over on Dean's word one of his guest bloggers is talking about the state of the American Health care system. The problem is the system though, not what we demand of it. So nationalizing the system will only leave us with a broken system that is ran by the federal government.
If you want to take a look at that go ride an amtrack train or take a look at the post office.
Instead of a patch on a current bad system or nationalizing a bad system why don't we try something different....a new system.
I support creating a New System but I am grown up enough to know most folks aren't as radical as I am so I thought about an opening salvo that is less radical
and as this was the hot topic on talk radio on my way to school...lets fo into it to
so first 20 ideas to come to my head to deal with healthscare reform
#1) Compliance Costs and Unfunded Mandates.
You go to a hospital or a doctor you have to pay for unfunded mandates and compliance costs. So I'd pass as a law a requirement that on evey medical Bill the amount of money that goes towards paying the compliance costs for your insurance company and the unfunded federal and state mandates for health care to your health care provider get listed. Also the amount of money they pay in taxes and malpractice insurance should get listed. I think this is important because I think people need to see just how much the Government and Insurance companies are forcing health care providers to spend to do their basic services. I think when you see the cost of the services (to make you healthy) and the cost of doing buisness that the government forces on them but doesn't give them money to do (unfunded mandates) should be there so the American people can make an honest choice in the health care debate.
#2) End the ludicrous homeless policies we have today.
This one will cost the state more money on the front end, but less money on the back end i feel which makes it a good investment. People should not have the right to live and recieve free government health care if they are insane or a drug addict without working to end those two conditions. These people are often a drain on the health care system due to the cost of their living "In the wild" and their inability to interact with the world around them. Force homeless people if they want to get the health care they should, to be psychologically regulated. Also make this clear i am speaking of real homeless people (folks who don't have a roof over their head) vs fake homeless people which homeless advocates refer to (people who have to live in homes of friends and families). Yes making big rehab centers and big mental health centers to keep these homeless people off the street will cost a lot of money. But this will keep these homeless people from being a drain on the ER system.
#3) Do something about illegal aliens in our health care system
While the mexican government has funded studies saying this doesn't happen...well that is simply BUNK. Ambulances have even delievered mexicans over the boarder to American hospitals to get health care. We need to find a way to get a real and objective (as objective as any government study can be) sense on how much it is costing our health care system and make the mexicans pay for it. We should also work with the Mexican government and the Roman Catholic church to improve the health care infrustructure in mexico so people illegally immigrating don't come north of the border and cost a ton of money.
#4)Change how health insurance prices work
If you are the ideal BMI or whatever measure of physical fattitude you want to use and I who am -not- ideal go to work for the same employer we pay the exact same amount for health insurance. I am not a fan of penalizing folks but i think health insurance companies should be allowed to offer discounts to people who do healthful things.
Good excersises, taking use of preventative services, not being a fatty fatty fatty, quitting smoking, etc.
If you do one of those things I think your health care company should be able to provide you with discounts either in the upfront area (what you pay in) or in the back end areas (what you have to pay out of pocket).
I also think however you should be rewarded for other kinds of "good" health care choices.
Not using the ER unless it is well an Emergancy. The ER is very costly and most hospitals do not make a good return on their money from ER visits. Many even make every ER visit as a loss. If we encourage people not to do this hospitals will not have to spread that loss out amongst other services (raise prices).
#5) Dental and Mental Health care equity
fact of the matter is most Dental and Mental health insurances are ludicrously under-paying. They don't give remotely what the consumer would need to get an adequate level of services... and thats assuming everything goes WELL.
as such people avoid proper dental care or proper mental health care and that can lead to problems down the road. We need to encourage employers to get better coverage for their employees as a way to reduce these injuries that have another root cause.
#6) Health Savings accounts
ummm DUH
#7) Medical Bankruptcy
I think the government should create a special kind of bankruptcy for folks that have 70% or more of their debt be of a health care nature. It should be recognized as something different and something that you get out of quicker and leaves less of a stigma on you financially.
#8) Medical School Costs
Doctors have to pay off OBSCENE medical bills. And here is a great solution for the student loan portion that the government controls.
allow the doctor to get a portion of the debt every year excused based on providing free medical services to the community. Require them to of course make payments during that time period. By making the cost of retiring their education debt less expensive it will enable them to make a similar profit margin at a considerably lower price.
Increase the amount they get forgiven if they go to work in an urban or rural area to help out in providing excellent care
#9) Bringing the Charitable Sector and the Health Care sector togther
I think the Department of HHS starting first in the major urban areas, then going to the remote rural areas should start bringing togther charitable resources with health care resources. They should hold some confrences to look at ways big charities, and big charitable donors can work on retiring the health care debt in their area. Also i think bringing in big time employers (like ford, Walmart, etc) into the mix could be helpful to.
#10) Allow benevolent societies to start up again.
Some churches are begining a collective approach to health care. Prior to the days of insurance that was very common place and it should be again. This serves an added bonus of helping build church and communitiy ties as well. I think systems should be set up to guarentee that the "community organization" can take a level of a collective hit...possibly making this primarily a supplimental expense to any other form of health care coverage
#11) Expanding the tax deductibility of health care expenses
Make it more tax deductable and people will go for it more.
#12) Make rich people in the Medicare system pay more
This should be a DUH but the democratic party and the AARP have made it less so. I think people with a certain retirement income (lets say 50K for an individual, and 100K for a couple) and up in retirement should have to pay in at least what the average worker pays.
#13) Make buying your own health care plan 100% tax deductable
just like it sounds.
#14) take those industries that the "average" pay is 5000 dollars or less from the poverty level and make the corperate health care expense 100% tax deductible.
#15)Require Insurance companies and government insurance programs pay in a timely manner
You run a doctors office...you have to send a bill and any query materials to medicare or big insurance within 90 days before they will even process your claim. They however can wait in some cases as long as 2 years before they give dollar one to the health care provider. This is a huge cost problem which must be eliminated. Require them to give the check in the same dead line they require for the information to be billed.
#16) Limit the amount of go-backs.
Lets say you send a bill out to medicare and the coding (numeric codes used for many features, but primarily to streamline billing in this case) is inaccurate. Medicare can then pull up every single account of that type and check for the same error. If the error exists they can take the money back from the health care provider as much as 2 years later. While some of this is nessecary, it can also be excessive.
#17) More billing disclosure:
This is less something for the government to do, but in some cases it is. I think the Major health care organizations should report once a quarter how much money they are owed by insurers that they don't pay up. This is much like my point #1 giving people a real sense of knowledge about how the money is spent and used.
#18) Allow for flex time
How is this health care related you ask? well some jobs allow for limited "sick" time from their employees. But by allowing flex time into the market place this could allow choices. "I earned 12 hours of flex time this month, and i feel feverish i can take the time off" and by doing this it allows the employee to make better choices about his own health and create less of an expense to the company from having a sick man working.
#19) Federalizing/Statizing malpractice insurance above 1,000,000 dollars a year.
I thinking 1,000,000 a year in damages from malpractice costs is a reasonable amount doctors should have to pay insurance for. I do think however if a doctor rakes up more then 1 million in costs the money above and beyond that should be a government insurance (not unlike national flood insurance). I think if the doctor did all the right things he should pay his fee into the government system. But if their are problems with what the doctor did it becomes a matter of public health concern that the state must look into.
#20) Re-examin the system every 10 years.
I think regulation of the health care system and modifications must be examined and re-examined on a regular basis. I think 10 years is about as short as is reasonable to do that in
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