posted on Mar, 11 2008 @ 11:48 AM
I have been thinking long and hard hard on the recent political football called the healthcare insurance crisis. And I do believe I have some ideas
and a plan that could be workable. So here it is, in all its glory, for you, the ATS community, to peruse and disect. Please, let's keep this thread
free of political sound-bites. This issue transcends politics.
A Redneck Health Care Plan ( I had to name it something)
The insurance industry is a recent addition to healthcare, and one that in itself does absolutely nothing to aid in the well-being or treatment of
patients. It exists as a convenience for users of the system, to simplify payment and admissions, and for practitioners, to guarantee payment.
The single largest problem in the healthcare industry itself is in the area of cost. COBRA (the optional continuation of insurance after termination
of employment) reflects this, with the cost commonly ranging between $1000 and $1500 per month for someone who is out of work. This high cost is not
simply greed by the insurance compamies, but also reflects the high cost of operating as a healthcare professional and therefore the high cost to
patients of healthcare.
What are the reasons for the high cost? High malpractice insurance costs to the doctors, a high standard of living for those doctors, expensive
equipment that is frequently overused in order to avoid lawsuits or because early care is unobtainable, and the cost of treating those who cannot pay.
This last cost is spread out among the bills of those who can pay, thereby raising costs.
My proposal has many parts. The first thing I would suggest is a pull away from the concept of spreading out costs for those who cannot pay. This
could be accomplished by removing the middleman (insurance company) from the equation where cost makes healthcare prohibitive. I suggest a
government-backed safety net for professionals who treat those who cannot or do not pay their medical bills. Simply stated, any doctor/hospital/lab
who provides service for which they are not paid may make a claim with the Federal government. They would receive 50% of their bill up front as
taxpayer-subsidized payment. The account would then be turned over to the most effective collection agency in the free world today - the IRS.
The IRS would attempt to collect the entire amount of the bill from the person who is responsible for it. The first collections would go to reimburse
the Federal government for the payment already made, and the rest to the professional who rendered the service. Since the IRS is an agency of the
Federal government, it would be a simple matter to specify income lines that would prevent collections from the truly indigent and allow collections
from those who would abuse the system. Types of care provided could be weighed into the equation as well, placing harder collection on those who
habitually use the emergency room rather than a doctor, thereby creating larger bills for the taxpayers.
At the same time, all healthcare professionals in the country could be required to provide care to anyone who requests it. This will not cause them
undue hardship, because they now have a single collection agency that fronts a portion of the bill and attempts to collect it all, at their
Step 2 involves the creation of a new arbitration body, specifically for the medical profession. All cases involving malpractice, illegal
billing, even in-compassionate service by nurses or over-prescription of drugs, would be required to be brought before this panel. The panel would
consist of doctors, hospital administrators, laymen, nurses, pharmacists, attorneys, and politicians. They would be required to hear any case that was
brought forward, without benefit of attorneys on either side. Their decisions would be binding on the professionals only; patients who do not believe
they recieved a fair hearing would still be free, after this step, to hire an attorney and enter the civil court system.
This in itself would reduce the amopunt of malpractice claims and leave doctors free to doctor without as much concern over legal turmoil. The risk of
abuse would be small, since any panelists who attempt to 'help out' their peers would be subjecting them to the court system, which has lately been
renowned for awarding ridiculously huge sums of money in malpractice cases. Check and balance.
This would also allow for a database of abuses by doctors. Many doctors have long records of making horrendous mistakes, yet they are allowed to
continue practicing medicine. Under my system, any professional deemed responsible in three major or six minor hearings within two years would have
their license to practice suspended for two years, and be placed on a probationary period for three more years. Any problems within that probationary
period would result in complete loss of their license permanently.
Step 3 would apply to pharmaceutical companies and hospitals. It would consist of price controls that would tie services rendered to prevailing
costs. For instance, it has been freely admitted that pharmaceutical companies sell their products to foreign countries for a tiny fractrion of what
they charge Americans. I propose that any pharmaceutical company based in the US be prohibited from selling their drugs to Americans for any more than
the lowest cost sold abroad. this would need an exception for humanitarian sales to third-world countries, but there is no reason to bilk the US
population while subsidizing other countries, when the benefits of the US are used to do it.
Hospitals would be limited to charging no more than 200% of the lowest available retail cost for items that are available outside the hospital. They
would not be prohibited from charging for service, but the very idea of a $20 aspirin should be infuriating to anyone with a conscience. Other cost
controls could be implemented in a similar way, to force the price abuses to stop and reduce the overall cost of health care.