Well we got a healthcare bill which was riddled with special interest riders and had most of the good parts emasculated. It will cost us a lot of money to implement and from the start was chewed up by Congress trying to undo it. In short it’s a debacle. But there is a rational way to have universal healthcare without breaking the taxpayer’s backs and building another Government bureaucracy.
First off let’s look at some issues in the current healthcare system. First, most people in the US have healthcare available at some level. The uninsured clog up ERs with problems that could have been taken care of by a family doctor if they could have gotten to see one without insurance. In many cases the problems have gotten worse by delaying treatment. Thus a problem, which could have been fixed by a $50 doctor’s visit, cost $500 for an ER visit. Someone in the healthcare system or government has to pay for this. Mostly it’s you and I, the insured, who pay higher prices for insurance so they can pay the higher costs of care so the providers can cover the losses of treating those who cannot pay.
Second, the costs in the healthcare system due to handling paperwork, in many cases equal the cost of the care. Every insurance company has it’s own set of forms and it’s own standards of treatment. Most doctors employ several people just to handle the paperwork.
Third, a large part of healthcare costs are related to malpractice lawsuits. Not only does malpractice insurance cost a huge amount, doctors are forced into a CYA mentality. This causes them to order many more tests than needed, not perform risky procedures, and stick to standard treatments rather than things that might be better for that specific patient.
Finally there is a lot of money in healthcare and medical insurance. Any type of reform that cuts out someone from the cash cow will be opposed by those being cut out and with billions of dollars in potential campaign funds at stake it is easy for those special interests to tie up congress.
So, the solution to universal healthcare has to work within the current system, and not significantly increase overall costs. That means we can’t have a new government bureaucracy formed to run it. With all that said here is my solution.
First a “minimum” standard of care needs to be written. This would be similar to a mid-level insurance benefits list. Co-pays for services and drugs and clearly stated approved treatments etc. all health insurance companies would bid on this package and a base price would be established. An insurance pool would be established consisting of everyone in the US, Employers could opt their employees out by offering a plan that was equal or better. But there would be a huge pool of people left. The pool would be divided among all the health insurance companies according to size and region The division would be selected in a way so there wouldn’t be any “cherry picking” of low risk people by any insurance company. Some flexibility would be given individuals to select their preferred insurance but there wouldn’t be much of a point, as all insurances would offer the same benefits for the same cost.
At the same time a schedule of fees would be established by the doctors and insurance companies who wish to be a part of this program so that normal procedures, office visits and such would have already established costs and there would be no surprises.
Employers could pay or subsidize their employee’s costs. Those who were self employed could pay for it themselves at the same rate as a large employer. There would be a sliding scale of subsidies for those with low incomes so anyone could afford it. All people currently on VA, Medicare or Medicaid would be placed in the pool and VA, Medicare or Medicaid would pay their premiums. The government workers currently running those programs would be adequate to handle the governments role in managing the new program so there would be no need for more government workers to administer the program.
Where would the funds come from for the subsidies? VA, Medicare and Medicaid funding is already there, The healthcare industry as well as the insurance companies would have to chip in for some, as a price for getting their share of the pool. Why would they do this? Lowering their costs by, commonality of paperwork. Everyone is insured, everyone has the same coverage, so one form would suffice to bill insurance. Furthermore the assurance of being paid for their services should allow them to drop the bill padding to cover people who can’t pay. Electronic records keeping, insurance filing, etc. streamlines the process and minimizes the chances for errors. This should also lower the chances for malpractice suits and reduce the cost of insurance. Perhaps the government could set up an office to handle malpractice disputes and eliminate malpractice suits entirely. Hospital ERs would unclog so the real emergencies could get timely treatment and their costs would go down. In short universal healthcare would cut costs to the medical industry enough that they could afford to assist in paying for the subsidies.
With the leverage of millions of customers the insurance companies (working together since there would be no purpose in competing) could persuade the drug companies to lower prices. The drug companies would benefit because of the reduced cost of marketing, and lower chances for lawsuits, as well as assured markets, would lower their costs as well. Streamlining the drug approval process could lower costs as well.
All in all, I would bet that the total cost of this program would not be significantly higher than what we currently pay in medical costs and other costs related to inadequate medical care. So we get universal medical care for free. It’s a win win except for the medical malpractice attorneys and all those friends of the politicians, who were expecting to feed at the government trough.
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