American Style Health Care Reform That Will Work

Why are you blaming the insurance companies? You are demonizing legitimate American corporations for doing what they are supposed to do, make money for their shareholders. Regardless of whether the company is public or privately held, in a capitalist economy the bottom line is making a profit and they seem to be doing a bang up job. Contrast that with the programs that are run by the US Government like Medicare and Medicaid. Both of these programs are broken with hopelessly bloated bureaucracies and ramped with fraud and abuse from contractors and vendors alike. The US Government could take a lesson from the Insurance Companies when it comes to managing cost and personnel.

It is estimated that up to 1/7th of the US Economy is represented by some part of the health care industry. There is no possible way for any one entity to maintain control over that much money in as many delivery locations as are involved in health care. It frankly boggles the mind that any reasonable person could consider that a bureaucracy could attempt to find a way to do this even in a highly controlled environment such as the US Military. We’ve all seen what can fall between the cracks with military health care, so let’s not even go there.

The bottom line is quite simple; the US Health Care System cannot function without Insurance Companies. No Country in the industrialized world has to manage as many delivery points of health care as we do here in the US and maintain our level of quality. None of those countries have the number of citizens that the US has, and none consume as many prescription medications or take up as many hospital beds. It is a miracle that our system runs as well as it does. We rob Peter to pay Paul every day in order to absorb the cost of those who cannot pay and pass them on to those to can. Universal Healthcare is virtually present as we speak.

There is no question however that serious reform is needed. Medicare has been operating on a non-existent trust fund for decade. Medicaid is busting the budget of nearly every state. That system is woefully in need of reform and repair. It is going to cost all of us money and that has been no secret for a long time; how much money depends on what efficiencies can be found and implemented, and how quickly. Reform in the private sector cannot and will not work until the public sector issues are resolved. Once the changes take place in Medicare and Medicaid, real reforms can be made in the way health care is covered in the private sector.

The first place to start is where the cost is highest and that is in the high premiums paid for liability insurance by physicians, hospitals, and other parts of the medical community driven to a large degree by insanely high jury awards won by the Trial Lawyers. If doctors can work for a reasonable living without fear of losing everything no matter how well he or she does their job, the system cannot work.

The next area of substantial cost is in medication. There should be a standardized formulary for all States, Territories, and the District of Columbia. Doctors should be able to write a prescription for a drug by brand name or as a generic in any size or quantity regardless of where they practice. Hospitals should have the ability to purchase drugs for all of their facilities nationwide, as should pharmacies, long term care facilities, etc. This still protects the patent rights of drug companies, but it makes it much easier for volume purchases to take place across state lines and without more than 50 sets of rules and regulations to accommodate.

The next area is competition in the market place. Small businesses have to be allowed to ban together to purchase insurance in groups so that they have the same purchasing power as large companies. Small businesses often have fewer than 10 employees and many of those employees are part time or older in age. Risks have to be able to be spread more evenly, and that can only happen in more diverse groups. Association Insurance Purchasing has to become a reality in order for premiums to come down to reasonable rates and for more people to be insured.

The next area is expansion of COBRA so that no employee is left without insurance regardless of the amount of time he or she is left without a job. The insurance from the previous job follows them until they find a new job. Once new insurance is in place the COBRA ends. This solves the portability issue without having people maintain ownership of policies or forcing people to buy policies.

The next area is a program to increase the supply of primary care physicians. Medical students should be allowed to have a portion of their educational expenses deferred or excused for service in community hospitals and clinics. If they decide to opt out and go into private practice they can repay their debt to the treasury on a prorated basis. A serious commitment of at least ten years should be required of doctors. A similar program should be developed for highly skilled nurses(RN’s). They provide a huge amount of the health care burden and are depended upon by physicians and patients alike for the delivery of proper and responsible care. Nurses should be given an opportunity to receive an education for service.

Lastly, there should be a commitment to community health care and wellness centers. Hospitals should not be overburdened with insignificant non emergency cases. Lower cost community health care and wellness centers run by doctors and nurses in the program outlined above can extend primary care in both urban and rural areas so that private practices are not over run with a glut of new patients. These centers should be well equipped and focus not only on treatment but on community health education. They should work with local health departments to as part of our Homeland Security efforts and be a focal point for outbreaks of viruses and other disease.

These reforms will make our health care system work. These reforms will give our country the opportunity to remain the best hope for the world where medical science and delivery of health care is concerned. Our citizens deserve no less and they are willing to pay for a system that works. They are not willing to be taxed to death for another bureaucracy that will inevitably fail as all have before.