Friday, September 24, 2010

The health care solution

Once again there is no new news on Kyron Horman so I'll post a solution to the health care mess that neither democrats or republicans will even consider.  It is a solution that will not violate the constitution and will help people who cannot get health insurance.  It is meant as a fall back system and not the primary health care system.  It should be implemented primarily by individual states with a federal system as a back up to states unable to implement the program on their own.

The first part of the program is education of doctors.  This is entirely voluntary to the student doctors There is no mandatory participation in any part of this health care program.  The government entity (state or federal) will pay for the doctor's entire education in exchange for a number of years service.  Number of years is dependent on the specialty of the doctor.  If the doctor drops out of the program, they will owe the amount paid for their education plus a penalty.

Doctors in the program will serve in hospitals or clinics with their salaries and malpractice insurance covered by the government.  The hospitals will be reimbursed for a percentage of that doctors specialty.

Hospital or clinic has ten oncologists.  One of the oncologists is in the government program.  The total billable in the oncology department is a million dollars including all patients - in and out of the government program.  The government reimburses 10% of the billable amount in the oncology department or $100,000. (1 out of ten doctors = 10%  If there were two out of ten doctors in the government program, the hospital would be reimbursed 20%)  Having the reimbursement based on the entire oncology department  instead of based on the doctor(s) in the program prevents patients being assigned to doctors based on whether they are in the government program or not.
People in the program will pay a copay depending on how much they earn - anywhere from $0 to $200. plus there will be a deductible depending on how much they earn - from $0. to whatever is determined.  No elective procedures over basic health care (wellness exam - checkups / to be determined) are covered and any optional procedures / non covered the government will receive a percentage based on hospital or clinic wide billable procedures (the government is paying the salary of the doctors in the program so it is all profit to the hospital / clinic)  The income from the elective procedures will help pay for the rest of the program (examples of procedures not covered: liposuction, plastic surgery / etc.)  Hospitals cannot refuse patients in the government program.

Doctors and clinics can also be set up in areas that have no access to doctors.  The government will pay for the clinics / doctors and will accept other insurance to help pay for the clinic / doctor.  There will need to be some sort of fraud prevention in place without invading peoples privacy.

In order to be allowed in the program, people will have to waive their right to sue their doctors or the hospital / clinic. There may need to be some laws changed to get this part passed.  There is a need to keep the sue happy bottom feeders out of the program to protect taxpayer dollars.  If there is a problem with malpractice, the government will negotiate an at cost solution which will not include punitive damages.  This again will keep this as a fall back system and not the primary health care system.

 Only American citizens can be covered.  American born citizens can be covered from birth, immigrants can be covered when becoming a citizen.  Insurance companies cannot dump people just because they are sick.  The government program will not be a dumping ground for insurance companies to get their high cost insured off their books.  Employers cannot use this government program as the health care program for their employees.  This protects the insurance companies as well as the taxpayers that will be responsible for any costs of this program.

This way regular insurance will still exist and will be primary for those who can afford it.  People cannot just go to the government program while earning $100K just to save money on health care - the copay for those making more than a certain level (to be determined)l will be cost prohibitive. This is meant for those who cannot get or cannot afford health care not as a money saving program for big business.

This is the general program it will definitely need some tweaking to get it to work.  This just shows there are alternative health care plans that will cover people that need it and will not violate the constitutional rights of American Citizens.  If operated correctly, it can also be self sustaining.


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