Wednesday, July 22, 2009

News Talk Online July 22, 2009: Gary's Health Care Reform Proposal

There's obvious no consensus in Congress over health care reform so, today, on News Talk Online on I proposed my own plan which I believe to be more palatable than any other that's thus far been offered.

First, I note that the health insurance industry does not want the government competing because it fears a federally funded option would put them out of business.

I also note that unless you are employed by a company that offers health care benefits or very poor - in which case the federal government already pays for your health care, you don't qualify for health insurance. Hospitals still have to treat you though. So the cost of health care for the rest of us goes up.

The problem is that people who are self employed, working for companies that don't offer health insurance, work part time or are students can't afford health insurance at current rates. So here's what I proposed for them.

Every medical insurance company in the United States will have to provide an affordable basic plan for those who can't afford coverage now but are not so poor that they qualify for government funded plans. A premium cap should be set by law to ensure that everyone in this group can get in. Basic coverage should also be defined by law.

Under my plan, the federal government would not get involved in health care, with the exception of regulating the private insurers to ensure compliance.

In return, Congress should pass tort reform to reduce the risk of medical practitioners and bring down health costs. Patients who are victims of medical malpractice should still have some recourse, but a reasonable cap should be established.

Also, the FDA should loosen some restrictions on the pharmaceutical industry to reduce the costs of prescription medicines and make them affordable and accessible to all. The costs of pharmaceuticals in the United States far exceeds that in other parts of the world.

My plan protects the private insurance companies, provides health care for all and doesn't cost the taxpayers a cent.

I know this is way too simple and represents common sense which is terribly lacking in Washington but I believe it would work.

What do you think?


medclaim said...

Part 1 of 2
As a licensed life health and accident insurance broker/agent for 29 years I have seen a lot of good and bad healthcare plans and ideas come and go.
A pilot program that was started in the middle 80s under Medicare in the Midwest springs to mind.
People age, that's a fact of life. As they age, they require more health services.
A group of elderly ladies once met for a shopping date. After the shopping, they gathered outside on a park bench and were complaining how their feet hurt from walking.
One said to the other, you know, I have free healthcare that includes podiatry and the clinic it's right here next to the store. Right away, another member of the group piped in with, I have that same coverage, I should get my feet checked after all this walking. A little more talking and soon, the entire group ended up in the clinic getting their feet checked. and why? Because someone else was paying for it! Within 2 years that program was out of business. 11,000 People in it were then scrambling to find other coverage, and a list of 10 private insurance companies were asked by the state attorney to jump in and accept them WITH pre-existing conditions, Medicare recipients who had wanted something for nothing. and eventually got just that and had to return to private Medicare health supplement coverage and Medicare.
I'm not saying those elderly ladies were entirely responsible for the ultimate bankruptcy, just an example of how giving something away is not always the best way to treat illness.

Whether it is an employer based or government based health plan people don't take as much responsibility for their own health insurance because someone else is paying for it, so why not use it, abuse it, and let someone else worry about it, it's not their concern.

Emergency rooms are over used in part because people don't want to take the time to see their normal physician when he is already overbooked, sit in their office half the day to see him for the 10 minutes allowed by an HMO for each patient. I am strongly against plans or ideas that limit freedom of healthcare choice or by default, limit the patient from seeing the BEST care giver of their choice. HMO networks that don't work in rural areas, doctors after being shafted by HMO carriers.. and Medicare paid by the way.. waited 10-12 months for payments as recently as the Medicare Choice plans of the late 90s and early 2000, delayed payments, collecting Medicare funds for each person they were supposed to be taking care of, and denying care to people due to a specified dollar amount spent per person, per month.
HealthCare Managed Prevention programs are just that. Preventing the patient from care.
Free is not always the best choice. its not even a close 2nd.

There are now and have been available BASIC health insurance plans that provide an individual with basic hospital testing, lab work, surgery, anesthesia, inpatient and outpatient services, doctor office and inpatient charges, without a network and in a network, they provide up to an additional 30% savings of the patients portion of their bill through an add on discount plan that also includes dental, vision, hearing, chiropractic and prescription discounts. ALL at an affordable price!
What 1 person's affordability or coverage or areas of the country lifestyle, etc are the same. Not all plans fit. There are a number of choices, over 1200 companies, and yes, some do accept pre-existing conditions.
In Florida: a 45 yrs old male $102,female $132. for example., around $8/day.
People who have lost their jobs and find COBRA plans unaffordable can usually find a plan from any one of those companies who offer them. Healthcare is not a right, its an individual's choice as to what care they desire. Free enterprise, free choice of doctors and other providers, not a lock step government laden bureaucracy with no solutions to healthcare spending, just keep throwing money at a problem doesn't work. Government sooner or later will run out of other people’s money as in the illustration I have presented here.

medclaim said...

Part 2 of 2
Healthcare reform is needed, not total dismantling of the present system

1.Stop Paying the Crooks. First, we must dramatically reduce healthcare fraud within our current healthcare system. Outright fraud - criminal activity - accounts for as much as 10 percent of all healthcare spending. That is more than $200 billion every year.
healthcare fraud and abuse, Medicare alone could account for as much as $40 billion a year.

2. Paper to an electronic health system ( already implemented between Medicare claims and most Medicare supplement companies since 1986).As it stands now, it is simply impossible to keep up with fraud in a paper-based system. An electronic system would free tens of billions of dollars to be spent on investing on the kind of modern system that will transform healthcare. In addition, it would dramatically increase our ability to eliminate costly medical errors and to accelerate the adoption of new solutions and breakthroughs.

3. Tax reform, allowing tax incentives and vouchers that would help cover those Americans who currently can't afford coverage. In addition, we need to expand tax incentives for insurance provided by small employers and the self-employed. Finally, elimination of capital gains taxes for investments in health-solution companies can greatly impact the creation advancement of new solutions that create better health at lower cost. Create a Health-Based Health System. In essence, we must create a system that focuses on improving individual health. The best way to accomplish this is to find out what solutions are actually working today that save lives and save money and then design public policy to encourage their widespread adoption.

4.Create a Health-Based Health System. In essence, we must create a system that focuses on improving individual health. The best way to accomplish this is to find out what solutions are actually working today that save lives and save money and then design public policy to encourage their widespread adoption.

5. Reform Our Health Justice System. Currently, the U.S. civil justice system is the most expensive in the world-about double the average cost in virtually every other industrialized nation. But for all of the money spent, our civil justice system neither effectively compensates persons injured from medical negligence nor encourages the elimination of medical errors. Because physicians fear malpractice suits, defensive medicine (redundant, wasteful treatment designed to avoid lawsuits, not treat the patient) has become pervasive. CHT is developing a number of bold health-justice reforms including a "safe harbor" for physicians who followed clinical best practices in the treatment of a patient. You can learn more at

6.Invest in Scientific Research and Breakthroughs. We must accelerate and focus national efforts, re-engineer care delivery, and ultimately prevent diseases such as Alzheimer's Disease and diabetes which are financially crippling our healthcare system.