you that you cannot receive services, but doctors will be less likely to treat you because they will be paid less for services to Medicare patients. If we cannot believe the president on this point, on what else has he misled us?
c. The president says we need more competition and a government plan will force insurance companies to become more competitive. The truth is: there are around 1300 medical insurance companies in the US, but they are not allowed to compete with one another due to laws restricting certain insurers to certain states. If we were able to buy insurance from any of these companies – rather than just a select few licensed in our states – we would have competition. A government plan could lead to a single payer system because our government can legislate unfair, artificial, taxpayer subsidized pricing with which insurance companies cannot compete. Again, this is the first step in the ultimate goal of single payer, government run healthcare.
4. BUREAUCRACY:
People say that paperwork and bureaucracy are costing us a fortune. This is absolutely true. Doctors and hospitals have to pay salaries and benefits to additional workforce just to handle all of the paperwork, coding, and to keep up with rules and regulations. What do we think we will improve here by implementing a government run healthcare plan? Do we really believe that bureaucrats can give us a smaller bureaucracy in healthcare? Have you seen the insane structure of this proposed plan? If not, here is the bureaucracy in its full glory: http://docs.house.gov/gopleader/Hou
5. WHAT OUR CIVIL SERVANTS ARE NOT SAYING:
If this plan is so great, all civil servants should be REQUIRED to use it – this includes our president and his cabinet, congressmen/women, and senators. If they are not comfortable entrusting their families’ healthcare to a new government insurance company, then why should we trust it? After all, they work for us – not vice versa.
Undoubtedly, health care needs to be repaired. However, there are other simple solutions that will get us closer to where we need to be without putting our entire well being into the hands of bureaucrats.
This does not require a 1000+ page bill. Here are some ideas:
1. ENCOURAGE COMPETITION:
a. Allow all medical insurers to compete nationally.
b. REQUIRE medical providers to post pricing of all procedures, supplies, success rates, and complaints annually to a single online clearinghouse where patients can research and compare their options. Pricing should not be a guessing game.
c. Allow Chambers of Commerce and members of other organizations to purchase medical plans as a group – this will lower insurance costs with bulk rates.
d. Allow discounts for healthy behavior – such as non-smoking.
e. Allow those who are "generally healthy" to purchase high deductible catastrophic coverage and give them the option of a health savings plan. Those who save in a health savings plan will eventually have enough to cover their high deductible and they can keep adding. The money in their plan would roll over year to year - so it was available if/when it is eventually needed.
f. Do not REQUIRE people to get health insurance, but hold them to their obligations should they need healthcare without insurance. That means, no bankruptcy protection except in the case of extreme hardship for those who received treatment without insurance.
2. TORT REFORM:
Lower doctors’ malpractice costs by enacting REAL tort reform that discourages frivolous lawsuits. Those who have legitimate claims should have remedies that do not have an artificial dollar limit – especially for death or severe morbidity. However, simply requiring the loser of the case to pay the cost of legislation and capping a lawyer's pay based on actual work performed (instead of the current 30-40%) should eliminate illegitimate claims. I dare say that, if our government wasn’t already run bunch of lawyers, we would have seen tort reform a long time ago.
3. COST REFORM:
a. This may sound harsh, but, if you are in our country illegally, you should not have access to subsidized medical services except in the case of life or death emergency. We simply cannot afford to pay for medical care non-citizens who are not contributing to our society.
b. All medical facilities and insurers must go to electronic methods of billing and record keeping. It would save time, money, storage facilities, and lessen mistakes. There is no reason to not require this reform in our electronic age. We need to set a deadline for all providers to use electronic billing going forward AND a separate deadline for conversion of all records.
c. Reward patients who make healthy choices (like a safe driver discount) – for example, non-smokers, patients who lose weight, type 1 diabetics who keep their A1C below a certain level, etc.
d. Encourage preventative care. Currently, Medicare and many private insurers will not pay for continuous glucose monitoring systems (approx. $2000 per yr.), but they will pay for kidney transplants caused by diabetic nephropathy (hundreds of thousands of dollars every 10-20 yrs. plus approx. $4000 per month in anti-rejection drugs). Currently, Medicare and most insurers will not pay for weight loss drugs or health club memberships, but they will pay for heart disease treatment and most other medical problems caused by obesity. Does any of this make sense?
