Healthcare is a $1.6 trillion business. Over 30% of it is spent on marketing, billing, and utilization reviews. Doctors take only 3% of this business, yet they perform procedures, tests, prescribe medicine, and perform elective procedures-- all for 3%. We all now are living with the affordable care act (ACA). It gives you access to affordable health care by preventing insurance companies from discriminating against you if you have a pre-existing condition, but also gives subsidies and expands Medicaid, and encourages you to either buy insurance or pay a tax ( known as an individual mandate).
You really can’t afford to get sick anymore. The uninsured find more rising out of pocket medical costs. The medical system is fragmented, inefficient, complex, and very costly. Obama-Care argues that private insurance is wasteful, and stands between you and your doctor. All the industrialized countries have some universal healthcare, so should we. They further argue that Medicare should be expanded and improved since it has kept high medical costs down and has provided care for the health care needs of people over 65.
Rep. John Conyers has introduced “HR 676 Bill” in Congress to expand and improve medicine by providing “Medicare for all”. Everyone gets enrolled, everyone gets necessary care and drugs, and everyone can choose their own doctors and hospitals. The health providers can stay independent and negotiate their fees with the government system. The system would be funded by “progressive taxes” and remove the burden of healthcare costs from the insurance business. The costs would be even lower, everyone will be covered, and the needs of doctors and patients would be the only concerns. The emphasis will be on “efficient primary care coordination” and “chronic disease management” without raising costs and providing “enhanced evidence- based quality assurance” to guide your medical care.
Where does the money come from? The dollars come from charging tax on the wealthy, and eliminating the “overpayments” of Medical Advantage, charge an “excise tax” on insurance companies who offer high cost policies, penalize employers who don’t pay their employees’ health insurance, collect taxes from those who choose not to get insurance (the individual mandate), charge new fees to the health industry, trim various “health related tax breaks”, and last, borrow $70 billion (half of all the money needed), from the CLASS PROGRAM ( and pay and remove the deficit created in later years).
The class program, began this year, and is : “community living assistance services and supports” a national voluntary disability insurance program that gives cash benefits to keep seniors in their homes”.
Early retirees will have access also to free preventive services, and will be able to purchase affordable health insurance by 2014. Seniors will be initially helped by getting preventable care without deductibles, free physical examinations annually, get up to 50% discount prices from drug stores, and after 2020 will not have to pay a copayment. Women will get free screening for cancer and diabetes, immunizations, mammograms, and contraceptive care. Students will get scholarships and loan repayments when they work in underserved areas, and grants will be given to colleges who increase the racial diversity of their healthcare workforce. (To ensure this, there has begun data tracking on such health disparities.)
The 2 million Native Americans will get more access to quality healthcare by receiving more funds and equipment to construct their Indian healthcare facilities. We will direct their healthcare to establish comprehensive preventive and treatment programs for Native Americans.
Legal immigrants will be able to buy health insurance from their state exchanges with no waiting periods by the year 2014. They must,however, be in this country for at least five years before becoming eligible for this Medicaid.
Students can stay on their parents healthcare till they are 26, and they can, for $5 dollars a month enroll in the CLASS PROGRAM, which will get them a cash benefit, if they need long-term care.
In 2013, the primary care doctors will get the same pay for Medicaid patients as they do for their Medicare patients. Paperwork is standardized now, and there are increased loan repayment programs and scholarships available. The Medicare program for in-home care will be expanded in 2014.
Those of you with chronic health problems, will get a temporary tax credit to help you invest in new ways to prevent, diagnose and treat your chronic disease (through end of life “medical directives”, and”physician order life sustaining support (POLST). Most hospitals now have a departmental “palliative care” program to cut their costs, help you ease your pain and suffering quickly, keep you out of the hospital, eliminate unsuccessful treatments, and save you from using their critical beds if you are a chronically ill patient. To ensure program’s success, doctors who do not meet the “quality goals” of national health, will be removed from the program.
Decisions of life, health, illness, and subsequent death, are very important to us all. We all certainly disagree on the essentials and effectiveness of health care reform. We are all told to be responsible citizens about our health, yet we are told to rely on the government to control our responsibility if we fail to change our lifestyles. . We empower the government to control our health needs by arguing that we ourselves are not responsible. Control is the foundation of the present “affordable care act”. You are told that healthcare is too complicated for you to understand, too unpredictable, too uncontrollable, and too emotional for you to handle. It would be nice if you could distribute the money rather than our government and corporations.
In every plan that is presented, you are told you will have access, quality, and cost control . The adjectives for all of these are never explained. You will have increase access with increased complexity and cost. The special interests should be on you, not the government corporations, hospital, nor your doctor.
You can define your own healthcare quality needs, and your personal satisfaction. Diagnoses and treatments should all have an optimum price for their services. The only people that can give you a dollar figure on these costs are those who are doing the job in an effective way. Your medical outcome is a better measure of the quality of your medical care then the government’s process control. The government’s price controls on medical services is politically optimum, certainly not statistically optimal. The health providers should control their prices, but only you, the patient, should authorize the payment if you are satisfied.
Today cost control is price fixing. Having a government administrative department control your money is not a real solution. Healthcare providers should compete with each other. If the government allowed you to have a healthcare pension fund, it would no longer be able to control your health care. There would be more health provider competition, and result in more efficient medical ideas.
The legal profession, both defense and plaintiff attorneys, should publish their costs and quality data just like the doctors do. There should be no contingency fees. Doctors now must publish their clinical qualities and also their costs. Electronic medical record-keeping should be expanded to “legal medical record-keeping”.
The bottom line is for Congress to come up with an efficient and responsible method to collect and distribute your money.