One possible scenario is for Medicare to have an age sensitive baseline benefit plan and an optional Medicare sponsored supplement.
Past that, private insurance companies could offer other supplement plans as they see fit. Furthermore, drug formularies
for medications used to treat most major illnesses could cease to exist. Medicare would simply pay a set amount for a given
class of drugs that would be paid no matter what drug of that class was written. If the patient or physician desired a different
drug of that class, the patient would simply pay the difference. The patient would steer the physician to the lowest cost drug
unless they both were convinced that the different drug choice was justified. Cost of the common drugs would decrease as
the drug companies make an effort to capture part of the market. Certain classes of drugs could not be accommodated in this
way for many reasons. An example would be cancer therapeutic medications.
Efficient,
Cost
Effective
All concerned want high quality healthcare, and a one party payor system would finally allow this to happen. Medical errors,
waste and inefficiencies are hard to track across the multitude of payers. A unified system would allow aggregate
tracking across all providers, epuipement suppliers, patient age groups, illness and treatments. The current system cannot hope
to capture all of this data. The discovery of patterns or systems of errors could steer us to a safer delivery of healthcare and improve
the educational process giving better trained providers. Hopefully we could finally eliminate the rampant use of the wasteful,
unfair, and punitive insult that is now the malpractice litigation industry. It certainly is an industry and they certainly
will oppose these changes to the current system.
The
Challenge
There needs to be a big change in healthcare. I believe that all Americans need to be covered from cradle to grave. I challenge
anyone to justify to me how the current patchwork of insurance plans and government programs with all of it gaps in coverage and with
its massive paperwork can ever hope to be efficient enough to work for America.