4. PATIENT EDUCATION:
For example, here is something Medicare is doing partly right - Medicare part B pays for insulin only for insulin pump users and not for those taking shots. If you are a pump user on Medicare with a supplement, your insulin is 100% covered. Those who choose to inject insulin (a treatment that is ultimately not nearly as healthy & greatly increases risk of all sorts of diabetes related illnesses) must use part D, which has a copay and a gap in payment. However, they do not tell patients that they have the option or why an insulin pump is beneficial. Patient education just on this one issue could lead to a dramatic shift in the treatment diabetics choose as well as a long term cost savings with reduced morbidity and mortality. Imagine if patient education was comprehensive.
5. MEDICARE/MEDICAID REFORM:
Why don’t we just get rid of Medicare & Medicaid and their ridiculous rules and simply subsidize private insurance for seniors/disabled & the poor? We could require that certain plans be offered in a variety of rate categories – for example, a no copay/no deductible option, a low copay/low deductible option, a medium copay/medium deductible option, high copay/low deductible option, and a high copay/high deductible option, etc. – all available with and without prescription coverage. OR we could just let them in on the government employee plan - see reference 6b below. Currently, Medicare is so complex that it’s hard to believe any senior can understand it. They already pay a monthly premium to have part B and are required to pay a premium for part D or face a penalty in the future if they do not purchase part D. They pay a part A and part B deductible plus a 20% copay. Then, they can pay a separate premium for a supplement to cover the remainder of the copay. OR they can get an advantage plan, which is like an HMO. Part D works like other drug plans, but there are several levels of out of pocket cost PLUS a gap. Then there are rules as to when you can get a supplement and there are at least 10 different types of supplemental coverage and only certain insurers can provide coverage in certain states. Oh, and you cannot purchase private health coverage if you are on Medicare. Sounds confusing, doesn't it? That's what you get when government is in charge of healthcare. My description is only part of the complex maize of rules to which seniors and the disabled are subject. This is what government bureaucracy will give all of us if we don’t speak out against the current bill.
6. HELP THOSE WHO NEED IT:
a. Currently, people who pay for part of their health insurance at work receive a huge tax benefit by being taxed only on money they make AFTER they have paid their insurance premiums. This benefit should be given to all Americans in the form of a tax credit. This would help the uninsured to purchase their own plans through private insurance groups as outlined above.
b. Our federal government, the largest employer in the US, already has a great healthcare plan for all of their employees. If a citizen cannot get private insurance due to pre-existing conditions, why not give them access to this plan? The cost would be low – due to the size of the group and it would cover those in dire need.
c. Of course we should help those who cannot afford healthcare – it costs us all in the long run when uninsured people need care. We can subsidize private insurance for these people (let them in on the government employee plan, too) rather than becoming their insurance company. In exchange, those who are able bodied should be required to work in government community service for a reasonable number of hours – for example, we could require 52 hours per year per able-bodied person over the age of 16 who is receiving subsidies. That amounts to about 1 hour per week. Surely people would be willing to participate in their own health coverage by putting in such a small amount of effort – and, if we, the taxpayers are to subsidize this cost, this should be a requirement. This may only equal $7 a week to the person being insured, but could save the taxpayer much more than that by eliminating certain government positions– as we all know, government workers get paid very well by us. We would still be paying for these subsidies, but it would lower our costs.
7. GOVERNMENT REFORM:
Require that a percentage of all donations to political campaigns be collected as a tax that contributes to subsidizing healthcare. Let “the special interests” pay for part of this healthcare reform. Alternately (and I know this next idea really has nothing to do with the healthcare debate- except for the "special interest" aspect), eliminate government corruption and any misconceptions that our civil servants are being lead by “the special interests” by eliminating ALL knowledge of who is providing campaign contributions. If people/businesses want to contribute to a campaign, they can do so anonymously to a 3rd party entity (to ensure total anonymity) that cannot disclose the nature or amount of the contributions. Put large penalties in place for breaking these rules.
