I'd Vote for THIS Health Care Plan

A good friend of my dad's (and of mine) has made this proposal to fix this country's health care crisis. It's the most comprehensive plan I've seen yet. He plans to send this to his representatives.

Enjoy Scott's brilliance:

First I would like to state that every legal man, woman and child in this country should have access to adequate healthcare treatment. I know the Constitution and its amendments don't state this as one of our rights. However, I'm not so sure it shouldn't become one.

It is very uncertain if Congress will create a bill with a national health insurance option, a vital requirement to any reasonable kind of healthcare reform. In fact, it appears that Obama seems to be back-peddling about this being a critical component of the bill (politics as usual). I'm afraid the drug and insurance industry lobbyists are being effective as usual; given the multiple lobbyists per Congressperson with deep pockets to bait and threaten. My God, just think, a national competitor to private insurance with an overhead of only 4% (as reported Medicare is today), with no pre-existing condition exclusions, with no right to turn you down, and with no annual or lifetime limits! I think a lot of companies would include this option to their employee's choices (remember most large companies offer multiple health plans at corresponding employee co-payments). Individuals without employer insurance would have the right to purchase at rates consistent with the ability to pay. (Yes, this will cost money. But, see below where I think the savings will come from.) Small companies should pay at the same per person rate as large companies. (Today insurance companies set rates very differently for small versus large companies.)

I believe tort reform needs to be a major part of the cost reduction component of the solution. A lot of health care is art and mistakes do happen. Exorbitant jury settlements are driving up malpractice insurance to the level that in a few years it will be impossible to get a family doctor or care from high-risk specialties. In Mississippi OBGYN doctors are becoming almost non-existent due to this issue (this was from a 60 Minutes piece I saw a few years ago). Fear of lawsuits causes doctors to give unnecessary tests and treatments just to cover themselves in case of lawsuits. All of this contributes to the high cost of healthcare. I am in favor of independent arbitration to establish appropriate payments for malpractice. However, negligent malpractice (that beyond reasonable human errors) does need appropriate punishment. I think negligent malpractice needs to be redefined as a criminal, rather than civil, law issue. After all, if I get drunk and kill someone with my car my crime is considered a criminal not a civil issue. However, I believe there is no chance of tort reform happening with a Congress made up of mostly lawyers.

One bizarre standard today is that emergency rooms can not turn patients away for medical problems that should be considered urgent or normal (next day) care issues. If everyone had coverage there would be no need for emergency rooms to treat every problem. Emergency rooms could screen patients and for non-emergency issues direct patients to appropriate care facilities. After all, every patient would have coverage to all three levels of care.

And then there is the issue of emergency and extended treatment of illegal aliens by hospitals. Hospitals should have the right to stabilize true emergency problems and then work with the INS to have illegals shipped to their own countries of origin. In Arizona the INS has told our hospitals that they will only support sending illegal patients home if they've broken a law! Excuse me; they did that when they illegally came across the border! Recently the news reported about one illegal who is in a Phoenix hospital with about two million in unpaid bills. The hospital offered to pay to medivac the person to his own country, but the INS won't support it because they said that “THE PATIENT HAD BROKEN NO LAW"! Guess who gets to pay for this.

In general, I don't have a problem with the current private "healthcare givers" and drug companies. They add value and have a right to profits like any other capitalistic sector (however something has to be done about drug company lobbying). My problems are with the private insurance companies that add nothing of value to the health care process and are interfering with "healthcare giving" by dropping clients, excluding pre-existing conditions, denying medically recommended procedures and having annual and lifetime caps. The reported 30% overhead they incur is just wrong!

I'm at the point where I'm in favor of maintaining the current method of "healthcare giving" and switch to the use of a single payment entity (think Medicare) instead of adding a Federal Insurance option to the existing private system. The Federal Insurance Company would have the right to negotiate rates for health care and pharmaceuticals (unlike today's Medicare), as today's insurance companies do. But, we would no longer have the private health insurance leaches sucking 30% of the cost and dictating care. This approach is not socialized medicine because the "healthcare givers" and drug companies are still private. I can live with the fact that this is socialized health insurance. Maintaining the separation between the payment system (insurance) versus “healthcare giving” would promote continuation of pursuing the best-in-class and free market healthcare in the world. (Actually, today insurance companies tend to inhibit this through their cost containment policies.)

This Federal Health Insurance Company should be set up as a non-profit independent entity, separate from government, with an appointed chairperson (something like the Federal Reserve). It should charge at rates that result in a balanced budget over the years. It must not have the right to exclude for pre-existing conditions or refuse anyone legally in the country. There should be no annual or lifetime caps. There should be no ability to refuse treatment on an individual basis. (However, distinction needs to be made for experimental versus accepted practice, as there is today.) The insurance should cover end-of-life counseling as Medicare does today (not dictating care).

The Federal Health Insurance Company should offer a PPO format in addition to an HMO format, each priced accordingly. That way private institutions like Kaiser can continue with the payment side negotiated with the Federal Health Insurance Company. Many people are happy with the price performance of managed care. It is important that no disruption of service occur during the switch to single payer. One major benefit is that individuals directly paying for their insurance today would have the freedom to switch between PMO and HMO. Today they are locked in because of the pre-existing exclusion clauses that insurance companies use.

Like any business fraud detection would be the responsibility of the National Health Insurance and an active part of their budget. The responsibility for pursuing the crooks would be the same local and federal law organizations responsible for pursuing other white-collar crimes.

In summary, I think healthcare would be nationally affordable and result in better care if we were to:

Adopt an independent non-profit self-funded single payer national insurance system (getting rid of the private healthcare insurance system altogether).

Merge Medicare, Medicaid and the new single-payer into one Federal Health Insurance company.

Establish the right for every legal person in this country to have healthcare coverage at a cost proportionate to his or her ability to pay (mostly through employer contributions, as today).

Reform the tort system concerning medical malpractice.

Structure the use of treatment facilities to the actual medical problem (emergency, urgent and normal).

Take care of the alien problem.

Actively go after healthcare fraud (This is a huge problem with Medicare today).


Thank you,

Scott Vance