Saturday, October 24, 2009


Movie premiere? Nope, just people in Los Angeles who are without health insurance lining up for a medical clinic.

I couldn't help noticing that it's taking a while for a coherent health care reform bill to make it to a vote in Congress. Possibly the problem is the sheer complexity of the thing. Perhaps it would be better for the national legislature to focus on and highlight the essentials of a health care bill, pass it, then let Federal cabinets and agencies fill the spaces in between with any regulations which become necessary. Here is my proposal for a relatively simple and effective piece of legislation to reform the current system of providing coverage:

1. Create a publicly financed National Health insurance to cover all annual expenses for catastrophic illnesses (anything totaling more than $3,600 per family per year, which comes to $300 a month).

2. Use a single payer plan for all other medical expenses, including prescribed medicine, with everything up to $3,600 paid for with a "health care" type credit card.

3. The consumer can repay the monthly credit card bill out of his own pocket, with a private insurance plan, or over time like any other credit card- but with a 5% cap on annual interest.

4. Prohibit all health insurance companies from discriminating on any basis- if they insure one, they must insure all, regardless of pre-existing conditions or prior claims. (Lifetime caps will no longer be an issue because #1 will take care of catastrophic expenses; likewise, #1 will reduce exposure of companies who have to take people with pre-existing conditions). Prohibit any denials of coverage based on type of treatment, proven effectiveness of the treatment, or who the provider is. Require prompt payment of all claims (within 30 days) with severe penalties for delays.

5. Fund the government portion of the program with a relatively low (no more than 1 or 2 percent) national sales tax on all goods and services- so every one who consumes anything will be paying for his or her catastrophic insurance.

This proposal will eliminate all unnecessary administrative costs.

This proposal will eliminate the need for a "public option" or cooperatives or triggers.

This proposal will save medical providers and employers billions in administrative overhead costs, in collections, and in indigent write-offs.

This proposal will reduce stress on employees and their families who have already lost or are afraid of losing their medical coverage. It would also free up Americans to take any jobs they want without fear of losing coverage.

This proposal will put American companies on an equal competitive footing with foreign companies which do not have health care as a portion of their overhead.

And to recap my suggestions for cutting costs while improving services:

1. Eliminate all medical malpractice insurance premiums for doctors, hospitals, drug companies, and all other medical related fields. Substitute a no-fault system based on State Worker's Compensation programs. Fund it with a sales tax of no more than 2% on all medical services and products. Use a panel to pay out awards, with one representative from consumers, one from the medical profession, and a professional administrative judge, to determine whether the injury or illness was caused (without regard to negligence, hence the "no-fault" label) by a medical procedure or product, and, if so, what the extent of the harm was. Awards will be paid out in the same manner as in most Worker's Comp cases, without the need for defense or plaintiff's attorneys or jury trials, and with set amounts paid for set degrees of injury.

2. Identify bad doctors and hospitals by publicly posting on the internet all awards from the no-fault system, with all patient identifiers removed to protect confidentiality, listing only the type of injury or illness (i.e. staph infection), the amount recovered, and the year of the incident.

3. Require all physicians, hospitals, and other medical providers to post all costs, services, and fees on a prominent place at their front entrance, and also on the internet. If the foregoing proposal for paying for medical care is instituted, which will make patients responsible for the first $3,600 spent annually on their medical care, they will do enough price shopping and comparisons to cause providers to compete- and lower costs.

4. Require all physicians, technicians, nurses, and patients to certify each test administered and each procedure performed on each patient. This proposal is intended to reduce the fraud occurring in the current system.


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