So, there you have it. My opinion of the current healthcare situation and a good start to reasonable, common sense healthcare reform - and it took less than 5 pages. Remember, I am not a politician. So, while I am certain that these ideas need to be tweaked and additions need to be made, I think this is a common sense approach that keeps the government out of the healthcare business and gives us a really good start.
Oh, yeah, and I am well aware that this will cost money. However, the current proposal was rated by the Government Accounting Office to cost at least 1.5 TRILLION dollars. While I don’t have a GAO to ask, I would be willing to bet that my proposal will cost a lot less.
Please feel free to add your ideas and, if you like some of these ideas, send them to your representatives.
2. TORT REFORM:
Lower doctors’ malpractice costs by enacting REAL tort reform that discourages frivolous lawsuits. Those who have legitimate claims should have remedies that do not have an artificial dollar limit – especially for death or severe morbidity. However, simply requiring the loser of the case to pay the cost of legislation and capping a lawyer's pay based on actual work performed (instead of the current 30-40%) should eliminate illegitimate claims. I dare say that, if our government wasn’t already run bunch of lawyers, we would have seen tort reform a long time ago.
3. COST REFORM:
a. This may sound harsh, but, if you are in our country illegally, you should not have access to subsidized medical services except in the case of life or death emergency. We simply cannot afford to pay for medical care non-citizens who are not contributing to our society.
b. All medical facilities and insurers must go to electronic methods of billing and record keeping. It would save time, money, storage facilities, and lessen mistakes. There is no reason to not require this reform in our electronic age. We need to set a deadline for all providers to use electronic billing going forward AND a separate deadline for conversion of all records.
c. Reward patients who make healthy choices (like a safe driver discount) – for example, non-smokers, patients who lose weight, type 1 diabetics who keep their A1C below a certain level, etc.
d. Encourage preventative care. Currently, Medicare and many private insurers will not pay for continuous glucose monitoring systems (approx. $2000 per yr.), but they will pay for kidney transplants caused by diabetic nephropathy (hundreds of thousands of dollars every 10-20 yrs. plus approx. $4000 per month in anti-rejection drugs). Currently, Medicare and most insurers will not pay for weight loss drugs or health club memberships, but they will pay for heart disease treatment and most other medical problems caused by obesity. Does any of this make sense?
4. PATIENT EDUCATION:
For example, here is something Medicare is doing partly right - Medicare part B pays for insulin only for insulin pump users and not for those taking shots. If you are a pump user on Medicare with a supplement, your insulin is 100% covered. Those who choose to inject insulin (a treatment that is ultimately not nearly as healthy & greatly increases risk of all sorts of diabetes related illnesses) must use part D, which has a copay and a gap in payment. However, they do not tell patients that they have the option or why an insulin pump is beneficial. Patient education just on this one issue could lead to a dramatic shift in the treatment diabetics choose as well as a long term cost savings with reduced morbidity and mortality. Imagine if patient education was comprehensive.
5. MEDICARE/MEDICAID REFORM:
Why don’t we just get rid of Medicare & Medicaid and their ridiculous rules and simply subsidize private insurance for seniors/disabled & the poor? We could require that certain plans be offered in a variety of rate categories – for example, a no copay/no deductible option, a low copay/low deductible option, a medium copay/medium deductible option, high copay/low deductible option, and a high copay/high deductible option, etc. – all available with and without prescription coverage. OR we could just let them in on the government employee plan - see reference 6b below. Currently, Medicare is so complex that it’s hard to believe any senior can understand it. They already pay a monthly premium to have part B and are required to pay a premium for part D or face a penalty in the future if they do not purchase part D. They pay a part A and part B deductible plus a 20% copay. Then, they can pay a separate premium for a supplement to cover the remainder of the copay. OR they can get an advantage plan, which is like an HMO. Part D works like other drug plans, but there are several levels of out of pocket cost PLUS a gap. Then there are rules as to when you can get a supplement and there are at least 10 different types of supplemental coverage and only certain insurers can provide coverage in certain states. Oh, and you cannot purchase private health coverage if you are on Medicare. Sounds confusing, doesn't it? That's what you get when government is in charge of healthcare. My description is only part of the complex maize of rules to which seniors and the disabled are subject. This is what government bureaucracy will give all of us if we don’t speak out against the current bill.
