We all know the problems with Obamacare, both in content and in the way in which it was passed. However, the fact remains that our healthcare system is not serving our healthcare needs. People are being denied insurance and premiums are way up—especially after Obamacare (ironically named the Affordable Care Act) was passed. When a patient has insurance, providers bill substantially more—like five times as much—as they bill uninsured patients. And death panels (a nicer name could be found, but that won’t make what they do any nicer) already exist, denying life-saving treatments to the elderly in favor of cheaper “comfort care.” A solution must be found that values the life of every person, gives doctors and patients authority to decide best care, and also saves money.
The following nine points represent my modest attempt to solve the problem.
1. Extend the retirement age to 70 and also delay Medicare eligibility until that age.
2. Stop treating people over 62 (or even 55!) as “seniors” and acknowledge the (good) reality that people are living longer healthier, and can still contribute.
3. Reduce healthcare costs through tort reform, not requiring drug companies to give free medicine to the Third World–which is one reason why we pay so much for pharmaceuticals–and reducing paperwork requirements.
4. Reduce insurance costs through encouraging more groups to form voluntarily to spread the risk and allowing people to freely buy health insurance across state lines.
5. Stop allowing illegals to get on Medicaid, and enforce Medicaid laws.
6. Instead of increasing unemployment insurance benefits, allow the unemployed and underemployed to use part of those benefits to buy health insurance.
7. Instead of allowing insurance companies to reject folks with preexisting conditions, allow people to buy insurance to exclude certain treatments (for instance, instead of being rejected for having psoriatic arthritis, one could opt to sign an exclusion for Embrel, etc.) Life-saving treatments could not be excluded–in such cases, allow more U.S. citizens with low income to go on Medicaid. For instance, low income, childless singles are generally excluded from receiving Medicaid. That should change.
8. Require doctors to charge no more than 10% more for insurance cases than they do for self-pay (to account for paperwork), and require insurance companies to reimburse whatever the doctor orders (no formulary). Both insurance companies and doctors could report cases of non-compliance by the other party to the state insurance commissioner.
9. Any treatment recommended by a doctor and accepted by a patient should be followed. If the company won’t pay for it, there must be an option for partial self-pay in such cases.
Maybe not all of these will work, but they are all worth a try. And perhaps given time, maybe I can come up with two more nines to add some extra pizzazz.
Moe Lane
PG DeFreese
Victoria Coates
Daniel Horowitz
Dan Spencer
Appreciate You Thinking About These Issues But..
quill67 (Diary) Tuesday, January 24th at 1:33AM EST (link)There are some serious flaws. I’ll go through each of your points. point by point:
1) Social Security and Medicare are seperate problems. SS can be solved as you suggest by delaying retirement age. But SS is a minor problem. If the cost per recipient could be kept the same, we could add the babyboom population and still run a surplus. The problem is the growth in medical expenses per recipient.
2) Adjustment for life expencency should be given with delayed retirement or reduced payments. People of African decent do not live as long so their retirement age might not need to be raised. Private supplemental insurance could provide the adjustments.
3) Tort reform would help. How much is a big debate. Free pharmaceutical goods for developing countries has ZERO measureable effect on our health costs. R&D is the expensive part of drug development. Producing the drugs typically costs not much more than aspirin to produce.
4) More people will buy insurance if it was not so expensive. Figure out a way to reduce costs (I’ll mention later) and more people will buy. Studies have also shown it is cheaper for the costs to be spread around by county hospitals and clinics than by getting those people to buy health insurance.
5) Correct. Control the border and as part of entrance to US, must purchase health insurance and other appropriate bonds and insurances (since coming to the US is a privledge not a right)
6) How about letting the unemployed voluntarily choose, if they want, to delay their retirement or reduce their benefits to pay for their health insurance today. This gives the unemployed the choice of preventing potential financial distress due to illness.
7) Allowing companies to exclude certain conditions for pre-existing conditions is a solid idea–although many diseases create a variety of health issues. If we allowed people to use their SS funds to pay for health insurance, most would never be without insurance (and then a simple law saying people who have maintained health insurance cannot be denied coverage would work)
9) Perhaps a simple rule that said for non-covered treatments, the patient must pay X % out of pocket (say 20%) If the patient thinks the treatment is worth it, they will pay the 20%.
The bottom line is more of our bills should be paid out of our pocket for three reasons:
1) we will watch bill and cost more closely if we pay out of our pocket
2) It reduces paperwork cost (whether it is gov’t or private paperwork, it still increases the cost of care)
3) It increases cost innvoations because doctors know if they can bring cost down, they will gain more customers. (Obviously for elective surgeries)
W
Response and clarification
philliesfan (Diary) Saturday, January 28th at 7:08AM EST (link)Thanks for your comments. My points were not meant to be a closed set–just a starting point for further development (as you have done). I particularly liked your comment on point 6. Now I just have two points I need to clarify.
Re point 3, I wasn’t talking about the source of the cost, but how to bear it. Surely requiring people in developing countries to pay for drugs would have SOME measurable impact on what we have to pay. More people to pay for those R&D costs means each customer pays that much less.
Re point 8. I never implied that the 10% increase would be the same as what insurance charges now are–believe me, as one who once had insurance and now must go the self-pay route (having been rejected by insurance companies for having a very minor preexisting condition) I know that providers bill insurance companies many times more than that. I meant the 10% as a ceiling on what providers could charge., I actually have no problem making it the same as self-pay (and that was what I wrote in my original draft).
Perhaps we should all do self pay–but only if costs are reduced. Perhaps the market will do that. I do know that patient costs were much lower when I was young (before the advent of HMOs and co-pays for office visits, and before massive malpractice suits). I hope they can be again.
PF.