Monday, October 29, 2012

A better approach to health care

The Right Point Too!

The US spends over $2.5 Trillion annually on healthcare, amounting to 16% of the entire GDP of the country. The government pays 50 to 65% of this expense through programs such as Medicaid, Medicare and Veteran’s Hospitals. It is true we spend more per capita than any other country. This is a huge burden financially for our citizens, and a huge disadvantage for ...our businesses attempting to compete globally. Reducing these expenses would create jobs and allow more persons to afford health care services/insurance.

Today many persons see health care as largely free, as it is paid for through an employer provided plan or government programs. I offer you eye care and dentistry as examples of very similar industries yet costs have remained largely in check. I would assert this is because a large percentage of people still pay for these services directly so they are more conscious of the cost. Also, both of these industries advertise, incenting competition and driving down costs. How many have gotten coupons in the mail for free teeth cleanings?

With those things in mind the goal of a Health Care system should be:
• Simple.
• Available to all members of society, including the poor and elderly.
• Offers good, basic lower cost health care options.
• Portable. Not tied to employer or the government.
• Prevention of exclusions for those who have had "pre-existing" problems.
• Expandable. Option to purchase more extensive plans according to personal choice and ability.
• Shared and personal financial responsibility for all.
• Patient health centered care. Preventive care with financial penalties for continued poor choices and rewards available for good health practices.
Following is an eight point plan for reducing the cost of providing care:

1. REDUCE THE COST AVOIDANCE THE GOVERNMENT CAUSES BY UNDERPAYING FOR SERVICES. A study in 2008 showed the amount which Medicaid and Medicare paid out does not cover the costs of providing services. This was estimated to amount to 15% of the current healthcare spend. Putting it another way your healthcare would cost 15% less if not for this cost shifting. Under Obama’s plan the stated intention is to further cut the amount of reimbursement, shifting even more costs to private insurers.
2. ELIMINATE THE MANNER IN WHICH THE U.S. SUBSIDIZES THE ENTIRE WORLD’S HEALTHCARE. Today the U.S. is the only major industrialized country which does not have government run healthcare. The consequence of this is that we are the only one that allows a return on investment, known as profit, on big investments in research. This is why the U.S. has been the country where almost all new medical breakthroughs have been brought to market. In government run healthcare they dictate what will be paid. For instance a drug that costs $50 in the states, Canada may say we will just pay $15 as that is all it costs to manufacturer, ignoring all of the expense in research. Drugs are very expensive to develop but relatively cheap to produce. We should not be bearing this burden all by ourselves. We need to simply state you may not sell any pharmaceutical or medical device for less to other developed countries than what you sell it for in the U.S. You should also ask yourself, if we do the same thing in this country where will those developments come from tomorrow?
3. MAKE HEALTH CARE INSURANCE PERSONAL. Why does health care insurance need to be dictated by your employer? Is your life, home, or car? Why can we only choose from plans that are dictated to us by our employer? An employer can give you an allowance to help cover cost instead of actually selecting your plan for you. For example if your employer is paying $500 a month for your insurance right now they could instead provide this to you as an add to your paycheck or some voucher which could only be used to purchase healthcare. It eliminates the expense the employer has in administering the plans as well. Do you know if your employer provides good health care plan compared to another? You sure could if it was a transparent $$ amount. $550 is more than $500. You choose your plan that best meets your needs, not your employer. This addresses issues of pre-existing conditions and losing insurance when you lose your job. Some conditions the insurance companies would have to meet:
     a. For the first three years, no exclusions because of pre-existing conditions giving all an opportunity to sign up.
     b. Allow you to keep children on your plan if they have severe disabilities after the age of 18.
     c. All must offer a good basic low-cost health care plan with expanded health savings accounts.
     d. Insurance companies will be allowed to adjust premiums based on BEHAVIOR driven risk factors. Obesity, drinking, drug use, and smoking as examples may cause a premium to increase, while preventive health care checks and regular exercise may decrease premiums.
     e. Persons could change plans once per year even with a pre-existing condition.
4. PRIVATE HEALTH CO-OPS. Persons that have the financially ability and organizational skills should be able to band together in a legally binding manner and cover their own costs of providing health care.
5. ADDRESS ILLEGAL IMMIGRATION. These persons are getting health care without insurance driving up costs for the rest of us. We need to aggressively address this issue and put in place a very liberal work program. Under this program the Mexican government can allow whatever number of persons they want in, but they are responsible for providing healthcare insurance or the employer who hires them. In 2009 it was estimated $11 Billion per year was spent on illegal immigrants.
6. HEALTH SAVINGS ACCOUNTS AND MEDICAL SAVINGS ACCOUNTS. These enable larger deductibles and incentivize persons to take care of themselves and make better decisions about use. Policies that had a $50,000 or $100,000 deductible and millions of dollars in coverage would likely be very inexpensive and would protect people from being forced into bankruptcy due to medical expenses.
7. TORT REFORM with penalties for frivolous lawsuits and the loser paying some of the costs.
8. BETTER BILLING SYSTEMS AND INFORMATION SHARING USING TECHNOLOGY. I went to a hospital for a busted ankle and I was getting bills for months from many different sources. Why can’t I just get a single bill from the hospital for the service? When you go to McDonalds to you get a separate bill from the Fry guy? When you buy a car do you pay Firestone for the tires? Efficiencies in this area would improve collections and drive out the costs associated with these efforts. Electronic records would give you the ability to quickly provide medical history to the doctor or facility you desire.
Get these things done and let’s see where we are. At that point we can worry about the uninsured that CAN’T afford health care. By the way, when you have cable TV, smoke, have a new car, and can afford vacations you likely CAN afford health care. You are making a choice of priorities not to have health care coverage assuming the rest of us will pick up your cost and indirectly fund your discretionary expenditures. I don’t want to pay for your vacation.

Once these are done and we can see the true cost of Medicaid and Medicare and other unConstitutional government provided health care options we can determine if those are best folded back into the private sector as well. Does it make sense to have separate medical systems for the poor, financially strapped elderly, and our Veterans?

Perhaps we need to look at the supply side and provide for less expensive education options to encourage more doctors to enter the market? The way to drive down costs is not to increase demand by making persons think health care is “free”. We need to increase the supply!

I believe if we can introduce market principals and more personal responsibility to healthcare we will see more innovative solutions brought to market. What about hospitals that you pay up front for care, like you do with cars? A sort of extended warranty for your body. Hospitals advertising their costs “Get your ACL repaired for only $999!”

Now I ask you, is this preferable to Obama’s HealthCare plan?

It is specifically stated Obamacare will not apply to members of Congress. Members of Congress are already exempt from the Social Security system, and have a well-funded private plan that covers their retirement needs. Congress should follow the same rules as the rest of us.

That is my opinion and The Right Point Too!

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