a reply to: DBCowboy
There was a time, back when I was young, when dinosaurs roamed the earth, that medical care was expensive but affordable. There was a time when
doctors made house calls, knew and cared about their patients, and accepted the fact that not everyone could pay high costs. Some doctors, when a
patient's bills got too far out of hand, accepted a bit of land or livestock in payment. There were times when bills were simply forgiven.
Those doctors prospered. They lived in the finest homes, drove the nicest cars, and we're treated with nothing short of reverence. Some of them left
so much to their families that their descendants two generations later are still wealthy and powerful.
Then insurance became commonplace. Suddenly prices skyrocketed. Specialists became commonplace. The house calls stopped. Wait times of 2-3 hours to
see the doctor for 5 minutes became normal. Medicine became expensive.
So more people felt it necessary to buy insurance. And the cycle repeated. More insurance. Higher prices, less service. More insurance. Higher prices,
Mandatory insurance. Prices skyrocketed again, more than before. Nurses won't answer their phones - leave a number and wait 24 hours. Doctors' phones
are private. Medicine can cost more than the average household income. Insurance can cost more than a new car payment.
The solution has always been to return to the starting point, not to continue on the wrong path. If you're tuning a carburetor and the engine starts
to splutter, you turn back the other way; you don't keep going, hoping a wrong adjustment will become the right one by some stroke of magic. But
that's what we do.
Here's a fix that will work, in 3 phases:
- Make it illegal to refuse health care for any reason as long as there is time to treat the problem.
Not just for doctors, but for everyone involved in the medical field. At the same time, establish a single-payer collection service through the
government. Any new bill that has not been satisfied after two months of attempts can be remitted to this agency and the professional will be paid 50%
up front. If the money is collected, the rest is sent to the professional. I like using the IRS as the agency, since they are already in the business
of tax collection and have income data at their fingertips. Bills to those who cannot pay could be forgiven immediately; those who can afford to pay
could be subject to collection.
- Establish a national court system for medical professionals, composed of several hundred local panels chosen like jurors. One exception: certain
classes must be represented. At least one medical professional, one legal professional, so many from each economic class, etc. All medical claims must
go through this court first, and the verdict is binding upon the medical professional. No attorneys are allowed: you present your own case under
relaxed rules. If the plaintiff is not satisfied, they have the automatic right to appeal... if they want to pay a high-priced lawyer. The easier
route is to take the lower award and move on.
Another advantage: each local panel reports back to a national board. Too many legitimate cases against a professional and the medical license is
- Lastly, take care of the loopholes: limits on hospital charges for common items... say 500% of the lowest cost available privately. If I can buy an
aspirin for 4 cents, the maximum hospital charge is 20 cents. Maybe limits on insurance rates. Maybe penalties for emergency room abuse. Whatever is
needed to keep the system in check.
Day one, everybody has health care and the doctors don't go broke. A month (?) later, you kill the out-of-control malpractice industry (while making
it easier for those needing relief to get it) and you start weeding out bad doctors. Then you fix the loopholes as they appear.
That's how you fix healthcare. Not by some unholy communion between insurance and government. They're both evil.