Posted by
Bill S. on Thursday, October 01, 2009 12:00:00 AM
Obama and congress are on the wrong track to reforming health care. They are focused on ‘coverage’ for everyone when ‘access’ is the issue. Healthcare needs to be community based, NOT national or state based which only takes us further from the provider/patient point of car and into the huge bureaucratic mess that is currently being debated.
Consider this, if everyone will eventually be ’covered’ then why do we need any form of insurance (except a optional traditional catastrophic type of option)? With former levels of individual and corporate contributions (premiums) and state and fed payments provided to communities that are geographically defined to cover all lives in our country, AND eliminating MOST of the federal and state bureaucracies (because everyone would now have access) AND eliminating the complete level of HMO/insurance currently ‘running’ healthcare, the community based system would be adequately funded. Just think of the result:
- Doctors and hospitals determine the care necessary for best outcomes
- There is active competition in pharmaceuticals, durable medical equipment, AND in provider incomes (wages)
- Communities share morbidity and mortality data and compete for best practices
- EVERYONE pays something for care (including visits) the wealthy pay the full shot; the indigent pay a couple buck. The co-pay concept is gone. Sliding scales for payment are already used in some hospitals
- EVERYONE has access and everyone makes their own value choice in selecting care.
- Insurance companies can compete in selling a traditional policies for catastrophic risk avoidance but they are no longer involved in the health care delivery business. This is the realm of providers and hospitals
- Some ‘communities’ will have better care than others, some will cost less than others because of their geographic area, diversity mix of population, etc. but the same exists now with property taxes, etc. Some communities will be more attractive than others but that’s competition and competition improves the ‘product’.
- The feds and state roles become relatively minor in minimizing mandates and providing appropriate regulation, balancing some inequities in community structures (i.e. reservations, and other geographically caused inequities, etc.), and providing some level supplemental funding for disasters. They also would collect morbidity and mortality statistics, and provide some level of aid to balance the medical education costs among communities. Medicare, Medicaid, and the multitude of other state and federal programs become community based programs. There is no need for such programs if everyone has access based on an ability to pay structure. Interesting?? Any idea of the costs to support these programs, not just the benefits?
- The quality of care is determined by accrediting institutions and professional ‘colleges’ with best practices and minimum care standards.
- YES, tort reform is needed
- Last, the COMMUNITY determines the care that is needed for themselves, they can form Health Service Administrations with multiple representation to govern themselves. The community determines the level of taxes (premiums?) they need to sustain the care and programs they want. Federal and state level taxes for such purposes are gone (except to fund some balancing and disaster reserves mentioned above).
The main purpose of this is to STOP the current congressional mess and at least consider a different way of thinking that would potentially result in better care for everyone.