6. HELP THOSE WHO NEED IT:
a. Currently, people who pay for part of their health insurance at work receive a huge tax benefit by being taxed only on money they make AFTER they have paid their insurance premiums. This benefit should be given to all Americans in the form of a tax credit. This would help the uninsured to purchase their own plans through private insurance groups as outlined above.
b. Our federal government, the largest employer in the US, already has a great healthcare plan for all of their employees. If a citizen cannot get private insurance due to pre-existing conditions, why not give them access to this plan? The cost would be low – due to the size of the group and it would cover those in dire need.
c. Of course we should help those who cannot afford healthcare – it costs us all in the long run when uninsured people need care. We can subsidize private insurance for these people (let them in on the government employee plan, too) rather than becoming their insurance company. In exchange, those who are able bodied should be required to work in government community service for a reasonable number of hours – for example, we could require 52 hours per year per able-bodied person over the age of 16 who is receiving subsidies. That amounts to about 1 hour per week. Surely people would be willing to participate in their own health coverage by putting in such a small amount of effort – and, if we, the taxpayers are to subsidize this cost, this should be a requirement. This may only equal $7 a week to the person being insured, but could save the taxpayer much more than that by eliminating certain government positions– as we all know, government workers get paid very well by us. We would still be paying for these subsidies, but it would lower our costs.
7. GOVERNMENT REFORM:
Require that a percentage of all donations to political campaigns be collected as a tax that contributes to subsidizing healthcare. Let “the special interests” pay for part of this healthcare reform. Alternately (and I know this next idea really has nothing to do with the healthcare debate- except for the "special interest" aspect), eliminate government corruption and any misconceptions that our civil servants are being lead by “the special interests” by eliminating ALL knowledge of who is providing campaign contributions. If people/businesses want to contribute to a campaign, they can do so anonymously to a 3rd party entity (to ensure total anonymity) that cannot disclose the nature or amount of the contributions. Put large penalties in place for breaking these rules.
So, there you have it. My opinion of the current healthcare situation and a good start to reasonable, common sense healthcare reform - and it took less than 5 pages. Remember, I am not a politician. So, while I am certain that these ideas need to be tweaked and additions need to be made, I think this is a common sense approach that keeps the government out of the healthcare business and gives us a really good start.
Oh, yeah, and I am well aware that this will cost money. However, the current proposal was rated by the Government Accounting Office to cost at least 1.5 TRILLION dollars. While I don’t have a GAO to ask, I would be willing to bet that my proposal will cost a lot less.
Please feel free to add your ideas and, if you like some of these ideas, send them to your representatives.
I agree wiith some of your points but aren't all government bills way too long. I'm agains the one-payer govt. system dont get me wrong because it will ration healthcare. Still, at the rate people are going healthcare is going to break the nation anyway. So, we have to do something and I like some of your ideas! I know not everybody on the Right is a nut job but it does bother me that the number of people screaming at these politicans and getting cheered for disrespecting US Senators. I have no objection to asking pointed questions but when I think of the media the main networks might be a little liberal. FOX NEWS, TALK RADIO w/ the exception of Air America which funnily enough you can't get in Texas. They are way more Conservative than CNN are liberal.
ReplyDeleteThe thing is, all of these talk radio stations had an equal chance - supply and demand. If listeners really wanted to hear Air America, they would have supported it in the free market. It isn't like somebody banned left views from the radio. It is just that the people listening didn't like the particular brand of things being said (could it be that they did't like the blatant hate & negativity?). When you look at actual liberal talk radio, there have been some successes - for example, Alan Colmes. Now, why has he made it when other's haven't? I would say it has to do with content. While I largely disagree with Colmes, I have listened to him because he has refrained from spewing hatred & actually offers real dialogue. I support the free market - sink or swim based on demand.
ReplyDeleteI would say if you are going to quote an example, then please reference it.
ReplyDeleteI could say that the moon is made of cheese, and some people may believe it.
I am referring to your late stage breast cancer comment.
I would say it is not so much that my taxes are paying for others, but our taxes are paying for each other. That is the main difference between feeling like a community and being a bunch of individuals. Hence, what Margaret Thatcher once said, that there is no such thing as society.
So, apart from those two points, I agreed with everything again.