I am encouraged that many of us in the United States are Hopeful that we will Change our health care system, in order to improve it. The current system proposed by the Obama administration and the Congress is the polar opposite direction that we need to go. We should all work hard (calling and writing our representatives) to defeat this disastrous experimental take over of health care and our economic system. Once defeated we should push for real, helpful change. We have the best medical care in the world. We have an overly expensive system. We have a system that is becoming less and less responsive to the patient each passing day. Lets all agree to use the current debate to help improve and fix the current problems. Now a peaceful picture and my suggestions are below the picture.
Here are the general principles to improving access, service and cost control.
1) You can not have both inexpensive and unlimited quantity of resources. You have to either limit the access to resources or pay increased amount. We need an honest and open public discussion of this principle. The current administration fabricates an unrealistic fairy tale when they insist that they can lower cost and still provide unlimited access for all your health needs. Only self deceptive wishful thinking allows you to believe that. If the administration is not a lying to us, they are it is unbelievably naive. I am not sure which is more dangerous, when they are talking about a take over of 20% of our economy.
2) To improve care and cost, the consumer (the patient) must have final and ultimate control their medical care . They must also have financial responsibility for that care. The free market works to improve quality and reduce cost when the educated consumer makes the decisions about how to spend their own money.
3) To decrease cost, there needs to be meaningful tort reform (change the laws that make suing less likely and less costly). Every physician considers whether or not they will be sued when making recommendations to patients. It is a sad but true fact. When a Professional injures a patient due to negligence, they should suffer a suit and lose that suit. When a patient has an adverse outcome, through fault of the disease or through fault of their own decisions, the physician should not have to pay. Currently the system too often results in a physician losing, simply because something bad happened. We need meaningful reform to cap awards and to better decide negligence. When a patient has a bad outcome due to their own choice or due to the process of a disease, the physician should not be held liable. In order for the free market to work, the patient needs to accept responsibility for their own choice. In order for the medical care to maintain quality, the professional must be held accountable for their negligence not the patients decision or the outcome of disease.
Here are more specific recommendations. We should have medical insurance for catastrophic illness or injury only. That means an expansion of the high deductible health insurance program already in place. We should do away with managed care. Managed care takes the choice away from the patient. The insurers should not be allowed to contract for prices or services. Physicians and Other health care providers should be required to publish costs, like restaurants advertise their menu. Consumers (patients) should be free to shop around and choose where to have medical care. Insurance should not have “networks” of providers where costs are fixed by the insurance and coverage is either “allowed” or “denied”. Medical providers should compete for patients by providing a better cost or a better service, like other business. Real competition in the free market results in lower cost and improved service. Let patients decide whom they wish to see and for how much. Some of us choose to go to McDonald's because its quick and inexpensive. Others of us choose to only eat at PF Changs, because environment, taste or service are more important. When its our dollar we pay, we make better choices.
For those who can not afford even McDonald's (ie too poor for any any medical care), I would use tax credits or rebates to offset medical costs, based on income guidelines. I would also dismantle Medicare and Medicaid. The government can provide vouchers for medical insurance purchase by the consumer, who are currently on Medicare and Medicaid. The government could also provide savings accounts to be spent on medical care within the Deductible. This would be a new savings account for persons currently on Medicare or Medicaid. Any money not spent on medical care could be carried over into the next year. If an individual saves more than their deductible, that money can be used for education or other life expenses.
All of this would have to be offset with tort reform. Without reform of the legal systems and rampant lawsuits, none of the above free market will work. Physicians and patients can not make healthy decisions without rational litigation. We should make losing lawyers and litigants pay court cost and damages for suits that are not won. There should even be allowance for counter suit for frivolous lawsuits. The lawyer would then be held accountable to not bring large harassment type lawsuits, because there would be a penalty. There also needs to be a cap on “emotional” or “punitive” damage awards for lawsuits. Damages awarded in lawsuits should be limited to actual financial loss. Perhaps if the court wishes that punitive damages be awarded the lawyers should not be able to benefit from those awards or those awards should go to charity or research. (I have not thought that one out yet.).
If we let the free market work, we can still have great quality health care. We can still maintain our safety net for senior citizens and the poor. We can hold physicians more accountable for the service and care that they provide. We can keep from further government and corporate interference in our health decisions. My suggestion is that we all work hard to defeat the current Obama planned health care initiative. Then take the momentum and lets get some meaningful reform that will not kill our economy.
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