The president’s healthcare legislation will do nothing to improve healthcare delivery or affordability in this country. The exchange concept is fraught with administrative costs and inefficiencies and will create an unworkable leviathan where the best system in the world–by far–currently exists. I would urge you to read the Council of Economic Advisors report that led to the drafting of the Affordable Care Act. You will see that it is full of absurd, unsupportable assumptions that are designed to provide “proof” of the need for the president’s bill. This report is of no value and neither is the Affordable Care Act. Finally, and most importantly, it subjugates compassionate healthcare delivery and humanitarian concerns to an artificially established government bottom line.
A much better solution is outlined in the social security section of this site, but, in brief, placing medicare and medicaid principally in the hands of state governments would make these systems much more responsive to the needs of people in these states. As I noted before, the healthcare concerns of a Wyoming rancher can be quite different from those of a New York police officer. At any rate, with an appropriate matching grant program, the federal government could provide additional funding as needed to bolster those states with the greatest need or where the state government resources were falling short and insure through-funding of these very important programs for the foreseeable future. This would be approved on a state-by-state basis. Medicare and Medicaid are both excellent insurance programs and should be fully funded and preserved. Another way to help insure that these programs continue in a fiscally sound manner is to stop reducing physician reimbursement at every turn so that doctors are encouraged to participate in these programs at every level.
Insurance requirements, if any, would be the responsibility of the states. A minimum recommended coverage level could be devised and established, perhaps providing only for coverage for catastrophic injury or illness in younger segments of the population with obvious changes and increases in coverage as people age. Dr. Ben Carson’s recent discussion of cradle-to-grave healthcare accounts could easily provide for this need with lifetime investment by working adults so that the accounts grow as they age and healthcare needs and expenditures increase. Market competition would increase economic viability of insurance programs if insurance companies could compete across state lines. This would inevitably lower cost and provide incentive for more comprehensive and higher quality coverage.
Medicare should be fully funded at the state level with the federal government funding any shortfall. One of the finest aspects of medicare is the Medicare Advantage program. The preventive medicine entailed in this program should be encouraged and used as a model for insurance programs and medical treatment systems across the nation.
The reimbursement provided by these programs to physicians should be similar to that provided by insurance contracts available privately, if a broad availability of care is to be available to seniors. The same should be true of medicaid. Constantly reducing reimbursement to physicians must be curtailed if medicare and medicaid patients wish to have continued access a variety of medical practices. To insure the best, most fair pricing for insurance from private companies, artificial state line restrictions on commerce should be eliminated to encourage competition. This would result in the best companies with the best, most fairly-priced policies doing the most business and providing excellent private insurance to those who chose to go the private route.
There are a number of cautionary statements in the Council of Economic Advisers report regarding the percentage share of the economy occupied by healthcare. Why is this a problem? Healthcare provides excellent, satisfying, high-paying jobs and keeps the entirety of that share of the economy here in the U.S. Our healthcare system is best in the world by virtually every measure and no massive overhaul is needed in any respect–the average life expectancy in the U.S. is now 78, which is higher than at any time in history. The country does not need a political solution to phony problems created by government bureaucrats and politicians in order to sell a bill of goods to an unwary electorate as a means of vote-buying. Our system works well and it is an extraordinarily strong, important part of the economy–whether it’s 18% or not.
Malpractice reform is absolutely necessary in order to reduce costs and make the practice of medicine a viable career again. The ATLA is designed only to protect the interests of lawyers, not patients–don’t believe it when they pedal lies speaking about their commitment to patient protection. Patient protection and patient rights are absolutely the last thing on a lawyer’s mind. The only thing lawyers worry about is their own bottom line. The best advocates for patients and patient rights are physicians–period. By placing a pain and suffering cap on lawsuits as part of national legal system reform (the system that actually desperately needs reforming as opposed to the healthcare system) and also getting rid of arcane, circuitous laws that allow lawyers complete latitude in terms of who they sue, how they sue, and how they’re allowed to make backchannel deals to win settlements, huge cost overruns for medico-legal concerns in the daily practice of medicine would be avoided.
Finally, a panel of expert physicians, hospital administrators, practice managers, and insurance and compliance experts should be established to find local and regional healthcare models in both private industry and at the state level that work and have a proven track record of success. The group could then provide a series of recommendations and guidelines based on functioning, financially sound systems that actually work so that states then can consider which measures best fit their specific circumstances and legislate/implement as necessary; there should be only limited if any federal legislation concerning healthcare.